Low-Dose Aspirin and Sporadic Anovulation in the EAGeR Randomized Trial

Overview

Journal J Clin Endocrinol Metab

Publisher Oxford University Press

Specialty Endocrinology

Date 2016 Oct 19

PMID 27754808

Citations 10

Authors

Rose G Radin

Lindsey A Sjaarda

Neil J Perkins

Robert M Silver

Zhen Chen

Laurie L Lesher

Noya Galai

Jean Wactawski-Wende

Sunni L Mumford

Enrique F Schisterman

Affiliations

Soon will be listed here.

Abstract

Context: Among women with a single, recent pregnancy loss, daily preconception low-dose aspirin (LDA) increased the live birth rate with no effect on pregnancy loss. Ovulation is a potential mechanism underlying this effect.

Objective: We estimated the effect of LDA on the per-cycle risk of anovulation among eumenorrheic women.

Design: Multicenter, randomized, double-blind, placebo-controlled trial of daily LDA on reproductive outcomes. Preconception follow-up lasted 1 to 6 menstrual cycles (ClinicalTrials.gov, NCT00467363).

Setting: Four US medical centers during 2007 to 2011.

Patients Or Other Participants: Healthy women (n = 1214), age 18 to 40, were attempting pregnancy, had regular menstrual cycles (21 to 42 days), and had a history of 1 to 2 documented pregnancy losses, ≤2 live births, and no infertility. All participants completed at least 1 menstrual cycle of follow-up; none withdrew due to adverse events.

Intervention: Aspirin (81 mg) daily for 1 to 6 menstrual cycles.

Main Outcome Measure: Per-cycle risk of anovulation, defined as the absence of both a positive spot-urine pregnancy test and a luteinizing hormone (LH) peak (2.5-fold increase in daily urinary LH). Hypothesis formulation preceded data collection.

Results: Among 4340 cycles, LDA was not associated with anovulation (LDA: 13.4%, placebo: 11.1%; risk ratio = 1.16, 95% confidence interval, 0.88 to 1.52). Results were similar among women with a single, recent loss.

Conclusions: Daily LDA had no effect on anovulation among women with a history of 1 to 2 pregnancy losses. LDA may affect fertility via other pathways, and these warrant further study.

Citing Articles

Adiposity is associated with anovulation independent of serum free testosterone: A prospective cohort study.

Bloom M, Perkins N, Sjaarda L, Mumford S, Ye A, Kim K Paediatr Perinat Epidemiol. 2020; 35(2):174-183.

PMID: 33107110 PMC: 7878298. DOI: 10.1111/ppe.12726.

Sporadic anovulation is not an important determinant of becoming pregnant and time to pregnancy among eumenorrheic women: A simulation study.

DeVilbiss E, Stanford J, Mumford S, Sjaarda L, Kim K, Zolton J Paediatr Perinat Epidemiol. 2020; 35(1):143-152.

PMID: 32970334 PMC: 7854799. DOI: 10.1111/ppe.12692.

Low-dose aspirin in reproductive health: effects on menstrual cycle characteristics.

Evans M, Nobles C, Kim K, Hill M, DeCherney A, Silver R Fertil Steril. 2020; 114(6):1263-1270.

PMID: 32896390 PMC: 7722096. DOI: 10.1016/j.fertnstert.2020.06.022.

Aspirin or heparin or both for improving pregnancy outcomes in women with persistent antiphospholipid antibodies and recurrent pregnancy loss.

Hamulyak E, Scheres L, Marijnen M, Goddijn M, Middeldorp S Cochrane Database Syst Rev. 2020; 5:CD012852.

PMID: 32358837 PMC: 7195627. DOI: 10.1002/14651858.CD012852.pub2.

Antiplatelet agents for preventing pre-eclampsia and its complications.

Duley L, Meher S, Hunter K, Seidler A, Askie L Cochrane Database Syst Rev. 2019; 2019(10).

PMID: 31684684 PMC: 6820858. DOI: 10.1002/14651858.CD004659.pub3.

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