Aspirin for in vitro fertilisation

Area of Science:

• Reproductive Medicine
• Pharmacology

Background:

• Aspirin is frequently used to enhance live birth rates in assisted reproductive technology (ART).
• Evidence for aspirin's efficacy and safety in ART is inconsistent.
• Optimal timing and duration of aspirin therapy remain undetermined.

Purpose of the Study:

• To evaluate the effectiveness and safety of aspirin in women undergoing ART.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) involving aspirin for women undergoing ART.
• Data extraction and risk of bias assessment by two independent reviewers.
• Meta-analysis of outcomes including live birth, clinical pregnancy, and miscarriage, with GRADE assessment of evidence quality.

Main Results:

• No significant difference in live birth rates between aspirin and placebo groups (moderate-quality evidence).
• Similar clinical pregnancy rates observed in both groups (moderate-quality evidence).
• No evidence of benefit for multiple pregnancy, miscarriage, ectopic pregnancy, or vaginal bleeding; evidence quality ranged from very low to moderate.

Conclusions:

• Current evidence does not support the routine use of aspirin to improve pregnancy rates in the general IVF population.
• No outcome measure demonstrated a benefit of aspirin for women undergoing ART.
• The possibility of adverse effects associated with aspirin use in ART cannot be excluded.