Has the advice on aspirin changed? FET

[Purpleboon]

Hello, can anyone tell me what the current advice is for taking aspirin when TTC, and particularly in relation to doing a FET?

I remember taking it 2.5 years ago during my last (successful) FET and I think I took it through the entire process from CD1 due to a history of recurrent miscarriage.

This time round I've read that you should only start aspirin from BFP due to it potentially affecting implantation. When I asked the Dr he basically just said it was up to me and didn't seem to have a strong opinion on it.

What are the current guidelines for aspirin at your clinics? Transfer is next week and I'm not sure what to do!

Thanks X

My clinic gave me aspirin from iui, so conception. I’m in third trimester and still on it!

I have recurrent miscarriages and did my FET last week. I've been on daily aspirin since before I started my FET cycle. I did get a bfp. I'm on clexane too. But my protocol was done by my recurrent miscarriage specialist rather than my ivf clinic, but they didn't disagree with the protocol. Good luck x

Hey,
First FET (failed - ended in CP) I started aspirin on the day of transfer.
Second FET (failed - negative betahcg) I started aspirin before transfer (after period had ended).
I have just begun the third FET and I started aspirin after period and I must take until beta testing day.
I guess it depends on the doctor and on patient's history. I do have some clotting issues so I should be on aspirin anyway. We are still discussing whether we should switch to clexane after transfer.

Thanks everyone, sounds like you can take it right through then - and I'm sure that's what I did last time when I had success. At the time I had pieced together my own protocol from my personal research - wish I'd actually taken note of it! I was worried there had been a shift in the thinking since then.

Transfer is on Tuesday so I might start tonight, if I don't fall down another rabbit hole of research and confusion... X

Hi @Purpleboon interestingly I had this conversation with the professor at the implantation clinic yesterday. He wrote in my treatment plan that I shouldn't take aspirin.

I have been prescribed aspirin and heparin, I didn’t take it in my fresh and first FET, but took it in my second FET and I’m prescribed it for my current FET (I’m CD7), I’m prescribed it as I have an abnormal PA1 gene and the C4M2 mutation.

The professor has said that Thromboses do not cause implantation failure (a long disregarded misconception) but COX-2 is important for implantation (aspirin inhibits COX-2. Hence, there is no indication for aspirin . In pregnancy, aspirin is effective in preventing late adverse obstetrical disorders, like preeclampsia, but they don't recommend it in the first 7 weeks.

I asked if I should stop the aspirin, he said “my advice is to stop the aspirin, heparin has a number of actions, independent of its anticoagulant functions, that may potentially be useful. Starting on the day of transfer should suffice.”

I then asked if it’s normal to take just heparin without aspirin, he said “Heparin enhances the activity of heparin-binding growth factors, a number of which are mediators of implantation. No need to combine it with aspirin.”

So on his advice I've stopped the aspirin as I have recurrent implantation failure and if he thinks it's hindering rather than helping, it's best that I don't take it.

Thanks @Gardenlady543, that's really interesting. I visited the implantation clinic in 2018, and also saw the recurrent miscarriage team at UCLH around the same time, and do remember the different approach to aspirin (though I didn't probe it as you have done to get such a scientific explanation from the Prof regarding implantation etc.) I wish I'd used these consultations a bit more wisely to ask such questions.

Ultimately I have no clotting issues, or other known issues, and genetic testing showed my third miscarriage was chromosomal. I think that's why I basically just put my own protocol together last time, and decided to take it throughout (based on mumsnet success stories probably!).

Good luck with your transfer. X