Interpretation of DQ-Alpha matches

elle822

3 Posts
Reply Posted on: Oct 10, 2013 at 9:55am
Hi Dr. Braverman,
I'm a fan of your boards and appreciate that you take the time to answer public questions. I appreciate your opinion and would love to hear what advice you'd give our situation.

Background:
Originally sought IF treatment as a severe male-factor couple.
Everything is all clear with me, the only identified issues we have are sperm parameters and DQ-Alpha matches.
Four years of actively trying, no pregnancies. One failed IVF cycle.
My age is 28, husband is 30.

Our HLA Panels:
WifeHusbandDQ Beta03, 0603, 03HLA-A02, 0324, 26HLA-B40, 5107, 51HLA-C03, 1504, 07HLA-DRB104, 15, DRB4,
DRB5 present,
DRB3 absent04, 04, DRB4 present
DRB3 absent, DRB5 absentDQ Alpha1.2, 3.03.0, 3.0
All NK cell activity with me, the wife, is currently normal in its native state.


Questions:

In your opinion, how does the fact that my husband has the 3.0, 3.0 homozygous genotype, and the act that I also have one 3.0, impact our fertility potential?

If you were in our situation, would you proceed with another shot at IVF, or no? If so, would you include intralipids or another treatment?

My NKa cells are not yet activated, likely because we've never conceived. If we do successfully conceive with a future round of IVF, would it be more difficult to conceive again after that, thereby reducing the chance for a sibling?

Any other thoughts you can share?

Thank you,
Elle

Dr. Braverman

2026 Posts
RE: Interpretation of DQ-Alpha matches Posted on: Oct 10, 2013 at 10:58am
ok let me start by sharing your question at the end of your post.

"My NKa cells are not yet activated, likely because we've never conceived. If we do successfully conceive with a future round of IVF, would it be more difficult to conceive again after that, thereby reducing the chance for a sibling?"

you are quoting a very old and outdated school of thought , that the HLA genetics dictate NKa elevations . This is not correct. First of all DQalpha alone gives you no information and by itself can not evaluate your immune issues. Please read my blog on HLA on my website. DQalpha is not present on the embryo surface so it is not avaialbe to your immune system until well into the pregnancy. Most attacks on an embryo are most likley by T cells regardless , that are present in high numbers due to a lack of development of correct numbers of T regulator cells.

I cant make out the remainder of your HLA studies from the above post (i.e. which are yours and which are your husbands they seem to have run one on top of the other and its not clear)?

There is also a great deal of information missing as this immune workup is not extensive, which you should have if you are this young and not successful.

I would be happy to assist you with this. simply fill out a consult request on my website to initiate this.

it is still possible that your main problem is the male factor, you can see that the DQalpha testing does not add anything to your diagnosis. we have had 10 couples with complete DQalpha mathcing last year all but one had a baby . (that one had egg qualty issues).
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.