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Hum. Reprod. Advance Access published online on January 18, 2009
Human Reproduction, doi:10.1093/humrep/den489
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© The Author 2009. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Low-dose aspirin and uterine haemodynamics on the day of embryo transfer in women undergoing IVF/ICSI: a randomized, placebo-controlled, double-blind study

Mervi Haapsamo1,3, Hannu Martikainen1 and Juha Räsänen1,2

1 Department of Obstetrics and Gynecology, University of Oulu, PO Box 24, FIN-90029 Oulu, Finland 2 Department of Obstetrics and Gynecology, Oregon Health Sciences University, Portland, OR 97239, USA

3 Correspondence address. Tel: +1 358-8-3152011; Fax: +1 358-8-3154310; E-mail: mervi.haapsamo{at}oulu.fi

BACKGROUND: Increased uterine artery (UtA) vascular impedance at the time of embryo transfer can decrease implantation and pregnancy rates in women undergoing IVF/ICSI. We hypothesized that low-dose aspirin decreases UtA vascular impedance on the day of embryo transfer in unselected IVF/ICSI patients when medication is started concomitantly with controlled ovarian stimulation. In addition, as secondary outcome measures, we investigated whether low-dose aspirin decreases the incidence of non-optimal (bilateral UtA PI ≥ 3.0) uterine haemodynamics and whether it affects arcuate, radial and spiral artery vascular impedances and endometrial thickness.

METHODS: A total of 122 women who underwent IVF/ICSI were randomized to receive 100 mg aspirin (n = 61) or placebo (n = 61) daily, starting on the first day of gonadotrophin stimulation. Doppler ultrasonography was performed on the day of embryo transfer.

RESULTS: Embryo transfer took place in 57 women in the aspirin group and in 56 women in the placebo group. UtA mean PI values did not differ significantly between the groups. The incidence of non-optimal uterine haemodynamics was lower in the aspirin group than in the placebo group (P = 0.03). Other secondary outcome measures did not differ between the groups.

CONCLUSIONS: In unselected IVF/ICSI women, low-dose aspirin therapy, when started concomitantly with controlled ovarian stimulation, did not affect UtA vascular impedance on the day of embryo transfer. However, the incidence of non-optimal uterine haemodynamics was significantly lower in the aspirin group than in the placebo group. ClinicalTrials.gov: NCT00683202 [ClinicalTrials.gov] .

Key words: uterine vascular impedance/Doppler ultrasonography/endometrial receptivity/assisted reproduction/low-dose aspirin

Submitted on June 23, 2008; resubmitted on December 15, 2008; accepted on December 18, 2008.


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