DQ alpha and donor eggs

greenviolet

1 Posts
Reply Posted on: Feb 4, 2013 at 11:09am
Hi Dr Braverman,

I'd really appreciate it if you could answer me a question. We have suffered from repeat early miscarriages, biochemical pregnancies and implantation failure for the last four years. We have had Chicago tests done and I have elevated NK cells and TNF alpha. We also have a double DQalpha match - we are both 0301 and 0503. We have not had any other HLA matches tested. We have tried many immune treatments including LIT, steroids, intralipids, humira, clexane etc with no success. Ultra sensitive pregnancy tests and immune flares indicate that something tries to implant most months. I don't respond well to stimulation and my age is against us, plus my AMH is now only 0.32ng.

We always thought that if nothing else worked we could move onto donor eggs because they would have different DQalpha from me. We were going to have one last try with neupogen, and if this didn't work, move onto donor eggs (there are most likely quality issues with my eggs but none at all with my husband's sperm). In a post below you say that changing the egg doesn't usually work. I really thought this would be the answer for us and now I don't know what else we can do. Would you be able to explain why donor sperm might work better than donor egg? I don't understand because I thought that once the embryo is created and the sperm and egg have merged there would be no way of distinguishing what came originally from the egg and what from the sperm.

Dr. Braverman

1998 Posts
RE: DQ alpha and donor eggs Posted on: Feb 4, 2013 at 11:38am
Ok you have quite a few misconceptions that we should discuss , first you need the full HLA screeining, second DQalpha alone gives you no information, third the immune system scans the sperm not the egg. If you call me we can have a brief chat about this , the staff with schedule a free 10 minute consult so we can decide if you need our services and I can answer these qeustions.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

maxietunes

2 Posts
RE: DQ alpha and donor eggs Posted on: Mar 2, 2013 at 11:56pm
The doctor wrote , "third the immune system scans the sperm not the egg." I am wondering what that means. Once the sperm and egg fertilize, and you have a fetus, how can the immune system "scan the sperm" anymore? It would scan the whole fetus, wouldn't it?

Also, it seems to me, that in the case of a woman carrying a fetus with donor sperm and donor egg, she should be equally concerned about the dQalpha of the egg donor as the dQalph of the sperm donor, right? If not, could you please tell us why not, Dr. Braverman? Thanks.
Ceci Cela

Dr. Braverman

1998 Posts
RE: DQ alpha and donor eggs Posted on: Mar 3, 2013 at 8:38am
It means that part of the immune tolerance towards the paternal genetics occurs in the vaginal canal during relations . It is clearly more diffiuclt when the mother immune system has never been exposed to the paternal sperm in the vaginal canal. Clearly there are many pregnancies without this exposure as their are other pathways to create immune tolerance. But this is most likely why the incidence of preeclampsia is higher in sperm donors(i.e. poor immune tolence to paternal genetics). There does not seem to be the same assocation with the egg donor(although this is being studied)
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.