Dr. Spyridon Papageorgiou, Gynecologist, Obstetrician, Specialized in infertility, Specialized in Prenatal of pregnancy
Dr. Ioannis Toliopoulos, PhD, Molecular Biologist, Physiologist, Immunologist in Reproductive Medicine
The issue of anti-parental antibodies or the histocompatability of the couple, which leads in infertility and rapid spontaneous abortions (RSAs), has been quite know lately and also caused too much confusion in the public. The presence of anti-paternal HLA (human leukocyte antigens) antibodies in recent medical literature has been linked to increased risk for pre-term labor, Chorioamnionitis (an infection of the membranes – placental tissues – and amniotic fluid) and still-birth. Also, the issue for the immunization of the wife with the husband’s lymphocytes is still in doubt.
Let’s clear what is going on with the anti-paternal antibodies. We know that half of the genetic material of the embryo comes from the father. It is necessary this genetic material to be recognized (DQ- α genes) the right way from mother’s side so it won’t be rejected as a foreign body. In reality, the mother’s body recognizes father’s genetic material and forms so called anti-parental antibodies, allowing the developments of gestation. These protective antibodies block embryo in pregnancy to be recognized as normal part of the immune system. Also, in couples that their genetic material is similar (rare phenomenon), the adaptive mechanism is not activated (since DQ- α genes are the same and woman’s immune system does not develop the necessary anti-parental antibodies) so the pregnancy won’t go on.
Some years ago, the scientific community developed vaccines from the husband’s lymphocytes and injected into wife’s body. This method was very doubtful from the US FDA and has been abolished some years ago. For this reason, a new test has been developed that covers all the histocompatibility issues and the anti-parental antibodies. This test is called blocking factors.
It has been established that normal pregnancy requires the presence of blocking factors (antibodies) in woman’s blood circulation. Such factors are not detected in most women with recurrent pregnancy losses (RPL) or unexplained imminent abortions (IA) or failed IVFs.
Lymphocytes from previously HLA-phenotyped donor have been used. The lymphocytes were incubated with one specific anti-HLA antibody and used ex-tempore or stored frozen in liquid nitrogen until used. The lymphocytes with HLA-Ag-Ab complex were incubated with the tested serum for 30 min.
A rabbit complement was added and after an hour of incubation, a coloring agent (eosin or tripan blue) is dropped. The results are scored on light microscope: if blocking factors are present in the serum, no cellular lyses are detected and vice versa – blocking factor’s absence will lead to cell lyses.
With this test, the couple is not needed to do the whole immune system for histicompatability, so it secures the low cost. Also, the most encouraging message is that if the diagnostic result is positive, THERE is therapy and can solve the problem once and for all. This is intravenous biological therapy without side effects and low cost because the dosage used is low.
Conclusion: All couples must be very careful in their scientific choice in diagnostic and therapeutic level and must investigate by filtering data before they decide to be in the reproductive process with natural way or by in vitro fertilization. Also, they must select very well trained and specialized doctors with high morale and deontology in order to succeed pregnancy with the lowest possible cost.