The Efficacy of Low-dose Aspirin Therapy for Controlled Ovarian Hyperstimulation in IVF-ET

Lee, Eun Sil; Lee, Sang Hoon

Abstract

OBJECTIVE
To evaluate the efficacy of low-dose aspirin on IVF outcome and endometrium in patients undergoing IVF-ET.
MATERIALS AND METHODS
From February, 2001 to Jun, 2001, 60 infertile patients were randomly divided into study group (28 cycles) and control group (32 cycles). The study group received a daily oral dose of 25 mg of aspirin for at least 2 weeks from first visiting day. Controlled ovarian hyperstimulation was initiated in all patients with the GnRH agonist starting in the midluteal phase of the previous cycle.
RESULTS
There were no significant differences in age of the patients, basal serum E2, LH, FSH level and endometrial thickness among two groups. There were no statistically significant differences between the study group and the control group respectively in dosage (26.5+/-4.8 vs 26.2+/-5.3 amples) and duration (10.4+/-4.2 vs 9.8+/-5.3 days) of gonadotropin administration, serum E2 level on the hCG administration day (1823+/-342 vs 1854+/-543), LH (14.5+/-2.7 vs 14.8+/-3.1), FSH (16.7+/-3.4 vs 18.3+/-4.7), the number of follicles p> 15 mm (13.2+/-6.3 vs 12.8+/-5.9), the number of oocytes retrieved (9.2+/-2.4 vs 8.4+/-1.7), the number of embryos transferred (4.7+/-2.0 vs 4.7+/-2.0), fertilization rate (68.4% vs 64.5%), implantation rate (21.3% vs 17.6%), and clinical pregnancy rate (28.4% vs 26.2%). The endometrial thickness and the percentage of endometrial trilaminar pattern on hCG day were significantly higher in study group than control group (12.9+/-3.7 mm vs 10.4+/-2.8 mm, 78.3% vs 64.5%).
CONCLUSION
Many reports suggest that low-dose aspirin improve ovarian response, implantation rate, fertilization rate, implantation rate, and pregnancy rate by increasing the blood flow, but we couldn't prove the significant effect of low-dose aspirin on the IVF outcome except on endometrium. This may be affected by dose of aspirin, duration, and number of patients studied. This trial is small, so our results highlight the need for a large randomized controlled trial to identify the effect of low-dose aspirin on IVF-ET outcome.