Low-dose aspirin for in vitro fertilization or intracytoplasmic sperm injection: a systematic review and a meta-analysis of the literature.

Abstract

BACKGROUND:

It was hypothesized that low-dose aspirin could improve implantation rates in subsequent pregnancies in women undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). Previous studies have shown inconclusive results or focused on surrogate endpoints. We therefore conducted a systematic review and meta-analysis of the literature investigating the effect of low-dose aspirin on hard outcomes, including live birth rate, pregnancy rate and miscarriage.

METHODS:

MEDLINE and EMBASE databases were searched up to November 2011. Randomized controlled trials comparing low-dose aspirin with placebo/no treatment in IVF/ICSI women were included. Pooled odds ratios (ORs) and 95%confidence intervals (CIs) were calculated.

RESULTS:

Seventeen studies with 6403 patients were included. The use of aspirin did not improve live birth pregnancy rate compared with placebo or no treatment (1.08; 95% CI, 0.90, 1.29). Pregnancy rates were significantly increased in patients randomized to low-dose aspirin (OR, 1.19; 95% CI, 1.01, 1.39), but miscarriage rates were not (OR, 1.18; 95% CI, 0.82, 1.68). Results of sensitivity analyses including high-quality studies did not show statistically significant differences in all considered endpoints.

CONCLUSIONS:

The results of this study do not show a substantial efficacy of aspirin inwomen undergoing IVF/ICSI and do not support the use of low-dose aspirin to improve the success of IVF/ICSI in terms of pregnancy outcomes. Further high-quality studies evaluating the possible efficacy of aspirin in selected groups of patients are warranted.

• Authors: F Dentali, W Ageno, E Rezoagli, E Rancan, A Squizzato, S Middeldorp, M Margaglione, E Grandone
• Journal: Journal of thrombosis and haemostasis : JTH (J Thromb Haemost) Vol. 10 Issue 10 Pg. 2075-85 (Oct 2012) ISSN: 1538-7836 [Electronic] England
• PMID: 22900525 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
• Copyright: © 2012 International Society on Thrombosis and Haemostasis.

Chemical References

• Fertility Agents
• Aspirin

Topics

• Abortion, Spontaneous (etiology)
• Adult
• Aspirin (administration & dosage)
• Embryo Implantation (drug effects)
• Female
• Fertility Agents (administration & dosage)
• Fertilization in Vitro (adverse effects)
• Humans
• Live Birth
• Male
• Odds Ratio
• Pregnancy
• Pregnancy Rate
• Sperm Injections, Intracytoplasmic (adverse effects)