I. Wada et al., THE BENEFITS OF LOW-DOSE ASPIRIN THERAPY IN WOMEN WITH IMPAIRED UTERINE PERFUSION DURING ASSISTED CONCEPTION, Human reproduction, 9(10), 1994, pp. 1954-1957
The objective of this long-running study was to determine whether the
addition of low-dose aspirin to a standard hormone replacement therapy
(HRT) protocol improved uterine perfusion during assisted conception.
A total of 99 women scheduled for frozen embryo replacement were stud
ied. Endometrial preparation was with a standard buserelin/HRT protoco
l. Uterine perfusion was assessed by Doppler ultrasound and classified
as impaired or normal. In their first attempts, those with impaired p
erfusion (group I, n = 37) received low doses of aspirin [150 mg (n =
26) or 300 mg daily (n = 11)], starting from day 13 of HRT. Women with
normal perfusion (group II) did not receive aspirin. In subsequent at
tempts, those from group I were arbitrarily allocated to start aspirin
on day 1 or day 13 of HRT, and 10 women from group II were arbitraril
y selected to receive aspirin from day 1 of HRT. In group I, the cance
llation (46 versus 36%) and pregnancy rates (15 versus 25%) in those w
ho received 150 or 300 mg aspirin daily were similar. In those with ca
ncelled first attempts, good perfusion was achieved in 82 versus 20% (
P < 0.02) of subsequent attempts using aspirin from day 1 versus day 1
3 of HRT. Higher pregnancy rates (47 versus 17%) were achieved in thos
e taking aspirin from day 1 of HRT. In group II, pregnancy rates were
not statistically different in those who did or did not receive aspiri
n during their subsequent attempts (10 versus 35%). The addition of lo
w-dose aspirin to a standard HRT protocol in women with impaired uteri
ne perfusion is associated with improved blood flow and satisfactory p
regnancy rates.