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Response: Aspirin to improve IVF unexplained implantation rates: time for an individualized approach

Published:September 20, 2013DOI:https://doi.org/10.1016/j.rbmo.2013.09.009
      To the Editor
      The letter by Nikolaos Vlachadis et al. (this issue) raises an interesting point of view.
      However, the most recent Cochrane review (
      • Siristatidis C.S.
      • Dodd S.R.
      • Drakeley A.J.
      Aspirin for in vitro fertilisation.
      ), which included 13 randomized studies with 2653 participants, showed no difference in live birth rates and clinical pregnancy rates with use of aspirin compared with control.
      An individualized approach rather than a blanket approach to treat patients with implantation failure with adjuvant therapy (aspirin or heparin) is certainly the way forward. A prospective randomized control study should be undertaken to see if women with inherited platelet thrombophilias will benefit from aspirin treatment to improve implantation. At the moment, this is a theory which has to be translated into clinical evidence (
      • Akhtar M.A.
      • Eljabu H.
      • Hopkisson J.
      • Raine-Fenning N.
      • Quenby S.
      • Jayaprakasan K.
      Aspirin and heparin as adjuvants during IVF do not improve live birth rates in unexplained implantation failure.
      ). We think that there is an opportunity to undertake such a study where facilities are present to offer testing for inherited platelet thrombophilias.

      References

        • Akhtar M.A.
        • Eljabu H.
        • Hopkisson J.
        • Raine-Fenning N.
        • Quenby S.
        • Jayaprakasan K.
        Aspirin and heparin as adjuvants during IVF do not improve live birth rates in unexplained implantation failure.
        Reprod. Biomed. Online. 2013; 26: 586-594
        • Siristatidis C.S.
        • Dodd S.R.
        • Drakeley A.J.
        Aspirin for in vitro fertilisation.
        Cochrane database Syst. Rev. 2011; 10: 4832https://doi.org/10.1002/14651858.CD004832.pub3