Adjuvant Low-dose Aspirin Therapy in Poor Responders Undergoing in Vitro Fertilization: a Prospective, Randomized, Double-blind, Placebo-controlled Trial

Objective: To evaluate the effect of adjuvant low-dose aspirin on utero-ovarian blood flow and ovarian responsiveness in poor responders undergoing IVF.

Design: Prospective randomized, double-blind, placebo-controlled study.

Setting: University-affiliated teaching hospital.

Patient(s): Sixty patients classified as poor responders undergoing IVF.

Intervention(s): Supplementation with low-dose aspirin (80 mg daily) or placebo to a long down-regulation protocol.

Main Outcome Measure(s): Doppler measurement of intraovarian and uterine pulsatility index was performed before (baseline) and after ovarian stimulation (day of hCG administration). Duration of use and dose of gonadotropins, cycle cancellation rate, number of mature follicles recruited, and oocytes retrieved were also measured.

Result(s): High cancellation rates were found in both groups (33.3% vs. 26.7%, placebo vs. treatment). There were no significant differences in total dose of hMG used (66 vs. 57 hMG, 75 IU ampules), median number of mature follicles recruited (3.5 vs. 3.0), or median number of oocytes retrieved (4 vs. 3). No significant differences were found in either intraovarian or uterine artery pulsatility index measured at baseline or on the day of hCG administration.

Conclusion(s): Supplementation with low-dose aspirin failed to improve either ovarian and uterine blood flow or ovarian responsiveness in poor responders undergoing IVF.