Partial HLA C match

Nicole

5 Posts
Reply Posted on: Aug 17, 2014 at 3:18am
Hi Dr Braverman,My husband and I share a partial HLA C match; me (07,12) him (06, 07). Which I know, based on your blog, carries some significance compared to other matched HLA genes. How serious is this? The presence of people out there with homogenous HLA C genotypes confirm it's certainly possible to achieve live birth despite the match -- so maybe it isn't THAT bad or maybe I'm just rationalizing.

Also wondering -- Is this a situation where it would be wise to only transfer one embryo at a time? Is it plausible that the presence of a matched HLA C embryo could inadvertently sabotage ALL growing embryos in utero, by creating an immune/cytokine flair, i.e. hostile uterine environment? Or would this *attack* be localized to only the matched embryo, while sparing the viable non matches. I ask because it seems I am only able to transfer 2 embryos at a time, as they were frozen in pairs.We plan to meet with you very soon for a consult but I first need to know if a transfer (without a surrogate) is even worth pursuing at this point.Thanks so much for your input! Nicole

Dr. Braverman

2027 Posts
RE: Partial HLA C match Posted on: Aug 18, 2014 at 12:04pm
We have since learned (and I guess I need to update the website Im sorry) that the HLA partial matches are not of significance and certianly even if they were the idea of single embryo transfer is opposite of what you would want. (i.e. a good embryo helps to generate tolerance for a bad embryo). You need the eintrie set of HLA analysed to look at HLA issues. We now look most closely at the HLA class 2 (see our paper presented at ASRI on this topic) as well as looking at autoimmune predispostions that are in your HLA data(see our diagnositc testing page).
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Nicole

5 Posts
Reply RE: Partial HLA C match Posted on: Aug 19, 2014 at 12:29am
Thank you Dr Braverman! Very helpful. I wish a minor HLA-C match were our only problem! Unfortunately I learned (through you) that I have the 8.1 halpotype. Through my own research I've recently discovered that my drb1*03 (along with my dqb1*02) has strong linkage disequilibrium with hla-g allele g*0101201 14bp predisposing me to repeated miscarriage. With this knowledge I now have very little hope in being able to carry a pregnancy myself.

That said, just how deep of an effect does this have on our embryos? does this only effect implantation in ME ? Or will our embryos likely not survive in even a healthy uterus (surrogate) bc of my crappy halpotype/14pb ?! As I know hla-g is already expressed by blastocysts in vitro. I currently have 7 of them (excellent grade) frozen and now I'm worried about their long term viability in even the healthiest of carriers. Thoughts?

Dr. Braverman

2027 Posts
RE: Partial HLA C match Posted on: Aug 19, 2014 at 5:38am
We now have the ability to test for the HLA G 14bp ins/ins to see if you are homozygous for this. We have many pregnancies in patients that have this . It is something we can treat and although an important issue is not by itself a determination that you can not concieve. All of the issues that you have mentioned can be treated.

If we have not seen you recently or treated you , please call and let me review all of this with you again to be sure you understand all your treatment options which are always being updated.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Nicole

5 Posts
Reply RE: Partial HLA C match Posted on: Aug 19, 2014 at 10:58am
This is reassuring. It does seem almost impossible with everything stacked against us but if anyone can help it is likely you. We have a phone consult set for next week so I look forward to working with you. Thanks again!

Nicole