At Braverman IVF & Reproductive Immunology we have long recognized the important contributions made by HLA genes to unexplained infertility and recurrent miscarriage. A recent publication by a group of scientists from the Netherlands has now further advanced our understanding of this important area of reproductive immunology. This publication demonstrated that females carrying certain copies (called alleles) of an HLA gene called HLA-G are predisposed to both primary (no history of a live birth) and secondary (prior live birth) recurrent miscarriage.
This same study also found that females with a history of a firstborn boy are susceptible to secondary recurrent miscarriage and to giving birth to boys with a low birth weight when they have certain other HLA alleles known as HY-restricting HLA (HYrHLA) alleles. These HYrHLA alleles can specifically alert the mother's immune system to the presence of male-specific proteins (HY antigens) encoded by genes on the Y chromosome of a male fetus. In some women this can lead to the development of a dangerous immune reaction to the fetus mediated through T cells and HY antibodies produced by B cells.
While this study specifically looked at the effects of HLA-G and HYrHLA alleles in patients with primary and secondary recurrent miscarriage, we believe that these genes are also likely to be important in the development of primary and secondary unexplained infertility.
Here at Braverman Reproductive Immunology, we are already testing our patients for HYrHLA alleles and we are actively developing new tests that will soon allow us to detect HLA-G alleles and HY antibodies. These new tests will not only expand our ability to diagnose specific immunological issues, but also to further personalize and tailor therapeutic approaches for each of our patients.