The Journal of clinical endocrinology and metabolism · 2017
Low-Dose Aspirin and Sporadic Anovulation in the EAGeR Randomized Trial.
СтатьяМногоцентровое исследованиеРандомизированное исследованиеResearch Support, N.I.H., IntramuralНазвание и аннотация: Перевод в очереди
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Radin Rose G, Sjaarda Lindsey A, Perkins Neil J, Silver Robert M, Chen Zhen, Lesher Laurie L, Galai Noya, Wactawski-Wende Jean, Mumford Sunni L, Schisterman Enrique F
Аннотация
CONTEXT: Among women with a single, recent pregnancy loss, daily preconception low-dose aspirin (LDA) increased the live birth rate with no effect on pregnancy loss. Ovulation is a potential mechanism underlying this effect.
OBJECTIVE: We estimated the effect of LDA on the per-cycle risk of anovulation among eumenorrheic women.
DESIGN: Multicenter, randomized, double-blind, placebo-controlled trial of daily LDA on reproductive outcomes. Preconception follow-up lasted 1 to 6 menstrual cycles (ClinicalTrials.gov, NCT00467363).
SETTING: Four US medical centers during 2007 to 2011.
PATIENTS OR OTHER PARTICIPANTS: Healthy women (n = 1214), age 18 to 40, were attempting pregnancy, had regular menstrual cycles (21 to 42 days), and had a history of 1 to 2 documented pregnancy losses, ≤2 live births, and no infertility. All participants completed at least 1 menstrual cycle of follow-up; none withdrew due to adverse events.
INTERVENTION: Aspirin (81 mg) daily for 1 to 6 menstrual cycles.
MAIN OUTCOME MEASURE: Per-cycle risk of anovulation, defined as the absence of both a positive spot-urine pregnancy test and a luteinizing hormone (LH) peak (2.5-fold increase in daily urinary LH). Hypothesis formulation preceded data collection.
RESULTS: Among 4340 cycles, LDA was not associated with anovulation (LDA: 13.4%, placebo: 11.1%; risk ratio = 1.16, 95% confidence interval, 0.88 to 1.52). Results were similar among women with a single, recent loss.
CONCLUSIONS: Daily LDA had no effect on anovulation among women with a history of 1 to 2 pregnancy losses. LDA may affect fertility via other pathways, and these warrant further study.
OBJECTIVE: We estimated the effect of LDA on the per-cycle risk of anovulation among eumenorrheic women.
DESIGN: Multicenter, randomized, double-blind, placebo-controlled trial of daily LDA on reproductive outcomes. Preconception follow-up lasted 1 to 6 menstrual cycles (ClinicalTrials.gov, NCT00467363).
SETTING: Four US medical centers during 2007 to 2011.
PATIENTS OR OTHER PARTICIPANTS: Healthy women (n = 1214), age 18 to 40, were attempting pregnancy, had regular menstrual cycles (21 to 42 days), and had a history of 1 to 2 documented pregnancy losses, ≤2 live births, and no infertility. All participants completed at least 1 menstrual cycle of follow-up; none withdrew due to adverse events.
INTERVENTION: Aspirin (81 mg) daily for 1 to 6 menstrual cycles.
MAIN OUTCOME MEASURE: Per-cycle risk of anovulation, defined as the absence of both a positive spot-urine pregnancy test and a luteinizing hormone (LH) peak (2.5-fold increase in daily urinary LH). Hypothesis formulation preceded data collection.
RESULTS: Among 4340 cycles, LDA was not associated with anovulation (LDA: 13.4%, placebo: 11.1%; risk ratio = 1.16, 95% confidence interval, 0.88 to 1.52). Results were similar among women with a single, recent loss.
CONCLUSIONS: Daily LDA had no effect on anovulation among women with a history of 1 to 2 pregnancy losses. LDA may affect fertility via other pathways, and these warrant further study.