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. 2008 Jul;90(1):71-6.
doi: 10.1016/j.fertnstert.2007.06.033. Epub 2007 Sep 24.

Evidence of absence or absence of evidence? A reanalysis of the effects of low-dose aspirin in in vitro fertilization

Marcus D Ruopp  1 , Tara C Collins, Brian W Whitcomb, Enrique F Schisterman
Affiliations

Evidence of absence or absence of evidence? A reanalysis of the effects of low-dose aspirin in in vitro fertilization

Marcus D Ruopp et al. Fertil Steril. 2008 Jul.

Abstract

Objective: To assess the conflicting evidence whether low-dose aspirin is beneficial in IVF and to evaluate the meta-analysis performed by Gelbaya et al. and reported in March 2007 in Human Reproduction Update, in which they found no effects of low-dose aspirin and recommended discontinuing its use in IVF. We present a reanalysis of the effects of low-dose aspirin in IVF and raise methodological questions regarding the analysis by Gelbaya et al.

Design: A meta-analysis of prospective randomized trials evaluating the effects of low-dose aspirin in IVF.

Patient(s): Women undergoing IVF/intracytoplasmic sperm injection.

Intervention(s): Low-dose acetylsalicylic acid (aspirin).

Main outcome measure(s): Pregnancy rates, implantation rates, miscarriage rates.

Result(s): Ten randomized clinical trials were included in the analysis. Clinical pregnancy rate per ET was significant when low-dose aspirin was compared with no treatment (risk ratio 1.15, 95% confidence interval 1.03-1.27). Nonsignificant estimates comparing low-dose aspirin with no treatment were found for implantation and miscarriage rates.

Conclusion(s): Our results suggest that aspirin may increase clinical pregnancy rates and that more data are needed to resolve the issue. At this point, there is no reason to change clinical management and discontinue the use of aspirin.

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Figures

Figure 1
Figure 1
Forest plot of the effect of aspirin versus placebo or no treatment on clinical pregnancy rate per embryo transfer in full analysis using fixed-effects model.
See this image and copyright information in PMC

Comment in

References

    1. Centers for Disease Control and Prevention (CDC) Assisted Reproductive Technology Success Rates: National Summary and Fertility Clinic Reports 2004. U.S. Department of Health and Human Services; 2006.
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    1. Gelbaya TA, Kyrgiou M, Li TC, Stern C, Nardo LG. Low-dose aspirin for in vitro fertilization: a systematic review and meta-analysis. Hum Reprod Update Advance Access. 2007:1–8. - PubMed

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