HLA match treatment


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Reply HLA match treatment Posted on: Apr 10, 2011 at 9:53pm
Dear Dr. Braverman,

I have been reading about HLA testing. I would like to know how you treat an HLA match. Specifically:
1. Do you treat the “consequences that result from HLA matching”? In other words, an HLA match may result in increased NK cytotoxicity, decreased TH2 cytokines, increased TH1 cytokines, decreased T regulatory cell activation and so on? Do you test for these “consequences” (and others) and then treat what you find?
2. Or does an HLA match simply effect your treatment choice? For example, the choice of IVIG over Intralipid for increased NK cell cytotoxicity, as IVIG has been shown to have more diverse immunomodulatory functions than Intralipid and would be more appropriate for an HLA match? Do you add in LIT?
3. Or do you treat HLA directly and if so, how? Since this is a genetic problem, I am wondering how this can be accomplished?
4. Or does an HLA match simply effect the aggressiveness of your treatment? Or how IVF/FET is approached?

Thank you in advance for your time and effort! Karen

Dr. Braverman

2005 Posts
Re: HLA match treatment Posted on: Apr 11, 2011 at 2:24am
Not every HLA match results in RPL or failed IVF. We do look at the post pregnancy testing to decide on treatment as well as the clinical history. When some patients present with high numbers of HLA matches and a significant history of primary infertility or greater than 3 losses , we expect that tretment will be aggressive and most times do recommend IVIG. When there is no history of RPL and we find multiple matches we really need to see the immune profile once the patient has concieved to decide on the best method of treatment and if any is needed at all. I hope that helps you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.