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.
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/ICSIwomen 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: Sunni L Mumford; Robert M Silver; Lindsey A Sjaarda; Jean Wactawski-Wende; Janet M Townsend; Anne M Lynch; Noya Galai; Laurie L Lesher; David Faraggi; Neil J Perkins; Karen C Schliep; Shvetha M Zarek; Enrique F Schisterman Journal: Hum Reprod Date: 2016-01-11 Impact factor: 6.918
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Authors: Enrique F Schisterman; Sunni L Mumford; Karen C Schliep; Lindsey A Sjaarda; Joseph B Stanford; Laurie L Lesher; Jean Wactawski-Wende; Anne M Lynch; Janet M Townsend; Neil J Perkins; Shvetha M Zarek; Michael Y Tsai; Zhen Chen; David Faraggi; Noya Galai; Robert M Silver Journal: J Clin Endocrinol Metab Date: 2015-02-24 Impact factor: 5.958
Authors: Shannon M Bates; Anita Rajasekhar; Saskia Middeldorp; Claire McLintock; Marc A Rodger; Andra H James; Sara R Vazquez; Ian A Greer; John J Riva; Meha Bhatt; Nicole Schwab; Danielle Barrett; Andrea LaHaye; Bram Rochwerg Journal: Blood Adv Date: 2018-11-27
Authors: Enrique F Schisterman; Robert M Silver; Laurie L Lesher; David Faraggi; Jean Wactawski-Wende; Janet M Townsend; Anne M Lynch; Neil J Perkins; Sunni L Mumford; Noya Galai Journal: Lancet Date: 2014-04-02 Impact factor: 79.321