Abstract
OBJECTIVE: Aspirin, a simple, safe and inexpensive drug, might improve the effectiveness of IVF. Previous systematic reviews for aspirin in IVF have shown conflicting results. Performing a meta-analysis on individual patient data from each trial permits us to adjust for important variables, such as female age, and allows an analysis of differential treatment effects in patient subgroups. The aim of this IPD MA was to compare the effectiveness of aspirin versus placebo in IVF. DESIGN: Individual patient data meta-analysis. MATERIALS AND METHODS: A systematic search of the literature was conducted to identify randomised controlled trials examining aspirin in IVF. Authors of these trials were requested to send their original data. Treatment effect of aspirin was estimated with odds ratios (OR) and 95% confidence intervals (CI) using logistic regression, based on the intention to treat principle. The analysis was stratified for centre. We controlled for female age as well as interaction between age and treatment effect. RESULTS: Ten studies fulfilled the inclusion criteria. Three authors were not able to share data. We are currently waiting for two datasets. Therefore, five trials comparing aspirin with placebo in a total of 1060 patients could be analysed. Data on outcome or allocation were missing in 54 patients, leaving data of 1006 patients for analysis. Mean female ages in the aspirin and placebo groups were 31.1 years and 31.9 years, respectively. The number of clinical pregnancies was 174 (34.5%) versus 168 (33.5%) in the placebo group (OR 1.04, 95% CI (0.80 to 1.4). Addition of female age to the model did not alter treatment effect (OR 1.03, 95% CI (0.79 to 1.3). This point estimate of 1.03 was lower than the 1.09 reported in conventional meta-analysis published in Cochrane. CONCLUSIONS: Previous conventional meta-analyses have overestimated the treatment effect of aspirin. According to our meta-analysis, low dose aspirin does not improve pregnancy rates after IVF.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
