Hi Dr Sher
I am looking for any supportive data for the claim that complete HLA-DQA matching is impossible to treat with immune therapy. Can you help?
Thanks
Gavin
HLA-DQA complete match
Question
Answer
Unless there is a concomitant NK cell activation, a DQ alpha match is in my opinion irrelevant and no treatment is required. There has to be both NKa+ a match. This is regardless of whether iot is a “partial” or a complete match. A partial match is treatable but a complete (“total”) match is highly unlikely to respond to immunotherapy by propagating a viable pregnancy. It is not impossible but remote!
Geoff Sher
____________________________________________________________________________________________
There are two types of DQ alpha/HLA genetic matching:
- Partial DQ alpha/HLA genetic matching: Couples who share only one DQ alpha/HLA gene are considered to have a “partial match.” If NK cell activation is also present, this partial match puts the couple at a disadvantage for IVF success. However, it’s important to note that DQ alpha/HLA matching, whether partial or total, does not cause IID without associated NK cell activation. Treatment for partial DQ alpha/HLA match with NK cell activation involves IL infusion and oral prednisone as adjunct therapy. IL infusion is repeated every 2-4 weeks after pregnancy is confirmed and continued until the 24th week of gestation. In these cases, only one embryo is transferred at a time to minimize the risk of NK cell activation.
- Total (Complete) Alloimmune Genetic Matching:A total alloimmune match occurs when the husband’s DQ alpha genotype matches both that of the partner. Although rare, this total match along with NK cell activation significantly reduces the chance of a viable pregnancy resulting in a live birth at term. In some cases, the use of a gestational surrogate may be necessary.
_____________________________________________
PLEASE SHARE THIS WITH OTHERS AND HELP SPREAD THE WORD!!
Herewith are online links to 2 E-books recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)……. for your reading pleasure:
- From In Vitro Fertilization to Family: A Journey with Sher Fertility Solutions (SFS) ; http://sherfertilitysolutions.com/sher-fertility-solutions-ebook.pdf
- Recurrent Pregnancy Loss and Unexplained IVF Failure: The Immunologic Link ;https://drive.google.com/file/d/1iYKz-EkAjMqwMa1ZcufIloRdxnAfDH8L/view
I invite you to visit my very recently launched “Podcast”, “HAVE A BABY” on RUMBLE; https://rumble.com/c/c-3304480
If you are interested in having an online consultation with me, please contact my assistant, Patti Converse at 702-533-2691 or email her at concierge@sherivf.com\
More Resources
Ask our Doctors
Have a fertility question? You are not alone. Our doctors are here to answer your questions and support you on your fertility journey.
Learn From the Fertility Experts
Explore the latest videos from the SFS Physicians. They're here to share their perspectives on various fertility topics with you.
Fertility Topics Explained from the Experts at SFS
Read the latest fertility blogs by our physicians on the latest in the fertility field.