Anyone taken Aspirin while undergoing IVF. Advice welcome.

[Shellster52]

I usually start IVF with 2-3 follicles on each ovary. I took Aspirin for 2 cycles prior to Dec 2013 IVF and started with an amazing 15 follicles. I continued to take it throughout that cycle, only stopping for a few days before egg collection so I wouldn't heamorrage. Unfortunately BFN despite excellent embryo.

Cycles then went haywire and I read Aspirin can cause this so I stopped it but again only had 6 follicles on day 2 of IVF cycle of which only 3 responded, so I cancelled.

Am now taking Aspirin again in prep for IVF next cycle. I have read that it can interfere with implantation and have decided I won't take it after egg collection this time. Perhaps that is reason why embryo didn't implant last time? But I have read conflicting studies and can't decide if I should stop it at day 1 of my IVF cycle or continue until a few days before egg collection????

Did you take Aspirin during your IVF cycle and what was the outcome? Or do you have any knowledge on what would be the best choice?

My fertility specialist recommended taking 0.5 aspirin tablet daily to help implantation - his theory was that tiny clots when the embryo are implanting can block the blood supply and lead to early miscarriage (ie. failure to implant).

I haven't heard of aspirin affecting cycles or egg numbers...

FWIW, I took aspirin, but all our IVF embryos failed to implant (despite aspirin). I then fell pg naturally when taking an immune altering substance - as I have an autoimmune condition that attacks my own cells, let alone an embryo. I think I continued with aspirin for first pg, but not for second.

Best of luck, it is such a rollercoaster... highs when you get good numbers of eggs, or embryos, and lows when it doesn't implant.

Interesting that your specialist suggested taking Aspirin to help implantation. I have read one article that suggests the opposite! And since I took Aspirin last cycle after ET and it didn't implant, I am planning on not taking it after ET this time. Your IVF embryos didn't implant either while on Aspirin which gives me even more confidence that I am making the right decision not to take it... although hard to know the cause if you have other issues as well.

Can I ask, did you take the Aspirin from day one of your cycle until egg retrieval? This is the part that I am undecided on about whether to take the Aspirin or not. If you did, obviously the Aspirin didn't affect your embryo quality since you sound like you made it to day 5 transfer stage many times?

Thanks so much for your help.

Aspirin is quite short lived in your body, so maybe it would give you peace of mind not to have it whilst doing the egg stimulation and then decide on taking it after egg pickup. Has your specialist got any advice on it all?

For me, I think my immune system was "kicking in" and preventing pregnancy, but to me it "makes sense" about clots leading to less likely implantation - it's very hard, when all you want is one to stick and thrive... wishing you the very best of luck.

Thanks so much for your well wishes Jenny and taking the time to reply.

Yes it does seem to make sense about clots leading to less likely implantation. However as I stated above, I am confident in my decision about not taking Aspirin after egg pick up based on:

• my last IVF cycle was not successful after transferring excellent embryo and taking Aspirin after transfer
• research shows that it actually interferes with implantation sites.google.com/site/miscarriageresearch/how-to-boost-fertility

I am just really wanting help in deciding if I should take it or not during the stimulation phase of IVF. I am undecided because

• one study shows it doubles egg quantity

www.fertilethoughts.com/forums/i-wish-someone-had-told-me/382990-aspirin-may-boost-numbers-eggs-retrieved.html

• yet other information says it reduces follicle growth

sites.google.com/site/miscarriageresearch/how-to-boost-fertility

Just pasting the links to this info in case it helps someone else who is trying to research about the pros and cons of Aspirin

Hi Shellster. I took aspirin from EC onwards on all 4 of my cycles.

The results were:
mc
chem preg
chem preg
current pregnancy

My clinic doesn't recommend it before EC as it could increase bleeding during the procedure.

Hi, I'm not sure if you've started yet and made your decision already but I thought I'd share my experience just in case it's useful!
I've had 2 shots at ivf. The first without aspirin - on first scan after stimming (7 days?) follicles had grown quickly (only 2 though) and actually one was considered too large at 25mm.

The second time I had been taking aspirin for about a month as I'd read the study about increased quantity of follicles and at the day 7 of stims scan, the follicles were much smaller (2 at 10mm and 1 at 14mm). Could be nothing to do with the asprin but the difference was interesting. I wonder if growing the follicles more slowly would be better... sadly never got to the transfer stage though.
Best of luck to you x

eurochick, I remember you. Glad to hear everything is still going well. Didn't know you were taking Aspirin at the time though. Interesting you took it and got your pregnancy. I just followed another lady on here who stopped it after EC and got her pregnancy - two opposite things and both a BFP - making me more confused! Think I will stick to my guns and not take it this time after EC since I got a BFN when I did take it last time. Thaks for the tip about bleeding during EC. Will definitely stop Aspirin 6 days prior.

Zippy, thank you so much for taking the time to comment. You took it in the lead up to egg collection which is the part I was undecided about. Interesting that it slowed your growth. Haven't read about it doing that. Just reviewing my history and perhaps the Aspirin caused that for me too...

NON ASPIRIN CYCLE
Day 8 Right: 14 13 Left: 12

ASPIRIN CYCLE
Day 8: Right: 10 8 7 7 5 5 Left: 8 6 4

Can't recall if I changed my injection drugs / dose and perhaps that could also be a reason? Did you change anything else or do you feel it was deinitely the Aspirin that cause this?

Anyway, went for day 2 scan today and have 13 follicles instead of the usual 6-8. I figure it makes sense that if the Aspirin is getting more blood supply to ovaries so they have produce more follicles, then I should continue it so that more blood supply will continue to my ovaries as I start injecting my blood with FSH tonight to get the follicles growing.

FYI, I notice you only had two follicles during 1st IVF and then only 3 the 2nd IVF despite taking Aspirin. After my Sep 13 cycle failed, I started Aspirin for one cycle and still only had 6-8 follicles at my next day 2 scan. I was so upset. Aspirin doesn't work for me. I waited another cycle and had 15 follicles at nextday 2 scan. Couldn't believe it. So it seemed to need two full cycles for Aspirin to take effect. Not sure where you are at on your journey but just wanted to share in case you are attempting IVF again.

So sorry to hear you never made it to ET. I have 5 prior IVF attempts and only two transfers so I know the heartache. Have tried to stay practical and research things to improve quality and each IVF shows definite improvement. Can give you the info if you are interested but will stop now as this is starting to become a novel!

Hi Shellster
Sorry it's taken me an age to respond. That's brilliant you've started the cycle with 13 follicles and you are well under way with the stimming now too! I had actually read your post about it taking 2 months of asprin to notice a difference in quantity. If it hadn't meant cancelling a holiday I would have delayed my last ivf by a month just to see if asprin for that term would have the same effect on me. It's such a numbers game!

I'm not sure where I'm at with it all at the moment and what the next steps are but if/when I try again I'll definitely try asprin for longer prior to it.
Fyi my drug dose was larger on the second round (450 instead of 375) but my diet/ supplements were the same, the only difference being the asprin, so I'm fairly sure it was the asprin that caused the slower growing follicles... (unless of course I'm on the brink of menopause and this is one of the side effects )

Please do share any tips you have on improving quality etc. The more I can do to improve my chances, the saner I feel. So much of this is out of our control. Best of luck with your ec and keep in touch. I'm so hopeful for you x

Where do I begin ZippyBopit... I have pages of info on improving your chances. Will put it in short point form here and you can ask more about the ones that interest you. I can then point you to the website / book where I read the study:

-Calculate volume of ovaries. If hnormal size but poor follicle count, it CAN be improved with Aspirin.

• Ensure vitamin D is in optimal pre conception range of 100 to 150 pmol/L

• Take Dhea. 25 patients, who underwent cycles both before and after DHEA supplementation, demonstrated significant increases in fertilized oocytes , normal day 3 embryos, embryos transferred and average embryo scores per oocyte after DHEA treatment.

• Daily femoral artery massage

• Take 16 grams of l-arginine from day one until at least one follicle >17mm in diameter is present to reduce cancellation rate from 76% to 11%, to increase the number of oocytes collected from 1.6 to 4.1

• Ensure optimal estrogen growth rate of 0.31 to 0.41

EGRs of 0.31 to 0.41 were associated with optimal pregnancy rates.

• Studies have suggested that DNA fragmentation rates can be improved by frequent ejaculation (once a day) for at least 5 consecutive days (preferably longer) before egg collection.

• Eat high protein / low carb diet for 3 months prior to IVF.

Patients were categorized into 1 of 2 groups: those whose average diet was more than 25% protein (n= 48), and those whose average diet was less than 25% protein (n= 72). There was no difference in average body mass index between the 2 groups (approximately26 kg/m). There were significant differences in IVF response between the 2 groups. Blastocyst development was higher in the high-protein group than in the low-protein group (64% vs 33.8%; P

Definitely try estrogen priming protocol as research shows increased oocytes retrieved and increased good quality embryos in poor responder patients.

Shellster that's very interesting about the effect of protein. I've heard of people being told to take it during IVF, but never in the lead up.

I generally have quite a low protein diet (I love carbs a bit too much). I wonder how much that influenced my earlier cycles.

Makes sense to take it in the lead up to IVF as well as during, because they say the eggs are preparing for 3 months, not just during the stim phase. Like you, I was eating heaps of carbs and being vegetarian, not much protein. I am now starting every day with a protein shake and shoving fish down my throat daily (yuck!). The things we do.

You did get pregnant off your first cycle though didn't you? Anyway, who cares - you have your beautiful baby growing inside you now! I hope I am not far behind you. If this cycle fails, I feel like I have nothing new left to try and I don't know how I am going to cope.

I took aspirin in two IVF cycles with donor eggs. The second was successful and I have a beautiful 6mo DS now.

The first (unsuccessful ) cycle used a fresh embryo, the second time frozen and I also had an endometrial scratch.

Good luck x

I did, but mc'd. The 4th cycle resulted in current pg.

I had the scratch on the 4th cycle.

I wondered if the scratch was the difference when you got pregnant on your 4th cycle. I wish they offered that here. I watch everyone else on here doing that as a routine start up to their IVF but I never hear of it in Australia :(

I wonder too. Not sure if my earlier failed cycles were down to poor embryos or a Teflon womb! The scratch seemed worth a go anyway. Do no Aussie clinics offer it?

Shellster you are such a sweetheart to share all that info, thank you x

All very interesting and much of it actually touches on things I have come across myself but haven't come to a firm conclusion on. I can get a bit lost researching things on the internet! It's so difficult to know what's proven to be beneficial and out of that, what will work for you. I'm wary of bombarding my body with too many supplements as I'm not sure how they'll interact with each other.

At the moment I take a pregnacare, a COQ10, the occasional B complex and a spoonful of maca powder in my morning porridge every day (read it was good for egg quality & balancing hormones for ttc naturally...who knows). I used to take royal jelly & bee propolis but they ran out and I'm undecided so have never gotten round to replacing them.

The l-arginine is interesting. I had looked into that before but for some reason decided against. I may investigate again. Do you just take that during an ivf cycle or every month?

DHEA, do you take this? I would really like to give this a shot but as it's not licensed in the UK, I would have to buy it online and I'm nervous that I wouldn't be getting the genuine thing... I'll probably bite the bullet though and give it a bash.

The protein thing is very interesting. I am a fish eating veggie but very aware that I mostly eat carbs over anything else! I was really making an effort for a long while to up my protein intake and also eat lots of avocados (heard they were the bees knees), but after this last failed cycle I've thought sod it and I'm having a break from it for a couple of weeks I've eaten crisps for the first time in ages (love crisps!) and even had a couple of glasses of wine for the first time this year. It's felt quite therapeutic after being so focussed and strict with my diet for so long

Please tell me more about the estrogen priming protocol and your experience. I've read some very positive reports for poor responders like me and I'm quite excited about trying this protocol at some point. I have my review appointment at the end of June and although I know my clinic doesn't use this protocol (it's NHS so perhaps they are restricted) I'm wondering if it's something that I would be able to persuade them to do considering I would be self-funded. I'm quite hopeful that I might do better with it than just the flare protocol.

How are you doing anyway? Sorry for the essay. Where are you with it all, are you nearing ec? It's an emotional process so I hope you are hanging in there and looking after yourself x

Also Euro hi, I met you a long time ago in the 10+ thread and just wanted to offer you a massive congratulations particularly after the gloomy prospects you had at transfer. I find my fc's so depressingly negative, but stories like yours give me the strength to challenge their opinion and not just hang up my ovaries and call it a day . Really thrilled for you x

Thanks Zippy. I hope you will get your bfp very soon.

Yeah, you have to decide what is right for you with all the supplements. These are all things that have been researched on groups of women undergoing IVF and the studies show they increase the odds. That being said, I recall doing IVF in Dec 13 and I started an IVF thread on here. I had done everything right as per research and the other 3-4 girls were all doing IVF for first time and had no clue about supplements, diet etc. I felt like I was in with the best chance and then everyone got a BFP but me! So there are no guarantees. But I have seen definite improvement over each of my IVF's and the last one, I am sure the baby started to implant as I felt implantation cramping and a very new tingly sensation in my uterus on exactly the right day. So close.

I take 1mg L-Arginine in morning and 1mg at night every night and increase it to 8mg in morning and 8mg at night from day 1 of an IVF cycle until egg retrieval.

Yes, I take DHEA. I brought it on the internet too which probably isn't the safest way to know you're getting the right thing. But I am desperate!

Here's a link for the estrogen priming protocol research that I read which made me insist on giving it a go...

ivf.ca/forums/topic/13713-best-protocol-for-egg-quality/

My experience with estrogen priming...
I only got one/two eggs for first two IVF's before EPP, and have had 5 and 6 eggs collected my last two EC's while doing EPP. Of course, I have been doing all the other things I listed above so I don't know what is the main help.

Do you have any scans at home Zippy that show the size or measurements of your ovaries? Is it rude to ask your age?

Oh, forgot to answer your last Q. I am currently on day 12. Going to get ready for a scan now and hopefully EC in two days time.

Hi Shellster, that is a far more detailed description of the estrogen priming protocol than I've seen in any of my internet wanderings, very useful thank you. I'm not sure what my fsh levels are though. I think I had it tested before my referral to the acu but that was over 2 years ago. They don't test it again. They just offer IVF and keep you in the dark about everything else

I read on another thread you'd decided not to go for ec? I hope you're doing ok, I'm sure it was a tough call. It's a shame when you'd had so many follicles for them not to all grow at the same time (grrr!) but it sounds like you've made the best choice. I hope you have a lovely break and maybe sneak a wee miracle conception in while you're away?! You just never know...

Oh, I'm 39. My right ovary (that never shows up to the party) looks a bit small (found that out on last scan), but the left one is ok (wasn't given measurements). I'm concerned I have endo as I have some symptoms and lots of my discomfort and pain is on my right ovary and surrounding area... worried endo could cause premature ovarian failure . Anyway that's another discussion...

Thanks too for sharing your stats in favour of the estrogen priming protocol. It's so great to hear 1st hand results like this and really gives me hope for myself for a future try.

Yes, my Dr decided that with 14 starting follicles and yet only 3 matured, that is not usual and I could get more eggs another cycle with a better chance for all the $$$$ it costs.

I feel like a hypocrite because here I am telling you all these things that get you a great outcome - and I have a crappy outcome! I think I have found the reason though (in case this is any use to you in future attempts):

When I first tried EPP, I only started with 8 follicles yet a whopping 5 of them responded. Previously only 1 or 2 responded so I saw first hand that EPP works wonders.

I then read like you, that Aspirin increases follicle count and took it in the lead up to and during my next EPP IVF. I then started with 15 follicles but only got 3 mature eggs. This current EPP IVF I also started with 14 follicles yet only got 3 mature eggs. What's going on? I had taken Aspirin in the lead up to both of these IVF's to start with more follicles - and it worked because I usually only have 5-8 but these cycles I had 14 and 15. So I am starting with double the follicle count but I am getting less mature eggs.

But yesterday I just read a study showing that Aspirin actually inhibits the follicle growth which backs up your experience, and now it makes perfect sense why I am starting with double the amount of follicles yet getting less eggs, despite doing EPP. In the study, the women not taking Aspirin got more eggs than those who did!

So for my next IVF, I am planning on taking Aspirin in the lead up to IVF to start with more folliicles, but then stopping during the stim phase of the cycle so the follicle growth is not inhibited and the EPP can do its miraculous job. Argh, its so frustrating having to wait while I continue to age but I find staying practical like this helps me get through it.

I totally get how you are so fed up and crabby. I am in Australia so a different system to you but I have found the same thing. None of the doctors really care and I think that's why I've started doing so much of my own research and taking charge of my IVF cycle.

Did you get a day 2 scan with your first two IVF's to know if there were more follicles that didn't respond or were there just two follicles each time to begin with? I assume part of you is planning on pushing forward with another IVF and that is why you have the appointment at end of this month and continuing the supplements? Are you taking Aspirin? I plan to have a one cycle break and try again following cycle - mid July. Would be exciting to be doing it at the same time! Most women on here get 15 eggs and makes me feel like I have no hope. So would be nice to tag along with another 'poor responder'.

Hi Shellster, I was just going over this thread to see if I should start incorporating aspirin into a non-IVF cycle and saw your fish complaints. I'm newly vegan, but I've been vegetarian since I was 13, so the high protein thing is definitely something I've been mindful of as well. If you wanted to ditch the fish, you might want to take a look at a list put together by the No-Meat Athlete. He's really thorough, breaking down everything by actual quantity of amino acids per cup/serving of foods. I've found him pretty useful in any case.

Emma, nice to find other enjoyable sources as well so thank you so much for the link. I had a look. So you are aware of the high protein diet being beneficial as well. Did you do it in the lead up to this current IVF? Just curious because the study says a diet of > 25% protein and < 40% carbs gets 50% of embryos to blastocyst so I am curious if that was true in your case.

Did you come to any conclusion on the Aspirin?

Hi Shellster, I wasn't aware of that study, I just try to make sure that sort of percentage gets on my plate at least once a day as part of a healthy diet. I actually really just make a vegan 'bowl' out of every meal, which consists of one wholegrain, one protein, at least two-three veggies and a sauce -- the grain tends to be brown rice or quinoa (high in protein), beans or tofu (high in protein), very often some variety of broccoli/peppers/kale with sweet potato (all high sources of vegetable proteins), and our favourite sauce is miso/tahini/nutritional yeast/lemon. I'm getting the carbs, but everything else contributes some form of amino acid to ensure we get a complete balance. We have this about three times a week, IVF or no!

We did get to blastocyst, though, and we had a 4/B+/4, which our embryologist called 'excellent' in terms of quality, so perhaps that's why!

I'm not sure about the aspirin; mostly, I'm not sure when I should be taking it in a non-IVF cycle for the maximum benefit. The IVF cycle is so long, whereas a non-IVF cycle for me has only about 14 days till ovulation. Would I take it until say day 10, then stop, track my ovulation, then start again? I'm struggling to work out how to translate the timings.

But it's worth a shot, right? Anything that gets us closer is worth a shot.

You sound very very healthy Emma. Surely that must put you in with a better chance for IVF success. Perhaps once that fibroid is removed? Was it ever given as a cause for your miscarriage? You say 'our favourite sauce'. Must be easier if your partner likes this healthy food too. My hubby is a shocker - and he is the reason for our fertility issues which I am sure is no coincidence.

The only reason I take the Aspirin is for my IVF cycle. Without it, I start IVF with 5-8 antral follicles. The two times I took it in the lead up to IVF, I started with 15 and 14. I haven't researched what benefit it is in a natural cycle? The one thing I do know is that when I took it continuously, my cycles started going haywire. I then read that Aspirin inhibits ovulation. For my IVF protocol, I need to ovulate the cycle before IVF, so my next cycle is going to be an experiment to see how many days before ovulation I need to stop it to still ovulate and then start it again. Will report back to you with what happens and you will have to let me know how you go.