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IVF Success Not Helped by Aspirin

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While it is often recommended during an in vitro fertilization cycle (IVF), there is no evidence that a daily aspirin can boost IVF success, according to a new study.

Researchers from the University of Greece in Athens combined the results of 13 international studies and found that low-dose aspirin did not improve the live birth rate or any of the secondary outcomes examined, including clinical pregnancy rate, and ectopic and miscarriage rate.

However, even low-dose aspirin can have risks, including gastrointestinal bleeding. The authors of the study concluded: "Use of aspirin for women undergoing in vitro fertilization cannot be recommended due to lack of evidence from the current trial data."

Fertility doctors sometimes recommend aspirin for women undergoing IVF with the theory that aspirin will improve uterine and ovarian blood flow, prevent blood clots in the vessels of the placenta, increase endometrial thickness and stimulate interleukin-3.

The routine use of low-dose aspirin in IVF has been a matter of controversy for many years, according to Eric Levens, M.D., a fertility doctor with Shady Grove Fertility in Virginia. "At present, I do not routinely recommend low-dose aspirin, as much of the evidence has not demonstrated a benefit with its use."

Dr. Levens explains that this recent study is a Cochrane Review (meta-analysis) that combined the available randomized controlled clinical trial data. The researchers reported their findings in the Cochrane Library, which is published by the Cochrane Collaboration, an international research organization that evaluates medical evidence.

"In the past three years, there have been at least three such meta-analyses," Dr. Levens says. "Two of the three have shown no benefit to using aspirin routinely. Methodological approaches to analyzing the data may explain some of the differences, but by in large there is no appreciable improvement in IVF success with aspirin use."

Dr. Levens says the most recent study was well done and largely supports the conclusions of previous studies. "With that said, there may be some benefit for women with specific blood clotting disorders; however recent evidence has failed to demonstrate benefit among those with recurrent pregnancy loss," he says, citing 2010 research published in the New England Journal of Medicine.


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