Low dose aspirin therapy is prescribed to women who experience pregnancy loss (eg, miscarriage or stillbirth), but still wish to have children. Aspirin is hypothesized to improve uterine circulation, thus increasing conception rates, though the effectiveness of this treatment had yet to be proven.
The Effects of Aspirin in Gestation and Reproduction (EAGeR) trial published in The Lancet investigated the rates of pregnancy loss among women over a 5-year period. Patients were randomized to either daily low dose aspirin and folic acid or placebo and folic acid. As the largest study of its kind, over 1,000 women with histories of prior pregnancy loss were recruited for this multicenter, randomized trial.
Among the aggregate of women, the rates of live birth and pregnancy loss were similar between the aspirin and placebo group; however, one subgroup of women – those who experienced a recent, single pregnancy loss –yielded higher rates of pregnancy and subsequent live birth in the aspirin treatment arm (78% vs. 66%). Overall, 58% of women in the aspirin group and 53% of the placebo group got pregnant and later gave birth.
The investigators noted further studies in this population are needed to evaluate if aspirin might help improve fertility in other subgroups, including women who can’t establish a pregnancy because the embryo fails to implant in the uterus.
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