Abstract
Background: Suboptimal uterine perfusion with impaired blood flow has been suggested as a possible cause of embryo implantation failure. It has been hypothesized that low-dose aspirin (LDA) and low molecular weight heparin (LMWH) may enhance uterine and ovarian blood flow and improve the results of assisted reproductive technique (ART) by increasing endometrial receptivity and blastocyst implantation.
Objectives: To evaluate the effect of LMWH and /or LDA combination on implantation and pregnancy rates in infertile patients undergoing intrauterine insemination (IUI) cycles and to compare implantation and pregnancy rates(PRs) between different treated groups: aspirin treated, non aspirin, aspirin and heparin treated group.
Patients, materials and methods: A prospective cohort study including a total of one hundred eight infertile couples participated in this study through a period from December 2013 to October 2014. Patients were divided into three groups: the first one received no treatment and served as a control, the second received LDA alone and the third one received both LDA and LMWH. All Patients underwent IUI after full history and physical examination, hormonal assay ultrasound examination, and seminal fluid analysis for husbands. Some patients had HSG examination.
Results: There was no significant difference in the pregnancy rate among the three groups enrolled in the present study. The pregnancy rates were (13.89%), (19.44 %) and (11.11%) in group of women who received neither LDA nor LMWH, group of women who received LDA and group of women who received both LDA and LMWH; respectively. Moreover, age and endometrial thickness had a significant impact on the rates of pregnancy. Sperm parameters, size of follicles, number of follicles and hormone levels showed no significant association with the PRs.
Conclusion: The addition of low molecular weight heparin and/or aspirin to treatment protocols for the women who undergo IUI fails to improve the pregnancy outcome. Age of women, duration of infertility and endometrial thickness plays a significant role in the determination of pregnancy outcome.
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