Today's semi-bad news: donor is partial DQ-Alpha match

Today's semi-bad news: donor is partial DQ-Alpha match

Joined: September 16th, 2011, 4:55 am

October 13th, 2011, 5:38 pm #1

I just found out my donor and I are a partial DQ-alpha match. My doctor says this means I will need intralipids every 2 weeks around the time of transfer. I'm thinking this is not a big problem since I have other immune issues and it was already recommended that I treat with intralipids, prednisone and Lovenox anyway, and I don't want to go through choosing another donor since it was difficult for me to settle on this one. I really like everything about him--we're even the same blood type! The only thing wrong with him before (well, as far as one can ever tell when using DS) was that he's CMV positive and I'm CMV negative, but since I'm doing IVF with ICSI and the bank tests all sperm to make sure there's no active CMV infection present before they allow it out of quarantine, I decided the risk there was negligible.

However, my dilemma: I was waiting for these immune testing results before buying any more vials of this donor and I'm nervous about them selling out of him, but now I'm wondering if I should get full genetic testing done on both of us to see if there are any other reasons I might need to pick a new donor. (I realize the immune issues and other genetic issues are not necessarily connected, but I wasn't expecting we would be a DQ-Alpha match either... so now I just don't know.) The money is a bit of an issue too, since although the sperm bank does allow exchange of one donor's vials for those of a different donor as long as the vials have never left their facility, once that money is spent, it's tied up there--and they may not have any new donors I like as much any time soon.

Thoughts? I may also crosspost this to the immunology group, but I've seen a lot of knowledge and good advice on this board so if anyone wants to weigh in, I'm interested in your input.
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Joined: December 20th, 2010, 7:38 pm

October 13th, 2011, 6:30 pm #2

CMV positive is really not a good thing if you are negative, can't take the risk of mental retardation of the fetus. Partial DQ match is not horrible, but coupled with CMV positive, I'd probably start looking at other options. I would save the full blown immunology test and just look for another donor.

Btw, does your bank track the number of times that your donor donates his sperms? There are recently reports of certain donors with hundreds of off springs by different women because the banks don't care and don't track, and that would be a concern for the kid.
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Joined: September 16th, 2011, 4:55 am

October 13th, 2011, 6:53 pm #3

CMV with no active infection present AND using ICSI is such a minimal risk that I'm not worried about it on its own, and my doctor agrees. The bank has a 25 family limit per donor, but I don't think they track if he donates privately or through other banks... I don't know of any banks that do the latter. Unfortunately I see this as a problem with donor sperm in general--there's absolutely nothing to prevent donors from lying on their medical profiles, donating at multiple banks, etc. I personally am just planning to tell my child, should I be lucky enough to have one, that he or she may have donor siblings out there and therefore needs to have genetic testing done before having children with any partner to rule out any risks that might arise (like from their being half-siblings... although one generation of half-siblings reproducing might not even carry any significant genetic risks anyway).
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DeeinNYC
DeeinNYC

October 13th, 2011, 10:21 pm #4

I just found out my donor and I are a partial DQ-alpha match. My doctor says this means I will need intralipids every 2 weeks around the time of transfer. I'm thinking this is not a big problem since I have other immune issues and it was already recommended that I treat with intralipids, prednisone and Lovenox anyway, and I don't want to go through choosing another donor since it was difficult for me to settle on this one. I really like everything about him--we're even the same blood type! The only thing wrong with him before (well, as far as one can ever tell when using DS) was that he's CMV positive and I'm CMV negative, but since I'm doing IVF with ICSI and the bank tests all sperm to make sure there's no active CMV infection present before they allow it out of quarantine, I decided the risk there was negligible.

However, my dilemma: I was waiting for these immune testing results before buying any more vials of this donor and I'm nervous about them selling out of him, but now I'm wondering if I should get full genetic testing done on both of us to see if there are any other reasons I might need to pick a new donor. (I realize the immune issues and other genetic issues are not necessarily connected, but I wasn't expecting we would be a DQ-Alpha match either... so now I just don't know.) The money is a bit of an issue too, since although the sperm bank does allow exchange of one donor's vials for those of a different donor as long as the vials have never left their facility, once that money is spent, it's tied up there--and they may not have any new donors I like as much any time soon.

Thoughts? I may also crosspost this to the immunology group, but I've seen a lot of knowledge and good advice on this board so if anyone wants to weigh in, I'm interested in your input.
Hi Di,

I know that you intend to go forward with your current donor but I must say...I had the same reaction as MIR. I don't know a thing about CMV and therefore can't comment on it, but I have done a bit of research into immune issues. Although it is true that a partial DQ-Alpha match can be treated with intralipids, for many women, intralipids does not work. They have to use IVIG which is VERY expensive..I'm talking around $2,000 a shot and most need at least 3. Some evenhave to get a treatment called LIT which is illegal in the States and they go down to Mexico for this treatment. The fact is that even with treatment, some are never able to conceive with a partial match. I don't think I would knowingly opt to have a donor with this issue. You've already stated that you yourself have immune issues. Between your issues, a partial match and whatever issues that come with CMV...I think you might be taking an unnecessary risk. Once you pull that trigger and invest in even more sperm with this donor and go through IVF...you will already be out thousands of dollars before you find out that immune treatments will not cure this issue for you.

You might want to go to the following Immune Yahoo group and join and ask them their opinion. The ladies there know EVERYTHING..certainly much more than I do. I don't think the immune board here is very active. Here is the link:

http://health.groups.yahoo.com/group/immunologysupport/
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Joined: September 16th, 2011, 4:55 am

October 14th, 2011, 12:10 am #5

Thanks Dee! I am definitely going to cover my bases and start looking at other donors, and I plan to ask the immunology group for their thoughts too, but I want to get the exact numbers first--Dr. T just said that one out of 2 copies are both type "1.1". My other immune issues are MTHFR, elevated NK and lupus anticoagulant. So I'm going to get copies of the test results when I go in for my u/s tomorrow and then post on the immunology Yahoo Group, and go from there.

And I hear you about the money... I'll be out thousands of dollars either way to get a new donor, between the fees to look at pictures, the cost of the sperm, and the cost of getting the new donor tested--around $600, all OOP naturally--but if extra immune issues decrease the chance of immune treatments working, I have a feeling it still might be cheaper in the long run to go with a different donor. (The CMV status really isn't an issue for me at this time, so I think it comes down to a calculation of how likely the intralipids are to work and what the statistics are with our particular match numbers... and Dr. T didn't seem that concerned, which kind of worries me if intralipids aren't that effective in these cases.)
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DeeinNYC
DeeinNYC

October 14th, 2011, 12:49 am #6

Wow Di,

You have quite a few immune issues..thank goodness you tested for them first!! have MTHFR and slightly elevated NK cells. Did they tell you your NK cell #? If you have not done so already, you might want to pick up Dr. Beer's book "Is your Body Baby Friendly." You should also ask for a copy of the immune testing report so that you can ask others to interpret them for you. In particular, there is a section of the Report for NK cells that tells you how effective intralipids and IVIG would be in reducing the % of NK cells. It's not a guarantee but at least you can tell if intralipds should work for you. I'm in the unfortunate position of having a report that says that intralipids will not likely reduce my NK cell activity much..but I can't afford to pay for IVIG. I was told however that despite what the report says, intralipids would still likely be helpful as NK cells tend to go into overdirve upon a pregnancy. In any eventr..GL!!

I think that as much as SIRM is known to treat immune issues..if it is a boderline issue...Dr. T is not as agressive with the treatment as others might be. He doesn't really think my NK cell activity needs treatment but Dr. Beers book says otherwise..so..I'm doing the treatment. That said...you know I love Dr. T...but reading the real life stories of some women with these issues tells me that they need to be treated if possible.
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Joined: September 16th, 2011, 4:55 am

October 16th, 2011, 2:25 am #7

Update: I talked to Dr. T yesterday and he agreed to do a trial infusion with intralipids after my egg retrieval and then test my NK elevation levels again afterward to see how effective a treatment intralipids would be for me. He seems to think it would be effective because the 25:1 ET NK assay w/intralipid number on my report was 13.7--down from 25--and he says he uses a higher dose than what they used on the test, so hopefully that should get it under 10 (which I understand to be the desired target? although at 50:1, the intralipids only reduced my number from 25.1 to 23.7). But since it seems like I'll need treatment for elevated NK cell activity regardless of whether or not I have any DQ-Alpha match w/the donor, I feel like it makes sense to do everything I can to try to find out if I can be successfully treated with intralipids before even considering IVIG, which is so cost prohibitive.
Last edited by di_nyc on October 16th, 2011, 2:28 am, edited 1 time in total.
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DeeinNYC
DeeinNYC

October 16th, 2011, 4:03 pm #8

Di,

I like that plan. You are banking your embies right? BTW...did Dr. T say how many units of intralipids he gives. What you said made me take note becuase the results on my report did nit reduce my 50:1 at all with intralipids so it's good to know that Dr. T uses a different strength. I'm going to ask him about this. BTW..yes..under 10 is the target that Dr. Beers said should be attained.
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Joined: September 16th, 2011, 4:55 am

October 16th, 2011, 8:59 pm #9

Yes, I'm banking. Dr. T didn't say how many units of intralipids he gives, but it's higher than 1.5mg/ml because that was the dose listed under my NK Assay with Intralipid result... and it's also possible that it would act differently once it gets into the bloodstream (which is another reason I want to do the trial infusion). I'm going to ask him about the dosage before we do it, obviously, and am interested to hear what he says.
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