Low‐dose aspirin improves endometrial receptivity in the midluteal phase in unexplained recurrent pregnancy loss

Abstract

Objective To evaluate differences in Doppler parameters and pregnancy outcomes, if any, and to determine the predictive accuracy of such indices, as well as the effects of low‐dose aspirin (LDA) in unexplained recurrent pregnancy loss (URPL). Methods An observational study was conducted at Ren Ji Hospital, Shanghai, China, from May 2015 to December 2016. The endometrial thickness, and the pulsatility index (PI), resistive index (RI), and systolic‐to‐diastolic ratio (S/D) values of endometrial and uterine artery blood flow were collected. Receiver operating characteristic (ROC) curve analysis was used to analyze data from URPL patients (three or more first‐trimester spontaneous abortions with unknown etiology) and patients with normal fertility. A second ultrasonography examination was performed in URPL patients who had received daily LDA for 2 months. Results There were 190 URPL patients and 35 control patients. Endometrial thickness was significantly thinner in URPL patients than control patients (P=0.005). The PI, RI, and S/D values for endometrial blood flow and the mean PI, RI, and S/D values for uterine arteries were significantly higher in URPL patients (P<0.001). The predictive accuracy of the indices mentioned above were 0.660, 0.802, 0.852, 0.837, 0.784, 0.929, and 0.929, respectively. Following LDA supplementation, URPL patients showed a significant reduction in resistance to endometrial and uterine artery blood flow (P<0.001). Conclusion URPL patients had impaired uterine perfusion. Doppler parameters are valuable in predicting women at high risk of URPL. LDA could be effective in improving endometrial receptivity.

Nitric Oxide Donor Administration For improvement of Uterine Blood Flow in Unexplained Recurrent Pregnancy Loss

“…The success to maintain an early pregnancy and implantation is affected by uterine perfusion, which regulates uterine receptivity [3] .…”

Low‐dose aspirin treatment improves endometrial receptivity in the midluteal phase in unexplained recurrent implantation failure

“…14 Endometrial blood flow velocity waveforms were collected with the maximum color intensity on the endometrial-subendometrial area; while blood flow velocity waveforms of the anterior branch of both left and right uterine arteries were obtained by placing the Doppler gate on the vessel (identified at the lateral border of the colpocervical junction). 11 Mean indices of pulsatility index (PI), resistive index (RI), and systolic-to-diastolic ratio (S/D) were measured from 3-5 consecutive cardiac cycles.…”

“…Per our previous study, all women were examined by an expert who was blinded to the patient information to avoid intraobserver errors. 11 A total of 170 URIF patients received a daily oral dose of 50 mg aspirin (given in two divided doses of 25 mg). After 2 months of treatment, ultrasonography was performed in the same phase of the cycle to evaluate the effects of low-dose aspirin treatment on improving the Doppler parameters of endometrial and uterine blood flow.…”

“…10 Several studies have demonstrated that low-dose aspirin can significantly improve uterine perfusion. 11,12 Rubinstein et al 13 showed that low-dose aspirin treatment improved the response of uterine and ovarian blood flow velocity in patients undergoing IVF.…”

Effect of Prepregnancy Lymphocyte Active Immunotherapy on Unexplained Recurrent Miscarriage, Pregnancy Success Rate, and Maternal-Infant Outcome

“…To date, consensus on the treatment of unexplained recurrent miscarriage has not yet been developed. Despite the safety and effectiveness of lymphocyte active immunotherapy are challenged at times, it is the most common therapy in clinical practice [4][5][6]. Therefore, this study is to assess the effect of prepregnancy lymphocyte active immunotherapy on unexplained recurrent miscarriage, pregnancy success rate, and maternal-infant outcome.…”