4:1 allele DQ alpha match

Sarah J

4 Posts
Reply Posted on: Mar 22, 2013 at 3:05am
Hi

My husband and I had the Chicago tests done in 2008 for recurrent implantation failure and miscarriages. The results came back with a few issues. Nk cells were not elevated, but there was an abnormality which means I 'attack' the pregnancy hormones, but also we share the 4:1 allele.

Things got even worse with own egg/sperm IVf for various reasons so we decided to go for donor embryo treatment. Dr Ndukwe said there was no need for intralipids with donor embryos, but I wanted no stone unturned so I had intralipids in addition to 20mg prednisolone and Clexane. This happily resulted in our first child. We are going again for donor embryos so my question is, is it really not necessary to have the intralipids?

Best wishes
Sarah
S J Claypole

Dr. Braverman

2026 Posts
RE: 4:1 allele DQ alpha match Posted on: Mar 22, 2013 at 6:14am
Based on your short history , its not clear to me why you needed donor eggs? I certainly dont have enough information to assist you with treatment options. With that said it never hurts to duplicate success.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Sarah J

4 Posts
Reply RE: 4:1 allele DQ alpha match Posted on: Mar 22, 2013 at 1:11pm
Thank you for your response. The reason for using donor embryos eventually is because we were not getting any viable eggs at egg collection and there were problems with my husband's sperm.
The Clexane and the prednisolone are for highly elevated CD19+ CD5+ cells and the intralipids were only suggested for own egg IVF. I had a double donated frozen 6 day embryo transfer 7 days a go and got a positive hpt from 4 days after the transfer. I have been taking the Clexane and the prednisolone in addition to of course the necessary oestrogen and progesterone (800mg Utrogestan), but I guess was looking for some reassurance, as I have not had any intralipids this time.

Best wishes
Sarah
S J Claypole

Dr. Braverman

2026 Posts
RE: 4:1 allele DQ alpha match Posted on: Mar 22, 2013 at 1:24pm
IL "if needed" would be needed for own egg or donor embryo as its your immune NK cells that are being treated. I still dont see why you need it however. Again I dont know your case well so this is only advice you must follow your doctors orders. I do agree with all eles that you are doing however with the information you gave me.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Sarah J

4 Posts
Reply RE: 4:1 allele DQ alpha match Posted on: Mar 22, 2013 at 2:21pm
I am very appreciative of your replies.

We were told we would need intralipids for own egg/donor egg embryos due to the fact that we share the 4.1 allele. However with embryos from donor eggs and donor sperm, we were told that it shouldn't be necessary.

II am worrying 'after the event' if you like. I was concerned that because I have the 4.1 allele, there is a higher chance of a match with even a sperm donor because it is apparently the most common one and the treatment for this would be intralipids, am I getting this completely wrong? I am paranoid that by not having the intralipids I have put the pregnancy at risk. No one has said that I should have had it.

Just to clarify, are you therefore saying that there should really be no significant need for intralipids in my case based on the info you have?
All other Chicago tests were normal.

Regards
Catherine
S J Claypole

Dr. Braverman

2026 Posts
RE: 4:1 allele DQ alpha match Posted on: Mar 22, 2013 at 2:31pm
based on the results that I see , there is no reason for IL and the 4.1 match alone is of zero signficance. I would change my thinking if I saw your entire HLA panel but only looking at the DQalpha offers no insight at all to your problem. I think you will be fine without IL as it is not even the correct treatment for high order HLA class II allele matching.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Sarah J

4 Posts
Reply RE: 4:1 allele DQ alpha match Posted on: Mar 22, 2013 at 2:37pm
Thank you so much for your help.
That was apparently the only 'issue' arising out of the HLA DQ a test. I was hoping to be told it is irrelevant to these circumstances.

You have made me feel much better, so perhaps I will not have another sleepless night tonight!

Kind Regards
Sarah
S J Claypole

Dr. Braverman

2026 Posts
RE: 4:1 allele DQ alpha match Posted on: Mar 22, 2013 at 2:55pm
good luck, I hope you will update us on your status.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.