Effect of low-dose aspirin on the development of ovarian hyperstimulation syndrome and outcomes of assisted reproductive techniques in the women with PCOS, a randomized double-blinded clinical trial

Objective: Ovarian hyperstimulation syndrome (OHSS) is a major complication of assisted reproductive technologies (ART). Polycystic ovary syndrome (PCOS) is a risk factor for OHSS. The aim of this randomized clinical trial (RCT) was to study the effect of low-dose aspirin (LDA) on the development of...

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Main Authors: Bahia Namavar Jahromi, Jaleh Zolghadri, Elham Rahmani, Shohreh Alipour, Zahra Anvar, Afsun Zarei, Pegah Keramati
Format: Article
Language:English
Published: Elsevier 2019-03-01
Series:Taiwanese Journal of Obstetrics & Gynecology
Online Access:http://www.sciencedirect.com/science/article/pii/S1028455919300166
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author Bahia Namavar Jahromi
Jaleh Zolghadri
Elham Rahmani
Shohreh Alipour
Zahra Anvar
Afsun Zarei
Pegah Keramati
author_facet Bahia Namavar Jahromi
Jaleh Zolghadri
Elham Rahmani
Shohreh Alipour
Zahra Anvar
Afsun Zarei
Pegah Keramati
author_sort Bahia Namavar Jahromi
collection DOAJ
description Objective: Ovarian hyperstimulation syndrome (OHSS) is a major complication of assisted reproductive technologies (ART). Polycystic ovary syndrome (PCOS) is a risk factor for OHSS. The aim of this randomized clinical trial (RCT) was to study the effect of low-dose aspirin (LDA) on the development of OHSS and ART outcomes in PCOS during ART. Materials and methods: This double-blinded placebo controlled RCT was performed on 232 PCOS infertile women in their first ART cycles during 2010–2016. LDA and placebo capsules were prepared, packed and specified by code numbers in similar shapes. One package was given to every woman and asked to take one capsule/day since the 21st day of her cycle prior to the gonadotropin stimulation. Gonadotropin releasing hormone agonist long protocol and triggering by human chorionic gonadotropin were used. Development of moderate to severe OHSS and their ART outcomes were documented then the codes were broken and data analyzed. Chi-square and Mann–Whitney U tests were used for the statistical analyses. Results: Eighteen cases that did not follow the study design were excluded. 214 cycles remained for the final analyses with 109 cases in LDA and 105 in the placebo group. Rate of the moderate to severe OHSS in LDA group was 34.9% compared to 30.5% in placebo group (P = 0.494). Fertilization rate was 71.8% vs 65.1% (P = <0.001) and the mean number of grade III embryos were 3.28 ± 3.53 vs 1.46 ± 1.42 (P = 0.014) in LDA and placebo groups, respectively. The mean number of the oocytes in different grades, total and frozen embryos also implantation and clinical pregnancy rates were not different between the groups. Conclusion: Moderate to Severe OHSS was not decreased but fertilization rate and the mean number of poor quality embryos were increased in LDA arm. Registration number: IRCT 201105216541N1. Keywords: Ovarian hyperstimulation syndrome, Assisted reproductive technology, Polycystic ovary syndrome, Aspirin, Infertility, Fertilization
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spelling doaj.art-a6ad5af4436a4d66a9e62f5a5616bb982022-12-21T17:30:33ZengElsevierTaiwanese Journal of Obstetrics & Gynecology1028-45592019-03-01582255260Effect of low-dose aspirin on the development of ovarian hyperstimulation syndrome and outcomes of assisted reproductive techniques in the women with PCOS, a randomized double-blinded clinical trialBahia Namavar Jahromi0Jaleh Zolghadri1Elham Rahmani2Shohreh Alipour3Zahra Anvar4Afsun Zarei5Pegah Keramati6Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Corresponding author. Department of Obstetrics and Gynecology, Shahid Faghihi Hospital, Zand Blvd., Shiraz, Iran. Fax: +98 71 32332365.Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranOB and GYN Ward, Bushehr University of Medical Sciences, Bushehr, IranDepartment of Pharmaceutics, Department of Pharmaceutical Quality Control, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, IranInfertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranInfertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranInfertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranObjective: Ovarian hyperstimulation syndrome (OHSS) is a major complication of assisted reproductive technologies (ART). Polycystic ovary syndrome (PCOS) is a risk factor for OHSS. The aim of this randomized clinical trial (RCT) was to study the effect of low-dose aspirin (LDA) on the development of OHSS and ART outcomes in PCOS during ART. Materials and methods: This double-blinded placebo controlled RCT was performed on 232 PCOS infertile women in their first ART cycles during 2010–2016. LDA and placebo capsules were prepared, packed and specified by code numbers in similar shapes. One package was given to every woman and asked to take one capsule/day since the 21st day of her cycle prior to the gonadotropin stimulation. Gonadotropin releasing hormone agonist long protocol and triggering by human chorionic gonadotropin were used. Development of moderate to severe OHSS and their ART outcomes were documented then the codes were broken and data analyzed. Chi-square and Mann–Whitney U tests were used for the statistical analyses. Results: Eighteen cases that did not follow the study design were excluded. 214 cycles remained for the final analyses with 109 cases in LDA and 105 in the placebo group. Rate of the moderate to severe OHSS in LDA group was 34.9% compared to 30.5% in placebo group (P = 0.494). Fertilization rate was 71.8% vs 65.1% (P = <0.001) and the mean number of grade III embryos were 3.28 ± 3.53 vs 1.46 ± 1.42 (P = 0.014) in LDA and placebo groups, respectively. The mean number of the oocytes in different grades, total and frozen embryos also implantation and clinical pregnancy rates were not different between the groups. Conclusion: Moderate to Severe OHSS was not decreased but fertilization rate and the mean number of poor quality embryos were increased in LDA arm. Registration number: IRCT 201105216541N1. Keywords: Ovarian hyperstimulation syndrome, Assisted reproductive technology, Polycystic ovary syndrome, Aspirin, Infertility, Fertilizationhttp://www.sciencedirect.com/science/article/pii/S1028455919300166
spellingShingle Bahia Namavar Jahromi
Jaleh Zolghadri
Elham Rahmani
Shohreh Alipour
Zahra Anvar
Afsun Zarei
Pegah Keramati
Effect of low-dose aspirin on the development of ovarian hyperstimulation syndrome and outcomes of assisted reproductive techniques in the women with PCOS, a randomized double-blinded clinical trial
Taiwanese Journal of Obstetrics & Gynecology
title Effect of low-dose aspirin on the development of ovarian hyperstimulation syndrome and outcomes of assisted reproductive techniques in the women with PCOS, a randomized double-blinded clinical trial
title_full Effect of low-dose aspirin on the development of ovarian hyperstimulation syndrome and outcomes of assisted reproductive techniques in the women with PCOS, a randomized double-blinded clinical trial
title_fullStr Effect of low-dose aspirin on the development of ovarian hyperstimulation syndrome and outcomes of assisted reproductive techniques in the women with PCOS, a randomized double-blinded clinical trial
title_full_unstemmed Effect of low-dose aspirin on the development of ovarian hyperstimulation syndrome and outcomes of assisted reproductive techniques in the women with PCOS, a randomized double-blinded clinical trial
title_short Effect of low-dose aspirin on the development of ovarian hyperstimulation syndrome and outcomes of assisted reproductive techniques in the women with PCOS, a randomized double-blinded clinical trial
title_sort effect of low dose aspirin on the development of ovarian hyperstimulation syndrome and outcomes of assisted reproductive techniques in the women with pcos a randomized double blinded clinical trial
url http://www.sciencedirect.com/science/article/pii/S1028455919300166
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