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Consultant-Led Adenomyosis, Endometriosis & Fertility Strategy

Many women arrive after years of heavy periods, pelvic pain, or fertility uncertainty — having tried multiple treatments without a clear plan or a coherent explanation.
This practice offers something different: a structured clinical assessment that identifies what is actually driving your condition, and a plan that follows from it.
Advanced diagnostics. Consultant-performed ultrasound. Integrative clinical reasoning. In-person in Manchester and online across the UK. Consultations in English and Russian.

This practice is designed for
women who have complex symptoms,
have usually tried more than one approach,
and are ready to understand the full picture — not just manage the next symptom.
  • Persistent or worsening adenomyosis or endometriosis
  • Heavy bleeding, pelvic pain, or symptoms that have not responded fully to treatment
  • Fertility concerns — current or future — that need a coherent plan
  • Recurrent miscarriage or implantation failure without a clear explanation
  • A sense that something is being missed, but not knowing what
STRATA Clinical Framework™
The STRATA Clinical Framework is a structured assessment approach developed by Dr Ksenia Alex. It evaluates each case across six layers — structure, timing, reproductive intent, activity, terrain, and action — to produce a complete clinical picture and a sequenced plan.
Available in person in Manchester and online across the UK. Consultations in English and Russian.
For women with complex adenomyosis or gynaecological conditions where standard approaches have not provided clarity or resolution.

Who this practice is for

  • Heavy, irregular, or painful periods
  • Chronic pelvic pain or persistent, unexplained symptoms
  • Suspected or confirmed endometriosis or adenomyosis
  • Recurrent miscarriage or recurrent implantation failure
  • Subfertility and fertility investigations
  • Fertility planning where adenomyosis or endometriosis is part of the picture
  • Symptoms that have not fully resolved despite previous treatment
  • Perimenopause with complex or unresolved gynaecological symptoms
  • PCOS, thyroid disorders, and hormonal imbalance

Specialist Services — Manchester and Online

  • Endometriosis, Adenomyosis & Pelvic Pain
    • Consultant-performed ultrasound mapping for endometriosis and adenomyosis
    • Structured assessment and early diagnosis
    • Surgical guidance and referral where indicated
    • Symptom-led management with integrative options where appropriate
  • Fertility Assessment & Planning
    • Consultant-led fertility investigations
    • Adenomyosis and endometriosis impact on fertility — assessment and planning
    • Hormone, thyroid, and metabolic optimisation
    • Recurrent miscarriage and implantation failure evaluation
    • Structured plan before, during, or instead of IVF
    • Fertility is not always the primary concern — but it is always considered as part of the clinical picture, including in women approaching perimenopause.
  • Integrative Clinical Assessment
    • Functional medicine testing where clinically indicated
    • Systemic and metabolic factors influencing gynaecological conditions
    • Hormonal assessment and evidence-based supplementation guidance
    • Integrative approach alongside conventional care — not instead of it

Why Women Choose VPB-Fertility
You are listened to — without rushing, judgement, or dismissal

  • Consultant-led throughout

    You are seen by Dr Ksenia Alex at every stage. Not a registrar. Not a nurse practitioner.
  • Advanced diagnostic ultrasound

    Endometriosis and adenomyosis mapping, fertility assessment, and recurrent miscarriage evaluation performed by the consultant.
  • Structured clinical reasoning

    Findings are explained clearly, with a plan that follows from the assessment — not a list of options without direction.
  • Integrative expertise

    Functional medicine assessment where it is clinically indicated, working alongside conventional care.
  • English and Russian

    Consultations available in both languages, in person in Manchester and online across the UK.
  • Perimenopause &
    Hormonal Transition
    • Adenomyosis and endometriosis behaviour through perimenopause
    • Structured hormonal support — conventional and integrative where appropriate

Reproductive medicine specialist

Personalised care and advanced treatments for fertility challenges, specialising in adenomyosis, endometriosis, PCOS, recurrent miscarraige and assisted conception or IVF.
  • Fertility&Endometriosis

    Diagnosis and treatment of infertility, including endometriosis, PCOS, and other reproductive issues.
    Learn more
  • Advanced Ultrasound

    Advanced fertility treatments to help you achieve your dream of parenthood.
    Learn more
  • Gynaecological Endocrinology

    Expert care for hormonal imbalances and other gynecological endocrine disorders.
    Learn more
  • Functional medicine & Women's health

    Latest technologies in diagnosis, monitoring and treating of adenomyosis, PCOS, amenorrhea and recurrent miscarriage
    Learn more
  • Reproductive Medicine Surgery

    Minimally invasive surgical techniques in inpatient and outpatient settings
    Learn more
  • Education&Research

    Strive to improve the education of young females as future mothers regarding women's health and to promote research on endometriosis
    Learn more
There Is Hope and Help Available
The good news is that understanding these challenges enables us to provide targeted, effective treatments. As experts dedicated to caring for women’s futures, we truly believe that with personalised help, hope and the right approach, you can overcome the obstacles of endometriosis and move closer to your dream of motherhood.
Take the Next Step
If you’re ready to explore your options and get tailored support, contact us today. We’re here to guide, support and help you achieve your dreams of a healthy pregnancy. Together, we can make your hopes a reality.
ENDOMETRIOSIS AND ADENOMYOSIS MAPPING SCAN: Advanced Ultrasound for Early and Accurate Diagnosis&Fertility assessment
At our clinic, we utilise state-of-the-art ultrasound technology to offer comprehensive Endometriosis and Adenomyosis Mapping Scans. These advanced scans enable early detection and precise assessment of these conditions, which are often diagnosed late but can significantly impact quality of life.
This non-invasive, high-tech approach ensures a thorough understanding of your pelvic health, guiding personalised treatment strategies to alleviate symptoms and protect overall organ function.
Why Choose Our Advanced Ultrasound Scans?
Both endometriosis and adenomyosis frequently cause complex changes within the pelvic region, including chronic inflammation, muscle tension, nerve injuries, and impaired motor functions. The pelvis is an intricate structure composed of muscles, ligaments, nerves, blood vessels, and organs. Damage or alterations to any part can trigger a cascade of issues affecting overall pelvic health.
Early diagnosis is crucial. Many cases of adenomyosis, in particular, are diagnosed late due to subtle or overlapping symptoms. An early, detailed scan allows for prompt identification of these conditions, enabling timely treatment.
Key Symptoms Which Should Prompt an Early Ultrasound Assessment:
  • Severe dysmenorrhea (painful periods)
  • Heavy menstrual bleeding
  • Chronic pelvic pain
  • Bowel symptoms
Addressing these symptoms early with specialised imaging can prevent disease progression and associated complications.
The Assessment Process
Our comprehensive evaluation includes:
  • Review of your medical and family history
  • Gynaecological history assessment
  • Fertility assessment for women or couples.
  • Symptom analysis
  • Physical examination
  • Pelvic region mapping scan — a critical element providing detailed insights into the presence, extent, and severity of endometriosis, adenomyosis, and ureteral involvement (quiet obstructions or compression caused by endometriosis can impair urine flow, potentially leading to kidney damage).

If healing happened and I am not needed as your doctor my job is done

Services

Providing comprehensive and personalised care for women's health and couple's reproductive health
How It Works
Book an appointment online or discuss your preferences via phone, text, or email.
Get a confirmation through email and text. You'll receive a welcome message with an e-questionnaire, consent, and appointment details.
Choose your appointment location
Initial consultation, which may include transvaginal ultrasound and/or additional investigations as needed.
Note: The Hadley Clinic appointments are for self-funded patients only.
Follow up appointment
Follow-up online appointment for questions, answers, and agreeing on the initial management plan. Further investigations considered if indicated.
Individualised plan
Finalising the individualised targeted treatment plan, monitoring, fertility timeline (if required), and support package.

About the doctor

Dr Ksenia Alex is a consultant gynaecologist and reproductive medicine specialist with a PhD and over 30 years of clinical experience. She specialises in adenomyosis, endometriosis, complex fertility, and gynaecological endocrinology — with an integrative approach to cases where standard pathways have not provided resolution.
Her clinical focus is on understanding what is actually driving a condition — not just treating its most visible symptom. She works with women who have complex, often long-standing gynaecological problems, and who are ready for a structured, reasoned approach to their care.
Consultations in English and Russian. In-person in Manchester and online across the UK.










.

Why choose this specialist?

  • Patient-centered approach

    Individualised care tailored to your unique needs.
  • Advanced expertise

    PhD-qualified specialist in reproductive medicine, endometriosis, and fertility.
  • Integrative medicine

    Combines conventional and functional medicine approaches for comprehensive care.
  • Subfertility expertise

    Specialises in subfertility related to endometriosis, adenomyosis, PCOS, and reproductive surgery.
  • IVF trained

    Extensive experienced in assisted reproduction techniques.
  • Focus on fundamentals

    Care rooted in physiology, biology, and endocrinology for optimal results.

Credentials&Professional memberships&Licences

Certifications and examinations are integral to membership privileges.

Testimonials

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STRATA Clinical Framework™
Disclaimer: Information provided on this website is intended for educational and informational purposes only and should not be considered a substitute for personalised medical assessment, diagnosis, or treatment. Clinical decisions should always be made in consultation with an appropriately qualified healthcare professional.
Blog

Fertility First: Timing Endometriosis Surgery for Optimal IVF & Natural Conception Odds

Strategic Healing: Maximizing Your Fertility Window with a Root Cause Approach

For women facing endometriosis or adenomyosis during their reproductive years, the decision to undergo surgery is often complex and deeply tied to family planning. Our philosophy is clear: Surgery must be strategically timed and supported to ensure it dramatically improves, rather than compromises, your ultimate goal: a successful, healthy pregnancy.

We guide proactive patients through a Root Cause strategy designed to make any necessary operation the most effective step possible, especially when preparing for IVF/ART or pursuing natural conception.


What Surgery Can (and Cannot) Do for Conception

Surgical excision is sometimes crucial for fertility because it:

  • Restores Anatomy: Removes lesions and adhesions that mechanically block or distort the fallopian tubes, ovaries, and uterus.
  • Facilitates ART: Makes oocyte retrieval (egg collection) easier and safer by removing endometriomas or freeing up the ovaries.

However, structural correction alone rarely "fixes" infertility. Even after expert surgery, many women still struggle because endometriosis-associated infertility also involves non-anatomical factors:

  • Systemic Inflammation
  • Impaired Endometrial Receptivity
  • Oocyte Quality Issues (Egg Health)
  • Microbiome Dysbiosis (in the gut and uterus)


The Critical Question: When is the Best Time for Surgery?

  1. For our patients, surgery is not a standalone event—it’s a carefully chosen waypoint on a strategic fertility journey.
Conventional Approach
Our Root Cause Approach
Surgery performed whenever disease is found, often leading to multiple procedures
Focus on a Single, Well-Timed Operation that is coordinated around conception goals.
Little to no pre- or post-operative biological preparation.
Intensive Pre- and Post-Surgical Optimisation to maximize tissue healing, reduce inflammation, and improve egg quality.
Closing the Fertility Gaps: Our Integrative Targets

Our Root Cause Approach identifies and treats the factors that persist post-surgery and continue to limit live birth rates:

1. Endometrial Receptivity & Microbiome: We focus heavily on the uterine lining's health. Persistent endometrial-microbiota dysbiosis (lack of optimal Lactobacillus profiles) is strongly linked to reduced IVF implantation rates and miscarriage. We use targeted strategies to ensure the uterus and vaginal tract are a welcoming, biologically optimised environment.
2. Inflammation & Oxidative Stress: Ongoing inflammatory signaling and oxidative stress can compromise implantation and early placental development. We implement specific anti-inflammatory diet and nutraceutical plans to create a calm, biologically favourable environment.
3. Metabolic Factors & Egg Quality: We dive into often-overlooked drivers like insulin resistance, which directly impacts oocyte (egg) health and overall inflammation. We ensure your metabolic health supports the best possible egg quality before retrieval.


The Adenomyosis Challenge

For patients with adenomyosis (especially diffuse forms), surgery alone rarely normalizes uterine biology. We see the condition as a state of severe uterine infertility that requires maximal support. We use pre- and post-operative protocols (often including hormonal suppression and metabolic work) to enhance healing and boost the chances of implantation and reducing miscarriage risk.


Your Next Proactive Step

If you are planning to conceive in the next 6-18 months, let's discuss how to integrate a Root Cause Optimization period with your surgical planning to ensure your body is truly ready for pregnancy.