KatCarney

Aspirin and Infertility
By Christine Schroeder, Ph.D.

Aspirin is a commonly used over the counter medication which has traditionally been used as an analgesic and fever reducer. In recent years, however, more attention has been paid to its anticoagulative properties. People with a history of heart problems often take a precautionary aspirin per day; individuals experiencing suspected myocardial infarction are also frequently given aspirin in the prehospital care environment..

Why is aspirin used in infertility treatment?

The anticoagulative properties of aspirin have also been studied in the field of reproductive endocrinology. Low dosage aspirin is a common treatment component for women who are positive for antiphospholipid antibodies. Recently, its use in a more general infertility population has also been studied.

Antiphospholipid antibodies (APA) are a class of proteins which appear to be related to coagulation problems. The presence of APA is formally diagnosed through a series of blood tests; however, one of the hallmarks of APA is recurrent fetal loss, often through disruption of placental blood flow due to clotting.

Because of its anticoagulative properties, aspirin reduces the risk of clotting; consequently, the blood supply between an APA patient and her fetus is more likely to remain intact. Most frequently, aspirin is given in conjunction with heparin, a powerful anticoagulant that works at another phase of the coagulation process.

The success of low dose aspirin in the management of APA-related disorders has led to a more general study of its effects on the reproductive system. The focus of this research is upon whether or not the anticoagulative properties of aspirin will lead to increased blood supply to the ovaries and uterus. If there is an increased blood supply to these areas, the reasoning goes, these area will receive a higher dosage of serum-carried hormones. As a result, the ovaries may be more productive, and the uterine lining thicker and more well-developed.

The research on this aspect of aspirin and infertility has yielded positive to mixed results. Several studies have shown improved results for pregnancy rates, endometrial thickness, and follicle development. However, in most studies, patients were not classified in terms of APA status, which leaves the effect of aspirin on the general population less clear. Thus, at this point, the results have been promising, but are not as definitive as those associated with APA.

I'm wondering if I should take aspirin. What should I do?

Despite the fact that it is an over-the-counter drug, aspirin should not be used lightly. Many doctors are fond of saying that, if aspirin were to be discovered today, it would only be available by prescription. Additionally, there are certain members of the population that should generally avoid aspirin. These include individuals allergic to aspirin, a history of gastric irritation or bleeding, and clotting problems.

What should a patient do? First and foremost, the bottom line is that YOU SHOULD NEVER TAKE ANY TYPE OF DRUG (not even over-the-counter) without the ADVICE AND CONSENT of your treating physician. In some cases, doctors may feel comfortable prescribing aspirin in an empiric or prophylactic manner, especially in women who have had multiple unexplained miscarriages. However, the applicability of this strategy will vary from doctor to doctor and patient to patient - it is not a decision that should be made unilaterally by the patient.

But I think my doctor isn't taking my concerns about aspirin seriously.

What if you think that you fit the profile of someone who would be helped by aspirin, but your doctor will not listen? It's important to ask him or her about their reasoning. He or she may have extremely valid reasons for not wanting you to take aspirin. On the other hand, if you as a patient feel that your doctor is dismissive of your questions about any type of treatment, including aspirin, the best solution is to seek a second opinion - not self medicate.

© 2001 The InterNational Council on Infertility Information Dissemination, Inc.

source: http://www.inciid.org/aspirin.html

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