Supporting success rates for natural and assisted reproductive cycles is a key area of focus in the care we provide to our patients. From using evidence-based acupuncture protocols, clinical nutrition to support follicle and sperm health, botanical and lifestyle modifications to improve hormone balance, etc. Over the years there has been a build up of research around the use of baby aspirin for patients trying to conceive with In-Vitro-Fertilization (IVF). And while some of the clinical trials have demonstrated conflicting results, we are starting to see some important trends in how it may impact Fertility outcomes.
What is Baby Aspirin and How Does it Work?
Baby aspirin is a low-dose acetylsalicylic acid. Usually found in over-the-counter bottles at a dose of 81 mg per tablet. In a systematic review and meta-analysis published in 2017, the results of 13 randomized clinical trials were combined to help further our understanding of the effect baby aspirin may have in patients currently trying to conceive. Aspirin has been shown in to help reduce fever and pain, although usually higher doses are needed for this. It has also been used in other areas of healthcare to improve microcirculation and prevent thrombosis (blood clotting), and works as a blood-thinner. Acetylsalicylic acid inhibits the activity of cyclooxygenase (COX) enzyme and reduces the activity of thromboxane A2. It also reduces the production of prostaglandins. Together, it reduces blood clotting by reducing platelet activity.
Baby aspirin has also been suggested to reduce resistance in arterial walls, therefore increase blood flow and tissue perfusion. This may help to improve blood flow to the reproductive organs. This is important as some studies have found that the medications used during ovarian stimulation phase of IVF can increase blood vessel resistance and is associated with reduced blood flow to the uterus during IVF.
How Long Does it Take for Baby Aspirin to Work?
Studies have suggested that baby aspirin needs to be taken for about 1 month for there to be a noticeable change endometrial receptivity and potentially endometrial thickness.
Does Baby Aspirin Increase the Clinical Pregnancy Rate?
The clinical pregnancy rate (CPR) is how many patients go on to have a positive pregnancy test and have a normal and healthy ultrasound result showing a fetal heartbeat. The systematic review and meta-analysis could not find an increase in the clinical pregnancy rate for patients. However, this data is always evolving, and recently a new randomized clinical trial found that the use of baby aspirin was observed to increase the CPR in patients during IVF.
Does Baby Aspirin Affect the Number of Follicles/Eggs Retrieved in IVF?
Some studies have observed that patients that used baby aspirin actually had an increase in the number of eggs retrieved with IVF as well. Approximately 5 studies reported in this review found that the number of oocytes retrieved during IVF was significantly higher when compared to patients that used just a placebo.
Does Baby Aspirin Increase the Fertilization, Implantation, Miscarriage, or Live-Birth Rates?
The systematic review that evaluated for these rates could not find a significant increase in the fertilization, implantation, and/or miscarriage rates with IVF. They did observe a significant increase in the number of patients that went on to successfully give birth to a child after IVF if they used baby aspirin compared to patients that used a placebo (live-birth rate).
Can Baby Aspirin Increase Endometrial Thickness?
The systematic review from 2017 evaluated for 3 randomized clinical trials that could not find any increases in the endometrial thickness during IVF. However, separate trials have found that baby aspirin may increase the thickness of the endometrial lining during fertility treatments.
References:
Wang, L., Huang, X., Li, X., Lv, F., He, X., Pan, Y., Zhang, X. (2017). Efficacy evaluation of low-dose aspirin IN IVF/ICSI patients evidence from 13 RCTs. Medicine, 96(37).
This blog post is intended to educate viewers on the existing preliminary results of studies on the topic, and it does not represent a personal opinion about it. It does not give any medical diagnosis. For more information on about baby aspirin for fertility, and if you have any questions or concerns regarding the Impact of medications on your health or IVF/fertility treatment outcomes, please contact your healthcare provider(s). This article is in no way a replacement for medical advice or medical care, it is advised that anyone concerned about their Health should speak with their Naturopathic Doctor. Please discuss with your healtcare provider and only make changes to your medications regimen if recommended by your doctor and under their guidance.