Donor Sperm or Surrogate?

mcp

8 Posts
Reply Posted on: Apr 28, 2012 at 1:37pm
My husband and I are a partial DQ Alpha match but we also have 7 HLA matches total. Here is a list of our issues but I was curious to know if we used donor sperm would it take care of these immune issues or would you recommend that we use a surrogate? I have had 4 miscarriages, 2 of which were natural, 1 was a chemical with IVF, another IVF cycle ended in a blighted ovum, and my most recent cycle I did a Day 5 biopsy with GSN, transferred 2 expanded blasts that looked great and my beta was 0. I realize there are more expensive treatments than intralipids but I am not sure I want to risk anything with my body and husband's sperm. That is why I am asking if donor sperm would take away most of our issues or would using a surrogate be the best route? Thanks!

CD4+ is 56.4
My CD56+ is 15.4
CD3+/CD56+ is 3.1
TNFa is 57.1
IFN g is 30.1

DQ Alpha - 50% match
DQ Beta - 100% match
HLA-A 50% match
HLA-C 50% match
HLA-DRB1 2 matches

I also have elevated natural killer cells.

I realize that you only have a certain amount of information but based on the info provided would you recommend donor sperm or just move on to a surrogate with our embryos?

I forgot to mention that I have lost quite a bit of weight since these tests were done so I am assuming my cytokines have gone down as well but I haven't had them tested recently.

Dr. Braverman

2027 Posts
RE: Donor Sperm or Surrogate? Posted on: Apr 28, 2012 at 4:41pm
I have had great success with cases such as yours, so if it is very important for you to carry this pregnancy you should certainly schedule a consult wtih me.
With that said , the easiest route is certainly a surrogate, that will work just fine , no need to go to a sperm donor.
Again there are still many options to treat your situation. Let me know If I can help. Good Luck.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

mcp

8 Posts
Reply RE: Donor Sperm or Surrogate? Posted on: Apr 28, 2012 at 4:50pm
Thank you Dr. Braverman! Would donor sperm hopefully solve the problem? We are very open to using a sperm donor and the cost is significantly less than using a surrogate but I wasn't sure if it would solve the problem or not. Obviously assuming that we could still miscarry but would it solve the main problems with the immune stuff?

I forgot to mention that I did Intralipids with this last round of IVF where we transferred the 2 GSN embryos.

mcp

8 Posts
Reply RE: Donor Sperm or Surrogate? Posted on: Apr 28, 2012 at 4:56pm
I should clarify and say that if we do use donor sperm will I still need all the crazy immune treatments? Crazy as in crazy expensive? :-)

Dr. Braverman

2027 Posts
RE: Donor Sperm or Surrogate? Posted on: Apr 28, 2012 at 7:48pm
When I recommending treatments I was suggesting that you dont need donor sperm. I would either treat or just use surrogate. The treatments I would want sometimes are covered. But I would need to run some other tests before I could give you a final recommendation.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Dr. Braverman

2027 Posts
RE: Donor Sperm or Surrogate? Posted on: Apr 28, 2012 at 7:49pm
also intralipids are NOT the appropriate treatment for your problem. but I get most with your situation through without sperm donation.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

mcp

8 Posts
Reply RE: Donor Sperm or Surrogate? Posted on: Apr 28, 2012 at 7:55pm
Okay thank you! I actually consulted with you last year (August I believe) and you had suggested Intralipids based on everything that you tested for at that time. Now I am confused. At first you said IVig but then changed your mind after you saw a number on my CBC blood work that corresponded with a number for my natural killer cells? I can't remember what that number was but you said that it needed to be over 100 to use IVIg and mine was at 75.

I was thinking that if we used donor sperm that it would take away the issue of me attacking the embryo because of all the HLA matches. Maybe I need to consult with you again?

Dr. Braverman

2027 Posts
RE: Donor Sperm or Surrogate? Posted on: Apr 28, 2012 at 8:08pm
It was probably the NKT cells , where we would use only the absolute value which in your case was probably less than 100.(that thinking has shifted to just percent of which yours is 3.1 and slightly elevated, we have also begun using a subset of those cells to help give us a better idea of their inflammatory nature. IVIG is clearly better for that level of cytokine regardless but newer treatments are now available that we have been using with great success for the high HLA matches that you have. You should arrange a follow up consult so we can discuss.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Dr. Braverman

2027 Posts
RE: Donor Sperm or Surrogate? Posted on: Apr 28, 2012 at 8:13pm
I read your new post , would you mind if our website team contacts you to try and figure out what the problem is. If thats ok please email me at [email]Jbraverman@reproductiveimmunology.com[/email]
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.