Baby Aspirin in Pregnancy / Recurrent MC - Conflicting Advice

[PurplePansy05]

Hi all.

I'm expecting again (4th pregnancy) after 3 MCs. I had all the basic tests at a Recurrent Miscarriage Clinic, came back good, no identified issues. DH was tested too, no issues. Supposedly we've been unlucky to date.

I have also been in touch with the Coventry clinic re NK cells tests. Obviously can't have the biopsies now that I'm pregnant.

I'm on Cyclogest, prescribed by my NHS consultant and also endorsed by Coventry.

However, I've had contradicting advice regarding use of baby aspirin (75mg) daily. My NHS consultant said that it "won't do any harm" and that if I want to take it, I can get it over the counter. She said she's not sure it will actually help considering I have no thrombophilia-related issues.

Coventry said they don't recommend using baby aspirin at all before 10 weeks.

I'm now just over 4 weeks and in a real pickle. I only had one thrombophilia blood test which came back fine, but I read they should be done twice with a 6 week gap. I'm now paranoid the result may have been wrong. I do get lots of clots during AF, I told my NHS consultant but she didn't put me through another test. I'm confused.

Then I read lots of empirical evidence re baby aspirin, overwhelmingly positive, but again you just don't know the actual position of a stranger online. I haven't actually seen much on this topic regarding the risks.

I am obviously very cautious after multiple losses, but also don't want to avoid doing something that might help. I don't want a fourth loss.

So my questions are, to those of you who had thrombophilia blood test, did you all have two tests?

And to those of you who had no identified clotting issues, what advice have you been given regarding baby aspirin, please?

Are there any scientifically confirmed risks of use the 75mg dosage in early pregnancy (so for a short period of time) to mother and/or baby?

Thank you in advance xx

Hi @PurplePansy05 we've spoken before I think. Congratulations.

I was given similar advice re aspirin and was specifically told by professor Brosens at Coventry to not take it, so I took the cyclogest only in my 4th pregnancy and sadly I had another mmc (not to scare you, just sharing my own experience) - nothing to do with the cyclogest as I've had 2 other mmcs so the cyclogest didn't mask the miscarriage and I actually bled quite heavily on it.

I think you only need the thrombophillia bloods again if your first shows a positive or inconclusive result, so I wouldn't worry about that.

The frustrating thing I've found is that some recurrent miscarriage clinics seem to try things like aspirin or clexane even if there's not clinical reason to. Mine offered nothing, the only reason I got the cyclogest was because I'd been to the implantation clinic and got normal results, so they said try it.

I have since been to see a private clinic and part of my standard protocol I'm taking baby aspirin now (not pregnant yet). I have been diagnosed with aggressive nk cells, so am on other medication too, but the specialists view was that baby aspirin isn't going to harm.

Baby aspirin used to be the standard recurrent miscarriage protocol and I was asked by my epu if I had taken it as 'that's what we used to tell everyone'.

I know a couple of people who only used cyclogest in their 5th pregnancies after having no reasons for previous losses and they both have their babies and the prism study supports the use for recurrent miscarriages.

Best wishes xx

I was in a very similar situation - I also went to Coventry after three miscarriages. They found that I didn't have elevated NK cells, but prescribed me cyclogest. I had already been to the recurrent miscarriage clinic at my local hospital, who found nothing (I'm reasonably certain I only had the thromophilia test once but I think that was standard?) but told me to take aspirin. When I got pregnant a fourth time I did take both, despite Coventry saying not to take the aspirin - I can't really remember why I did that now, I guess I wanted to try everything. I had DS, now 2.5. I'm now 31 weeks pregnant with my second, and in this one I took aspirin but not cyclogest. This one is an not-quite-unplanned-but-certainly-not-really-trying pregnancy, in very stark contrast to DS, so I hadn't spoken to anyone about trying again and what to do first, which is why I bought the aspirin as a 'might as well' but didn't talk to anyone about being prescribed cyclogest. But that's all just more anecdote!

I did quite a lot of (obsessive) research when going through it all to have DS and my understanding is that the efficacy of aspirin in recurrent miscarriage is unclear but the safety of taking aspirin in pregnancy is well established - they tell a lot of women to take it for a lot of different reasons - which is why they take such a 'might as well' attitude to it in many clinics.

Wishing you the absolute best - it's a horrible thing to go through.

I've been having 150mg since 8 weeks.
Previous pre eclampsia.
On midwife advice.

Hello @VenusStarr, we did speak before, I remember! Thank you so much for taking time to respond to this, we're very much in a similar boat from what you've described.

I am so sorry about to hear about your fourth loss. I really hope your current protocol will balance the NK cells and allow your next pregnancy to progress without the need to endure any more pain and loss. Sending you lots and lots of strength xxx

I have to say, I am leaning towards taking it because it is such a small dose and it would only be taken for a short period of time. As you say, it used to be part of the standard protocol. I had a look at other countries too and in the US it's routinely taken BUT from 12 weeks onwards.

I will email my RMC to confirm their view on this. It's such a minefield, isn't it, you don't want to do anything wrong, but you don't want to miss out on something so easy that might just help.

Tbh, I was shocked when I heard I had no clotting issues, I somehow suspected they'll come back with an issue based on my AFs. But no. I understand you've not had any clotting issues diagnosed either, in addition to NK that you've mentioned?

Wishing you SOOOOO much luck, I really do. You're not alone! Xxx

@Hardbackwriter Wow, our stories are very similar! Thank you for responding, it means a lot. Congratulations on your healthy pregnancies and your little boy. I definitely feel just as you've described, I want to try everything possible, but do no harm. I'm a researcher too, I've read so much on pregnancy loss, probably too much, tbh! I know exactly what you mean. Best of luck for the remainder of your pregnancy, I hope you're feeling well xxx

Hi All! Thought I'd share my latest news, I had my 12 week scan and a private NIPT test and we're expecting a healthy baby boy 💙 I'm 12+5 now and ovee the moon. I have no idea if baby aspirin has helped, but I'm sticking to it and will do the same again going forward. For the first time there's some hope out there 🌈

@PurplePansy05 that's such fantastic news. I've had 4 mc (3 in a row since dd). My health Trust said they'd prescribe progesterone next time (if there is one) I've read really positive things about baby aspirin so will also probably try that too.
Wishing you a very healthy rest of pregnancy

Oh @Jeds55 that's awful. I have no DCs yet, I'm hopeful everything will go well now and we'll take our son home 💙 Re baby aspirin, have you been tested yet for thrombophilia/APS? My results came back fine but I never fully shook off a suspicion that I may be developing APS in pregnancy. I read a lot about this and unfortunately NHS doesn't normally test early on in pregnancy so it's very difficult to detect. For me it was between that and NK cells which I was about to get tested privately for, but this pregnancy happened and here we are. I hope you've been referred to an RMC and getting good care, v happy to share my knowledge so far if needed 💙 Wishing you all the luck in the world 🌈 xx

Thanks @PurplePansy05 I've been referred to RMC but I was warned that it's taking ages atm. It's complicated further by the fact I've moved out of the area completely. Tbf we haven't tried for a while (supposed to start this month but petrified) but if it happens again I think we'll pay privately for tests as I'm 39 now so running out of time. It's heartbreaking that so many women go through this and never get any answers. I can't help but think that if it was men actually carrying the baby there would be a lot more support/earlier diagnosis.

I'm taking vitamin D, folic acid and my iron atm. Did you take any other supplements?
I hope the next 6 months fly by for you x

@Jeds55 Thank you. I completely understand, I had to wait 5 months for my RMC appointment.

I am currently taking 5mg folic acid, progesterone (pessaries 2x400mg daily - Cyclogest), baby aspirin (75mg daily), Seven Seas pre-conception vitamins (but not the pregnancy ones as they have Vit K which is no good if you try to thin your blood with aspirin) and iron every other day. Seven Seas have 100% daily dose of Vit D in them so I'm not taking extra over and above this.

If I were you, I'd do exactly that, run them privately if you can. Very best of luck to you xx

Just to add, pre-conception I was only taking folic acid and Seven Seas pre-conception, nothing else xx

@PurplePansy05 I'm so happy I come across this post! I've also had 3 miscarriage in a row, I have no DC currently. My third MC was last month, I contacted my GP but I have been told it may take a while for testing. I'm going to try again this cycle though and have been considering taking small dose aspirin but was worried if it would so any harm when I haven't had any tests done. After reading this thread I'm tempted to try. Anyone know when I would start taking it? I read somewhere that some people take it from ovulation? Which in my case is over the next few days

@PurplePansy05 oh and congratulations on getting to 12+5 ☺️ what an amazing feeling it must be ❤️ x

@lockdownbabyx It's a personal decision. I would say if you start taking baby aspirin daily now and you're waiting for your tests it might affect your APS test results. I personally waited for tests, they were clear, but my NHS consultant recommended progesterone and said taking baby aspirin 75g daily won't do harm. Another private consultant said from 10 weeks because it may affect implantation apparently. I looked for that evidence and couldn't find it. I decided to follow my instinct and took it from BFP daily. I don’t think I'd take it without any medical consultation at all though personally. FWIW my midwife at 12 week scan said that I should safely continue on it until 36 weeks as it reduces the risk of pre-eclampsia and second term MC. I am waiting for final advice on this from my RMC consultant. Good luck to you, it's a horrid place to be, stuck between a rock and a hard place, I've been there for nearly 2 years myself xx

@PurplePansy05 I'm on the waiting list and have been told it is a long wait, I want to try again this cycle though so I'm undecided if it's worth a go or not. I read a lot about it and there seems to be no evidence that it would cause any harm.
The thing with me is I seem to fall pregnant really easily, each pregnancy has been on the first cycle trying but I'm yet to get past 7 weeks.
I think il continue to research up until I get a BFP and just see what my gut tells me 😊

@lockdownbabyx Get yourself to the Coventry clinic for an NK biopsy privately too if you can, this sounds like a potential implantation failure, but you'd need to be checked over. It's so hard because it could be a random event or a number of events too. At least you could exclude NK cells if they come back fine. If they're open now they can run it swiftly for you within 7-10 days after ovulation but you can't TTC for 2 cycles. Good luck 😊 Xx

@PurplePansy05 I'm looking into going private, I may give it one last go without aspirin and then go from there. I ovulate in a couple of days so I may aswell. It's odd because each of my pregnancy's have been different. The first I saw the heartbeat at 6 weeks and then miscarried a week later. The second was a pregnancy of unknown location and had to have methotrexate as my HCG levels were rising but slowly. Last month I had a chemical. So I'm really clueless and not sure if they're all connected in some way. It's so hard. Thank you for your advise though, it's really helpful ☺️

Thanks @PurplePansy05 that's very useful advice. Totally didn't know about vitamin k and Aspirin so would have definitely made that error. Will chat to partner about going private if we are not successful

@lockdownbabyx sorry you're going through this too. I'm due to ovulate in next few days too so hope this is a lucky month for us both

Got my BFP today at 10dpo, hope this is a sticky bean 🤞🏼. How are you all getting on? Xx

Huge congratulations @lockdownbabyx
Had BFN today @ 12dpo and now got usual pre af spotting so am definitely out this month. Feel bit crap but expected it really.
Did you /will you take the aspirin?

Oh sorry, just read above post again and saw you said you won't try aspirin this cycle
Got everything crossed for a sticky bean for you

@Jeds55 thank you! I actually ended up taking aspirin everyday from ovulation, and will continue to take it until I'm told not to. I did a lot of research and spoke to EPU who advised that it wouldn't cause any harm to try. At this point I will try anything to prevent another loss ☺️ xx

@Jeds55 also sorry to hear about your spotting, hoping it's just implantation for you 🤞🏼xx

I feel the same as you re willing to try anything to avoid another loss. I will try aspirin if get pregnant again, seems there's no reason not to.
Thanks, we only dtd once so was a long shot this month! Telling myself to use this month to lose a bit of weight so it's not all wasted.