Fertility Network UK

Still confused- to take asprin or not

Hi All.

I hope you are all spending nye doing something nice ☺

I wrote a post a while back asking for advice on whether or not I should take mini asprin for my next cycle.

I am on meds for my 5th ICSI cycle...i was hoping to have a natural fet but got very anxious when testing for my ovulation the past few months as it varied in timing so decided that as the only symptoms I have from meds are weight gain and headaches I'd stick to that.

We are on this journey due to my hubby having obstructive azoospermia. I dont have any issues and have now had all results from my blood works, hysterscopy, cavity scan, karotyping and dye test back...all of which are normal/good. I have been assured I don't have any blood clotting or sticking issues however the only advice I was offered at the recurrant misscarrage clinic was to take asprin and clexane however my consultant at the clinic is vehemently against it saying it can have a detrimental affect.....i did take it for my 3rd cycle which ended at 6.5 weeks (the furthest I've got)

I really don't know what to do....i feel like whatever decision I make if it fails or I misscarry I'll blame myself for the decision I make.

Please share your thoughts xxxx

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From what I understand, opinion varies from clinic to clinic so it may have to be a personal choice. If you're considering from the circulation perspective, perhaps try something like grapefruit or grapefruit juice instead. If from the immunology perspective, you may have to decide whether you think it could help, as this country as a whole clearly isn't at the forefront of tackling this aspect of infertility! Sorry that doesn't help much xx

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Thank you xx

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I wish you luck! I have had 1 MMC at 9 weeks from my fresh IVF cycle. Once I found out I was pregnant following a natural FET, my Consultant did agree to low dose aspirin, some blood thinning injection and low dose anti-inflammatories ‘just incase’. I haven’t been tested for anything regarding the whys / wherefores of miscarriage, but his view was that taking these things wouldn’t do me any harm if this offers any comfort.

It’s a tough call, as sadly everyone will have a differing opinion. That said, if you’ve been tested and these are not issues you have, if I were you I wouldn’t take them. But that’s because I am sick of pumping myself full of drugs that I don’t believe can be good for me long term and are making me chubby right now!!

What I understand is that genetic issues with the embryo are the biggest reason for miscarriage. Even if we have great looking blasts, not all of them will be normal and miscarriage is unfortunately the outcome in this circumstance. You are young however, so to the extent that has been an issue for you, you are incredibly unlucky.

I sincerely hope that everything works out well this time, but if it doesn’t you should ask to have the miscarriage / embryo tested (to the extent it’s possible). That may give you more information. I was offered this on the NHS when I had my MMC (ended up having a D&C), although the doc on the day didn’t read my notes and forgot to take it for sampling - added to an already awful day!

Another future consideration if you do further IVF is to have your blasts genetically tested. I plan to do this should we need another cycle given I have already miscarried.

I really don’t know how helpful this is for you, but this is my game plan to the extent it helps.

Try to remember none of this is your fault, and if you can, go with what your instinct is telling you to do.

I have my fingers crossed for you, x

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Hi hun.

Thank you so much for taking the time to reply, it means alot ❤

I would usually follow the advice of my consultant but the conflicting advice from the recurrant misscarrage Dr is what's so confusing.

Do you mind me asking what made them put you on thinners?

We have done alot of research into genetic testing on blasts but aren't convinced. We also spoke to the professor at Coventry who explained that of a 250 cell embryo they test 5, quite often they arent accurate. statistics show no increase in success so I have been put off tbh as there's a big risk that they won't survive the process.

The furthest I've got was 6.5 weeks, I misscarried at A&E on a Sunday night so sadly when the sack came out I wasn't advised to keep it for testing. I will insist on this in the future should I misscarry again.

Thank you so much...every doctor I've seen has said it's bad luck...surely bad luck can't go on forever, can it ☹

Xxxx

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I don’t mind you asking at all. I think it was as simple as that beyond genetic issues with the embryos, clotting and inflammation are the other common causes of miscarriage, but I could be wrong on that. I do have polysystic ovaries (not syndrome) which may explain the anti-inflammatories. I’m not sure he would have prescribed if I had not asked about it though.

My doctor isn’t convinced on genetic testing either, and certainly not on frozen blasts due to the risks of defrost, biopsy, refreeze then defrost. But he will agree to do so on fresh IVF. I have another post on his views on this you can read incase it helps (or not). I didn’t see the point in it originally as I thought at best we’d get 2-3 blasts and instead ended up with 7. Knowing not all will be normal (bear in mind I am at the wrong end of my 30s for fertility) means it’s a horrible lottery as to what will lead to a pregnancy and ultimately a baby.

It’s hard, but like me you have to take the positives that you and your partner can create a decent number of blasts and that you can get pregnant. As the doctors I have seen have said, it’s now a matter of when rather than if.

It’s a truly shitty journey, but whether it’s this time or next, it will happen. I keep having to tell myself this as we endure the long wait to see if this time is the time it works for us. If not, we have 3 blasts left, but I know further loss, disappointment and pain will not make it any easier to get ‘back on the horse’ so to speak.

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Thank you ❤

I too have polysistic ovaries (Not syndrome) and at my last follow up was informed that due to po making it likely you'll over respond I was given a trigger to limit this risk however this also doesn't support pregnancy so may explain my last misscarrage/chemical pregnancy. It's so hard to accept that should I not have been given this I may and it's a big may have continued the pregnancy.

I really hope so....my husband asked me to add a new years resolution to be more positive about this journey....i know there are alot of positives but can't help dwell on the fact that taking into consideration my good health and fertility health I shouldn't have had 2 failed rounds and 2 misscarrages in just over a year. But....you're right it hopefully is a matter of when not if (fingers crossed for us all on here)

Hope you had a lovely nye and are chilling today...im about to do some more research after a long run and gym session.

Xxxx

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Yeah, on my fresh IVF cycle I did overstimulate but only following transfer. Both embryos took and my HCG was sky high leading to moderate OHSS. Not uncommon in twin conception apparently if been through fresh IVF. Only 1 embryo had a heart beat at my 7 week scan. I’m sure it was most likely due to genetic abnormalities, but can’t help but wonder either what impact OHSS had as I passed out twice and was so sick and looked 5 months pregnant for two weeks!

I’m actually in Italy in a ski resort but not skiing due to unexpected positive pregnancy test before Xmas. Been walking in the snowy hills each day. Been lovely to be honest. Spent the day with my 13 year old niece. Have to take the good days where you can!

Well done on the run - great start to the NY!

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Ah wow sounds amazing 😁 hope you're enjoying the walks! Thanks for all of your responses, really appreciated.

Please keep me updated xx

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Ang I’ve had two failed ivfs and two miscarriages (natural pregnancies). We had karotyping and found that my husband has a chromosome translocation which makes us high risk of miscarriage. We asked for the karotyping through our ivf clinic. Just wanted to mention in case you, like us, turn out to be one of the unlucky ones who doesn’t just have one cause of infertility.

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Thanks for your reply. As azoospermia is linked to cystic fibrosis he had karotyping right at the beginning of our journey which came back normal. I had mine done after our 4th round which is also normal.

I wish you lots of luck and hope you get your miracle soon xx

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Glad you’ve had this checked xx

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My RE did not recommend it. However my OB suggested i take them so have been on them for past 2 months i think. However I have noticed that when i do my POI shots now i get a bit of bleeding. I may have to discuss with OB again. As others said maybe its a matter of personal opinion and preference. From what I have read low dose asprin cant do much harm

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Thanks Sandra...i did think that it couldn't cause harm but my IVF consultant was really against it and said there are studies which show it could have a negative impact....im damned if I do and damned if I don't aren't I. I'll blame myself whatever I so if it's unsuccessful or I misscarry. We've done so much research and are still in limbo 😑

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Oh my each clinic is different eh? My clinic recommends it. It’s so hard. All the best

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Thank you xx

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This is the big grey area! I have taken aspirin off my own accord in the past and pregnancy ended at 9wks with mmc.

I then visited Tommys in Coventry to discuss recurrent miscarriages and their latest research apparently shows that aspirin has a detrimental effect on the preparation of the womb lining so advise not to take it until pregnant, and even that they are not 100% keen on.

Some clinics recommend it and some don't and that's what makes it so much harder.

I have come back as borderline for sticky blood so now have clexane from just before transfer, but still yet to have a bfp that sticks around.

Such a hard decision to make. But for me Tommys are the leaders in miscarriage research so have followed their advice xx

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My clinic said quite definitely that it is no longer advised in pregnancy. Probably from the same research as the person above found from Tommy’s. This was very recent- in July they suggested it but in October when I was pregnant and asked about it, they said definitely not. So it would seem the advice is conflicting because it has recently changed. At the end of the day I would always do what my consultant advises, she is much better qualified to judge than I am and I trust that she is up to date with all the latest research.

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Hi All

So, today my husband and i called Tommys and was advised the following In an email after we explained our history and the extensive tests weve had;

Research does show that daily Aspirin (75mg dosage) can reduce miscarriage in women who have certain blood clotting disorders. These investigations for blood clotting disorders would usually be carried out after 3 recurrent miscarriages. There is no harm to mother or baby to take this dose of aspirin in pregnancy on the advice of your GP. I cannot guarantee you that this will ensure a full term pregnancy but is a precautionary measure in early pregnancy.

As you have been tested for Antiphospholipid syndrome (APS).This involves two separate blood tests looking for antibodies at least 6-12 weeks apart. Treatment with low dose aspirin in pregnancy is usually advised for those who have been diagnosed with APS – the NHS website on Hughes Syndrome (another name for APS) advises why aspirin is prescribed for women with an APS diagnosis.

So I have emailed my consultant again who I know won't be happy asking if I can have the APS test again as this was appx 9 months ago as Tommys advise to repeat it.

Baby 2016 - was it Tommys in Coventry or the uNK team that advised against it?

It won't help in my decision making if even Tommys are giving out different information 😒

Xx

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