Question regarding LAD's

Hope

4 Posts
Reply Posted on: Jun 30, 2013 at 1:05am
Hi Dr Braverman

Firstly, I just wanted to say how wonderful it is that you answer so many peoples questions, even when they are not patients of yours. I could only imagine this must take up a huge amount of your time. This site provides so much useful information and I am truly grateful to you for doing this.

After reading through some of your previous responses to peoples questions regarding the LAD test, I am a little confused. I have secondary infertility. My husband and I have a 6 year old son. I have been advised to have IVIG therapy and failing this to commence LIT therapy due to my LAD results but I am now thinking that my LAD should be negative and that this is normal for somembody who has a child already.

We have done 19 failed fully stimulated IVF cycles, I only had testing recently for immune issues and unfortunately in our last cycle we did not produce any viable embryos so are now looking at using donor eggs. I am 38 years old. I just want to be certain that my LAD results are not a problem as obviously we will be using my husbands sperm and my understanding is that even with donor eggs this could cause an issue when there is a problem with LAD??

My results are as follows (testing done at Rosalind Franklin - Chicago)

Leukocyte Antibody Detection Panel (LAD)
Flowcytometry - negative
[T-Cells] IgM+ 8.2
[T-Cells] IgG+ 4.2
[B-Cells] IgM+ 2.6
[B-Cells] IgG+ 7.3

The other results that show out of ranges are as follows:

TNF-a:IL-10 (CD3+CD4+) 54.2(H) ratio 13.2-30.6
IFN-g:IL-10 (CD3+CD4+) 26.8 (H) ratio 5.8-20.5

NK Assay Full Panel
%CD19 -13.5 (H) 2.0-12.0
%CD19+cells, CD5 - 14.3 (H) 5.0-10.0

I will be having clexane 60mg, asprin, dexamethasone and Intralipids in conjuction with the donor cycle to control the NK cell activation side of things.

Many thanks :)

Dr. Braverman

2026 Posts
RE: Question regarding LAD's Posted on: Jun 30, 2013 at 9:56am
I don't think it's an LAD issue you are correct a neg LAD is not diagnostic I suspect this may be more of an HLA issue after so many failed cycles
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Hope

4 Posts
Reply RE: Question regarding LAD's Posted on: Jun 30, 2013 at 1:37pm
Thanks Dr Braverman. We may have to look at having full HLA testing done. If it is an HLA issue would this also affect the outcome using donor eggs?

Dr. Braverman

2026 Posts
RE: Question regarding LAD's Posted on: Jun 30, 2013 at 5:55pm
yes it will. It mgith be best for you to fill out our consult form and schedule a consult , I would be happy to guide you hear , it is a very complex topic that unfortunately too many have tried to treat without a good understand of the immunolgyinvolved.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.