Alpha (wife) have a baby with a beta (husband)?

Hi everyone,

I am so happy to have found this forum.  I don't feel so alone anymore.

I am an alpha thal minor (2 deletions) and my husband is a beta thal minor (1 deletion) and we are trying to have a baby.  My husband is also a heptitus B carrier.  I am 41 years old and I have a small fertility window.

I recently had a miscarriage at 10 weeks, the baby had stopped growing at week 6.4 weeks with a weak heartbeat (88-104).  My fertility doctor said the baby stopped growing due to chromosone abnomaliies.  How true is this?  I had IVF with ICIS because my husband's sperm quality is not good.  DNA fragmentation was very high and according to the report our chances of having a baby is through IVF with ICIS.  I wondered how my husband's BTM and hep B damaged the quality of his sperms (viability is less than 50% and poor sperm motility)?

I have started to take 2mg of folic acid, 400g of vitamin E, 2000 iu vitamin D and two B50 complex pills a day.  Is this enough?  I don't have iron overload (it's around 100).  I am also taking a prenatal vitamin with iron.  Should I take one without iron?

I am going to see my family doctor to get tested for vitamin D, B12 deficiency and also ask him to refer me to a hemotogist.  We are planning another ivf with icis in 3-4 months.  We live in Toronto (Canada).

Kayla

Hi Kayla,

Do you have any information on your specific alpha deletions? This might help in advising you. I think your current nutritional program is fine, although if your ferritin level is 100 you may not need iron supplements right now. Once you get pregnant again, you may want to take the multi with iron again. Natural vitamin E is very important for a successful pregnancy so you are doing right with 400 IU daily. The one thing I would suggest is to talk to a hematologist about being monitored for any signs of thrombosis during pregnancy, as this is the most likely cause of miscarriage. Vitamin E can help to counter this but monitoring would be good if possible. If a doctor suspects that clotting may be an issue, the treatment is often as simple as one baby aspirin daily.

Hi Andy,

The molecular analysis says I am a carrier of Alpha Thalassemia. I am heterozygous for alpha thalassemia-1 deletion (--SEA/aa) Alpha thalassemia trait. They did a drawing to explain it to us-normally there's supposed to be four genes on two chromosomes and mine has two deletions both on the second chromosome.  Is this what you are looking for?

I don't know how to read these numbers from my blood report:

Hemoglobin 125
Hematocrit 0.40
RBC 5.55
MCV 72
MCH 23
MCHC 312
RDW 14
WBC 6.8
Platelets 342
MPV 8.1

I asked my family doctor and he didn't explain it in layman's term.  My RBC, MCV, MCH and MCHC are outside of the noraml limits/range.  What do these numbers mean, do you know?  Also, I read on the site that red blood count below 8 is bad, what's mine?

One of my concerns is the vitamin E I am taking right now.  It says "natural source", is this the natural kind I have been reading on the site?  I just want to make sure it's not synthetic.

My family doctor refused to refer me to see a hematologist.  I am seeing a new fertility doctor next week and I will ask him to monitor me for signs of thrombosis if I become preganant and maybe I will have better luck with him for a hematologist referral.

Kayla

Hi Kayla,

Your hemoglobin level is 12.5 which is normal. Your RBC is 5.55 which is slightly higher than normal and expected with thal trait. The below 8 you are asking about would refer to the Hb and not the RBC, and yes that would be a serious anemia. Your numbers are all what would be expected from an alpha thal trait. Your blood work will always show low MCV and MCH and this only refers to the average size and volume found in a test. Because some of your red blood cells ar smaller than normal, these numbers come in low for alpha and beta carriers. As long as your Hb stays above 11 when not pregnant, you are doing fine. During pregnancy the Hb will drop as the blood volume increases, diluting the blood a bit with fluid, so the measured Hb will appear to be lower than it really is when pregnant.  As far as your blood tests, no worries there. Natural sources would be natural vitamin E. Synthetic is a by-product of industry and should be avoided. If you see dl-tocopherol, don't take it. Natural will be expressed as d-tocopherol.

Of naturally fertilized eggs, only about 1/4 will implant and become successful pregnancies. Chromosomal abnormalities are one reason for this. This may have absolutely nothing to do with thalassemia. There might be a connection but only by chance. I would not assume that it was a defective sperm or egg, as it could be either or just an irregular development that caused the miscarriage. With IVF, you can expect failures and almost everyone I know who has gone through this has had failures before having a successful pregnancy. You can't expect any better percentages with IVF than the 1/4 in natural pregnancies. Once you commit to IVF you just have to expect and accept if it doesn't take. I would suggest continuing to try naturally also, as we have seen in this group that moms who were told not to expect a high chance of successfully getting pregnant, have gone on to have more than one child. My brother-in-law and his wife were told they would never have children, adopted two girls and then the wife got pregnant with a third child. Don't assume that low motility totally rules out anything.

I am sure your new doctor will agree that you have to be patient with IVF. I understand how disappointing it is when it doesn't work, but I have seen a 40 year old thal major have a child from IVF after two prior failed attempts where there was implantation that detached. Her spirit was an inspiration. She never expressed anything negative but had faith and kept trying and had a very healthy little boy. Stay strong for yourself and your husband. It may very well be that the miscarriage had nothing to do with thal and was simply chance.

Thank you Andy for the information and your dedication.

Kayla