Partial DQ Alpha Match?

StorkChaser

4 Posts
Reply Posted on: Jun 12, 2013 at 2:22am
Dear Dr. Bravermann,We’ve recently had 2 IVF at a local clinic (we live in Germany), both times 3 day-5 embryos were transferred but without any success. At my insistence the clinic did some immunological tests and it came out that I have raised ANA levels 1:640 as well as raised NK cells. In addition to that I have just received the results of our DQ Alpha/HLA matching and it looks like are a partial match. The doctor wrote that I am HLA-DQA1*01.02 and *03.01 and my partner is HLA-DQA1*01.02 and *02.01.After our two last IVF cycles, we have decided to travel from Germany to CCRM in Colorado in order to get our embryos genetically tested (not possible in Germany). We’re scheduled to go there next week for some initial required tests.

Does our particular DQ Alpha match mean that we won’t have a chance even with a genetically normal embryo?If we wanted to get our immune tests repeated at your clinic, would we have to come to New York or would it be possible to simply ship our blood serum, for example when we are in Colorado? Your answer would be greatly appreciated!

Dr. Braverman

2026 Posts
RE: Partial DQ Alpha Match? Posted on: Jun 12, 2013 at 6:34am
Your workup is incomplete, you can not asses any issues with HLA by only looking at DQalpha (see my recent blog on HLA). Yes I can order these tests for you while you are overseas, but if you come to the US then you must come to NY for me to order them as I can not order testing across state lines in the US if I have not seen you. You certainly have an immune issue and I think PGD is not a wise option for you as it will only serve to decrease the overall pregnancy rate, you should simply and correctly diagnose and treat the real issue.
If you would like my help please email the office and they will schedule a SKYPE consultation fo you . We also have an affiliate in Barcelona that could help you as well.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

StorkChaser

4 Posts
Reply RE: Partial DQ Alpha Match? Posted on: Jun 12, 2013 at 6:51am
Thank you very much for taking the time to respond!


I will certainly read the blog entry that you recommended. Our flights to Colorado are already booked for next week and since we both work we cannot rearrange our travel plans to come to NYC at this time :( However, Barcelona is only a 2 hour flight way (we live in Frankfurt) so that would be a possibility.


What would be the logistics of the immunology tests and treatment?
Should I schedule a Skype consultation with you first?
Would you be still able to advise us and direct our treatment remotely even if we went to have the blood tests done in Barcelona or would we have to communicate with a Spanish doctor?


The reason why we need to genetically screen our embryos is our age: we're both 43. We've wasted a lot of time with cycle monitoring and natural attempts before even any tests were done L By now, we realize that our chances of success are miniscule but we still want to give it a try and leave no stone unturned.


By the way, I am trying to find some information on your Barcelona clinic but cannot find anything. Is it listed someplace on the website?

Dr. Braverman

2026 Posts
RE: Partial DQ Alpha Match? Posted on: Jun 12, 2013 at 6:56am
Dr. Monica Redondo in Barcelona, she is on our website. We can not collaborate with CCRM , any patients that we treat here in the US must do the embryo transfer wtih us. My concern with PGD is that if the embryo is normal you will be pregnant but if not you most likely will not concieve. As you have so few embryos and we are aware that there are false positve reports for abnormalities the possiblity exists that you could be discarding your only normal embryo. In my mind the only benefit of PGD is to detect a known familial disorder.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

StorkChaser

4 Posts
Reply RE: Partial DQ Alpha Match? Posted on: Jun 12, 2013 at 7:11am
Oh no! I thought we could get our immune issues addressed at your clinic while moving ahead with CCRM. My time is running out so I am between the rock and a hard place at this point. We simply have no time to rearrange everything. I know that CCRM does not specialize in treating immune disorders but I thought they could cooperate with someone who does and that I could do it "in parallel".

Couldn't my immune issues get at least properly diagnosed? And perhaps treated in a cycle before my IVF attempt? I would really like to finally know what is wrong with me!

For all I know, I might also get pregnant the natural way if my immune issues are addressed. I was never diagnosed with any other problems, always ovulated regularly, hysteroscopy was normal, there is no family history of genetic disorders. The only thing I discovered through my own tests was that my vitamin D was low (20) and that I have the MTHFR Homozygous mutation.



This is all rather complicated. What are my options as far as immune diagnostic and treatment goes? Should I schedule a consultation with you? Or with Dr. Redondo? Would it help if we discussed it via Scype?

Dr. Braverman

2026 Posts
RE: Partial DQ Alpha Match? Posted on: Jun 12, 2013 at 7:37am
I no longer collaborate with outside US clinics, but CCRM would not collaborate with us regardless as they have refused to work with our patients in the past so I have not had that open even as a possiblity .
Of course you can still get an evaluation by us and I can make a diagnosis for you. Many of our patients do cocncieve after we treat them on their own.
Best would be to schedule a SKYPE consultaton with me by emailing Kim at our office.
[email protected]
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

StorkChaser

4 Posts
Reply RE: Partial DQ Alpha Match? Posted on: Jun 12, 2013 at 7:42am
All right, I will schedule a consultation with you.
Thanks a lot for your advice!