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Eeyore

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  • "Eeyore" started this thread
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Reg: Sep 27th 2005

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Monday, August 11th 2008, 9:50am

INFO: A ROUGH GUIDE TO IMMUNOLOGY

Information from The Alan Beer Centre

The purpose of this information is to inform and empower reproductive immunology patients and not to substitute for the advice of your doctor.

Indicators for Immune Testing
The indications are as follows:
(a)Two miscarriages or two IVF or GIFT failures after age 35 or three miscarriages or IVF or GIFT failure before age 35,
(b)poor egg production from a stimulated cycle (less than 6 eggs),
(c)one blighted ovum,
(d)idiopathic infertility,
(e)previous immune problems (ANA positive, rheumatoid arthritis, and/or lupus),
(f)previous pregnancies that have shown retarded fetal growth,
(g)one living child and repeat miscarriages while attempting to have a second child.

A Typical Patient
The patients that I see are 38.6 years plus or minus 2 years. They have been unsuccessful 4.4 plus or minus 2 times and are near the end of their reproductive career, bruised, abused, and often without hope. Most of them can be helped by finding out what is wrong, and if there is a problem, providing them with the understanding and offering of the proper immune treatment.

Some of our patients tell us they have heard many of the following statements:
1. You were unlucky this time, try again.
2. It is God's will; you can always adopt.
3. It was meant to be.
4. The baby was abnormal.
5. The body knows when a baby needs to be rejected.
6. Next time we will try more progesterone.
7. If you miscarry frequently we will try IVF-ET.
8. Next time we will try donor eggs; your eggs are too old.
9. Next time we will try aspirin and heparin.
10. Next time we will try IVIg.

Our research is showing that there may be additional options.

Categories of Immune Problems
There are five categories of immune problems that can cause pregnancy loss, IVF failures and infertility. Category 1 is the least severe, while Category 5 is the most severe. Without treatment, a woman with Category 1 problems can experience recurrent pregnancy loss, which may activate other categories of immune problems from Category 2, 3, 4 or 5.

For further details, please read

Consequences of Recurrent Pregnancy Loss: An Introduction to Categories 1 - 5 Immune Problems

Overview of Reproductive Immunology in the Alan Beer book or online at
http://repro-med.net/index.php

Category 1 DQ alpha matching in the couple. This results in a lack of blocking antibody to pregnancy, and the pregnancy fails.

Category 2Antibodies to Phospholipids. These are the glue molecules for implantation and placentation.

Category 3These women have developed antibodies to the baby's DNA or DNA breakdown products and this problem is reflected by a positive Anti-nuclear antibody test (ANA). This is often with a speckled pattern. We also advise that women have testing to double-stranded DNA, single-stranded DNA, polynucleotides and histones.

Category 4This is a group of women with anti-sperm antibodies.

Category 5Elevated CD 56+ Natural Killer Cells and elevated CD 19+5+ cells. The testing that typically defines this category are
a. Immunophenotype
b. NK Assay
c. Antibodies to Hormones and Neurotransmitters

The Immune Tests

DQ Alpha
This test measures whether the DNA of the couple is too closely matched. These tests give you back two numbers for both members of the couple. In a normal pregnancy the father's DNA in the baby tells the mother's body to set up a protective reaction around the developing embryo. If the father's DNA is too closely matched to the mother's, there is a good chance that the embryo created by them is unable to differentiate itself from the mother's body. The mother's body then rejects the embryo because it cannot identify the embryo as a baby.
Each person gets two DQ numbers from their respective parents. Similarly, when couples try to have a baby, they also give DQ numbers to their fetus. These numbers are, for example, 1.1, 1.2, 1.3, 1.4, 2, 3 or 4. Although there are breakdowns of the 2's, 3's and 4's, many scientists find that only the 1's are significant, so they break those down to one more decimal. Presently DQ Alpha testing is identifying more and more numbers, for example, DQ 4.0, 4.1, 4.2 and 4.3.

Leukocyte Antibody Detection (LAD)
The immunological chain reaction caused by the DQ Alpha match problems is measured by this test.

Reproductive Immunophenotype
This checks for the presence of Natural Killer Cells. In most cases, Natural Killer Cells are good because they keep the body from developing cancer. In this case, however, the body goes overboard and kills the embryo or interferes with your endocrine system that produces hormones essential for pregnancy.

These tests measure the following CD (Cell Designation) levels:
CD-3 (normal 63-86%)
CD-4 (normal 31-53%)
CD-8 (normal 17-35%)
CD-19 (normal 3-8%)
C56 (normal 3-12%) these are the Natural Killer Cells
CD3/IL2-R (normal 0-5%)
CD19/CD5 (normal 0-10%), high numbers in this category interfere with the reproductive hormones necessary for pregnancy.

ANA (Antinuclear Antibody)
This test checks for problems similar to lupus and rheumatoid arthritis or other similar immunological diseases that can also result in pregnancy losses or infertility. This test becomes weakly positive in women with infertility and in women with recurrent pregnancy losses. It is usually reported as ANA positive with at titer 1:40 or higher with a speckled pattern. This pattern is not typical of lupus or rheumatoid arthritis or other immunological disorders.

Anti-DNA/Histone Antibodies
If a woman reacts to the broken down DNA (histones) and it is a speckled pattern, then she is showing a reaction to her own embryos.

APA (Antiphospholipid Antibodies)
When this test is positive, the woman's blood clots too fast cutting off support to the baby. These antibodies also cause the embryo to attach too weakly to the uterus.

Natural Killer Cell Assay
This test determines the killing power of a woman's Natural Killer Cells in the test tube.

12% of women with recurrent pregnancy losses and 25% of women with three or more IVF failures have elevations in NK cells and these cells demonstrate aggressive killing of targets and placental cells when tested in vitro.

The Natural Killer cells are cultured with varying numbers of target cells that they can kill. This is called the Effector/Target Cell ratio and is given a number of 50:1, 25:1 and 12:1. In a separate panel of cultures IgG is added at 6.25 mg/ml (corresponding to an in vivo administered dosage of 25 grams once) or 12.5 mg/ml (corresponding to an in vivo administered dosage of 25 grams of IVIg for 3 consecutive days). The percentages of the target cells killed are calculated for both panels of cells, those with and those without IVIg.

Other Tests
It is important that the woman have other tests that are widely available in all laboratories. These are the Lupus Anticoagulant Antibody, Hormone Antibody Assay, APTT (a blood clotting test) and an antithyroid antibodies.

Note that you can self refer to the Alan Beer Centre for the tests or alternatively you can attend one of the two clinics here in the UK that offer some of these tests. Dr Taranassi of the ARGC in London and Dr George Ndukwe of Care in Nottingham have both been trained by Dr Alan Beer and offer the majority of these tests.

Eeyore

TECHNICAL ADMIN

  • "Eeyore" started this thread
  • United Kingdom

Posts: 21,402

Reg: Sep 27th 2005

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Monday, July 26th 2010, 8:22am

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