Aspirin and Infertility

photo by Esra Su

Aspirin is a widely used over-the-counter analgesic the anticoagulative properties (preventing blood from clotting) of which may offer benefits in the field of reproductive endocrinology.

Antiphospholipid antibodies (APA) are a class of proteins researchers believe to be related to problems of coagulation. Consequently, when clotting problems develop in the placenta and disrupt blood flow, it can lead to recurrent spontaneous abortion (more than two pregnancy losses) if the woman has elevated levels of these antibodies (detected through a series of blood tests). Aspirin therapy can significantly reduce this risk due to its anticoagulative properties. Often it is administered with heparin, another anticoagulant that works at a different phase of the process of coagulation.

The issue under research currently is whether this low-dose aspirin regimen in the management of APA-related disorders can also contribute to other aspects of the reproductive process, namely if aspirin can increase the blood supply to the uterus and ovaries. If so, it would mean that the uterus and ovaries would be on the receiving end of a more substantial dosage of serum-carried hormones, improving ovary productivity and thickening the lining of the uterus.

Aspirin and Heparin Therapy

It is not uncommon for some In-Vitro Fertilization (IVF) patients to receive aspirin and heparin or immunoglobulin treatment in an effort to prevent spontaneous abortions, whether or not they have APA-related disorders. Studies out of the CER Medical Institute in Buenos Aires found that women undergoing IVF treatments who were administered aspirin became pregnant almost twice as often as women also undergoing IVF but who did not take aspirin. This was in part credited to the belief that aspirin contributed to an increase in egg production.

According to a study published in Fertility and Sterility (operated by the American Society for Reproductive Medicine), "Low dose aspirin treatment significantly improves ovarian response, uterine and ovarian blood flow velocity, implantation rate and pregnancy rate in patients undergoing IVF. Aspirin seems to be a useful, effective and safe treatment in patients who undergo assisted reproductive technologies."

Despite this, the FDA has not approved either aspirin nor heparin, whether alone or in combination, as anticoagulation therapies for IVF patients. Data concerning benefits and risks of such anticoagulation and immunoglobulin therapy in IVF patients remains scant, but these therapies are gaining some acceptance in the US medical community. Thus far, there has been one fatality associated with IVF and anticoagulation therapy, that of a 38-year-old woman who in 1996 was nine weeks pregnant with triplets when she died of a cerebral hemorrhage.

To that end, the Centers for Disease Control (CDC) warns that there is a significant risk of bleeding associated with heparin and aspirin, meaning anticoagulation therapy for IVF patients must first be subject to vigorous scientific investigation and debate before it can become a routine and accepted practice. To that end, women seeking infertility treatments should discuss all potential therapies with their doctor or other certified health professionals.

Aspirin and Fertility in the Long Term

A potential drawback to the use of aspirin—as well as other non-steroidal anti-inflammatory drugs (NSAIDs), including Advil and Aleve—is the potential for ovulation problems. Notably, luteinizing unruptured follicle syndrome (LUF or LUFS), a condition in which the ovarian follicles fail to release eggs. Since aspirin and other NSAIDs have numerous other health applications and many women may take them long-term, the patient should consult her doctor about the best treatment option available.

Yes it is an over-the-counter medication that has proven medicinal qualities and is generally very safe. However, it is not safe for everyone, including people with ulcers, clotting problems or disorders, and of course, those allergic to it.

Ultimately, when a woman is trying to conceive, she must always consult her physician before taking any medication, even over-the-counter ones. If she has doubts, talk to a pharmacist or seek a second medical opinion.

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