When to begin aspirin???

[Dutchie80]

Hi girls, hoping to get some opinions and advice.

I have recently been advised to take aspirin for ANA when I next cycle. The Ob that advised me to do this said to commence aspirin following +ve BT. I'm worried that I may never get a +ve result this way and so agreed with DP to start taking it the day after EPU which is the day before TF. My rheumatologist at my appt yesterday told me to not be taking it at the time of TF and to wait 24hrs after TF before starting aspirin.
I just feel so confused atm and am unsure as to what to do. Any opinions, advice, experiences greatly appreciated. TIA.

[Baby Dreamtime]

Hi Dutchie,
I take low dose aspirin every day, when cycling I would stop about 5 days before EPU (on the Colorado Protocol they say to stop 7 days before EPU as they are worried about bleeding during EPU) - but I always pushed the envelope a bit , and would start again the day following EPU and continue. If I was doing a FET I just stayed on it.

Is your FS the same as your OB? I know I have mentioned in the past that daily low dose aspirin seems to be a bit of a standard for immunological or some genetic issues, and the risks of taking it daily are low (especially if it is relatively short term, I have no side effects at all) and I don't want to push you, ultimately it is your body/decision, but I do think it is worth doing some research on.

Same goes for Prednisone and Clexane, they are pretty standard treatments for the above issues and can make the world of difference.

Thinking of you and wishing you all the luck in the world, what ever you decide. xx

[Dutchie80]

Thanks a million BDT, I secretly had hoped you would reply.

My FS is not the same person as the Ob I saw and I don't believe that I will be seeing the Ob again. FS mentioned aspirin and heparin when I mentioned my +ve ANA but didn't mention when to start etc. FS is away atm but when they return, this will be the first thing I ask about.
It's interesting you said aspirin sems to be the standard for immunology and some genetic issues. My rheumatologist said that he uses aspirin as a matter of course in his pg patients with a lot of the auto immune diseases he treats BUT, RA (rheumatoid arthritis) isn't really one of them LMAO (of couse it isn't), however he is happy for me to begin following an ET. He said that it's not good to be on it at the time of TF as it impacts implantation. Now this is where I start to get really confused. I'm not sure if when he says implantation he's referring to implantation of the embryo into the uterus lining or the implantation of the embryo back into the uterus at ET. From what I have read so far aspirin does not negatively impact the embryo implanting into the uterus lining so I'm assuming he was talking about implantation of the embryo back into the uterus. I did check and he definitely said it was ok to start 24hrs after ET. My thinking is this is what I will do, I'd hate to think that I was jeopardising (sp?) treatment in any way by starting too soon but I agree with yourself and CPie- starting after a +ve pg test may be too late and I may never get a BFP if I do. I hope my ramblings have made sense. TIA.

[Baby Dreamtime]

Hi Dutchie, I would bet anything that when you see your FS they will recommend commencing aspirin right away daily, with Clexane from EPU or ET, and Prednisone for at least 5 days from trigger, if not longer. But...I am not the Dr lol, will look forward to hearing what your FS has to say.

I have read some where that there was some theory that the aspirin could contribute misscarriage in high risk (or previous mc women), which is perhaps where your RA is coming from about being on aspirin at time of implantation? I guess it is all theories. And for me anything was worth a try. But I would definitely push you FS to make sure they are taking your + ANA seriously. Can't wait to see how you go. Big hugs. xx

[Rommy'sMummy]

I have some experince of Asprin so thought I might share what we are doing in case it helps at all;

I am on Aprin (100mg daily) and have been since TTC with this bub (29 weeks pg now). Theory is that due to having a couple of m/c and a small for dates baby previously Asprin would help with avoid another m/c as often the cause is clots forming and would also assit with bubs growth dureing pg. Both have turned out to be true for me.

My DS was on Asprin from birth to 3.5yrs due to heart condition and is now on Warfrin. Asprin is thought to be safe for long term use at the right dose unless stomach issues arise. You can get 100mg tablets of Asprin from supermarkets now.

Also, we were asked to take DS off Asprin 5 days before heart surgery due to needing to have more clotting factor in his blood for surgery - obviously open heart surgery is a pretty bloody operation and I was always told that the Asprin does take 5 days to take full effect and to wear off.

HTH.

Good luck with this cycle!

[Dutchie80]

Thanks heaps BDT and RommysMummy.
I guess I will just have to wait and see what the FS says but I have no issues with pushing the boundaries to get a BFP. I have only had one TF thus far but I would hate to do another 4 or 5 without success knowing if I had of used aspirin things might have been different.
BDT- I had also read of aspirin contributing to m/c and I guess this is where my reservations about starting too early have come from. To my knowledge I have no clotting issues, no lupus anti coagulant antibody, no anti cardiolipin antibody and I'm guessing this is why heparin/clexane hasn't been offered to me, only mentioned by FS and this was before I got the results of the immunology tests I had done.
I'll update when I have spoken to my FS, thanks again for your help.

[phynna]

To my knowledge I have no clotting issues, no lupus anti coagulant antibody, no anti cardiolipin antibody

Don't know if this is of any use to you at all, but I have the anti-cardiolipin antibodies, years ago with my ex we never could fall pregnant except once, which was a miscarriage very early. I don't have the syndrome that goes with the antibodies, just the antibodies on their own. But after doing some research, I briefly started taking aspirin daily not so long ago, and when I trace my pregnancy with my current man back to conception, it's exactly when I was taking the aspirin, so perhaps it does help to take aspirin ahead of time if you are trying to conceive?

[Dutchie80]

Thanks phynna, your story is reassuring. Congrats to you on your pregnancy.

[Dutchie80]

Hi guys,
The FS today said to follow the instructions from the Preg Management Clinic and start aspirin following a +ve BT. I feel a little bit anxious atm especially as I'm about to start another round of ivf.

[Baby Dreamtime]

Hi Dutchie,
I just Googled 'ivf treatment antinuclear antibodies' and found this:

What Are Anti Nuclear Antibodies?
Anti nuclear antibodies (also referred to as antinuclear antibodies) are a unique type of antibodies that have the ability to bind to certain structures within the cell?s nucleus, which is the core part of the cell.

Anti nuclear antibodies generally indicate autoimmunity and therefore can be a sign of autoimmune disease. As such, these antibodies have been linked to such autoimmune diseases as rheumatoid arthritis, Sjogren?s disease, rheumatoid arthritis and pernicious anemia. In addition, antinuclear antibodies have been linked to diseases other than autoimmune diseases, including chronic infections and cancer.


Anti Nuclear Antibodies and Infertility
While anti nuclear antibodies are present in small amounts in about 5% of the population, high amounts of these antibodies are linked to fertility problems, including unexplained infertility and miscarriage.

In fact, many women with high levels of anti nuclear antibodies are unable to conceive or to carry a pregnancy to term. Irregular anti nuclear antibodies levels are also linked to implantation failure as well as miscarriage, due to the inflammation of the uterus and placenta with which anti nuclear antibodies are linked.

An abnormal presence of these cells in the body is also linked to a low pregnancy success rate for methods of assisted reproduction, especially intracytoplasmic sperm injection (ICSI) and in vitro fertilisation (IVF).


Anti Nuclear Antibodies Blood Test Procedure
Your fertility specialist will conduct a blood test in order to evaluate the level of antinuclear antibodies in your bloodstream. Test results are typically available after a few days, following comprehensive analysis in the laboratory.

Antinuclear antibodies are measured in units known as titers. A negative result of less than or equal to 1:40 titers means that levels of antinuclear antibodies are low and that irregular amounts of antinuclear antibodies are likely not the cause of female fertility problems.

However, a positive result of levels of antinuclear antibodies above 1:40 titers means that antinuclear antibodies can be contributing to infertility.

If you test positive, there are a variety of infertility treatment options available. The most effective treatment for anti nuclear antibodies is fertility drug therapy. Prednisone is one particularly beneficial drug therapy treatment; upwards of 54% of women taking this drug successfully conceive during their next fertility treatment cycle.


I can only assume that your levels are on the low side hence your FSs belief that it is not contributing to your infertility. Do you have a copy of your test results? I don't want to be a drama queen, but you don't want to get down the track after a few unsuccessful cycles to have this come up again. xx

PS, so maybe it is not the aspirin you should be looking at but rather the Prednisone?

[Dutchie80]

Thanks BDT- your help is greatly appreciated

It's soo frustrating that no one thinks that ANA contributes to implantation failure but I certainly do. I have read a lot about it and I'm convinced they are problematic for implantation as well as pg. Dr Beer's book defines ANA as a category 3 immune problem where these antibodies first form in the blood and later graduate to the lymphatic system and tissue. After repeated losses, antibodies to DNA components can develop into antibodies that occupy organs such as the uterus, and cause local inflammation that may contribute to further m/c. Dr Beers uses IVIG for patients with ANA but I've read of a lot of women using prednisone and some using heparin/clexane. I've fortunately never had a m/c and have even achieved a natural pg about 11 yrs ago that didn't end in m/c, perhaps this is why no one thinks it contributing to implantation failure for me.

It's just soo damn confusing and I'm no doctor but I am going to keep 'bugging' my FS about it. I think I'm just going to go with the aspirin this cycle as my rheumatologist said there's some newer research out thats shows that ANA may benefit from aspirin, he also said if aspirin works for some antibodies (APA for example) then why couldn't they work for ANA.

So I'm going to begin aspirin 24-48hrs after ET. I don't know if this is enough but I'm content with just aspirin just for this cycle. I suppose I want to see if it will work with just aspirin.

My ANA titer was 1:320, I don't know what my most recent titer was, I stupidly forgot to ask though he did say that it was quite high so I'm assuming it was higher than 1:320.

[Rommy'sMummy]

HI Dutchie,

Wow, what a lot you are dealing with. Congrats on being so persistent and informed.

Regards to taking Asprin for 24-48 hours from FET - it will take around 5 days for the Asprin to be effective in your system for blood thinning. We were always told to cease it 5 days prior to DS surgery and when I had an amnio with this pg my OB didnt think there was enough risk of a bleed to even stop my Asprin at all (I did so ceased it 5 days prior).

I wish you luck with this cycle!

[Dutchie80]

Thanks for your well wishes RommysMummy I really appreciate them. I had heard that it can take a few days to take effect so hopefully if I take it 1 or 2 days after transfer by the time my embryo implants ( I have a day 2 transfer) the aspirin will be working it's magic (hopefully)

[Daisie]

Hi all

Does anyone have any thoughts on taking Aspirin even if not prescribed? It sounds like it has helped a few people conceive whether for immunology reasons or whatever....

I'm kinda thinking...what the hell... shall I just take it and see if it helps? It's a cheap enough option if it works, surely...

I had a chat with my FN today and she is of the "there's not necessarily anything wrong" opinion... whereas I'm in the "lets find out what is wrong and fix it" camp.

Any opinions on whether aspirin could hinder progress and if I take it, should i let the FS know, or should I sneak it? I"m leaning towards sneaking it (that sounds terrible, I know).

Thanks.

Daisie

[Baby Dreamtime]

Hi Daisie,
I did lots of sneaking and am very guilty of self medicating, but this was rather further down the track than you currently are (I did 10 cycles and 7 ETs). From what I remember of my googling days, low dose aspririn is quite common as treatment for fertility issues, even if you haven't tested specifically positive to any particular immunological or genetic issues. I think FSs in the UK are quite pro low dose aspirin. But it is up to you. I guess you have to way up the chance of you simply needing one or two more transfers ( and that is all some need) to get you BFP, versus the possibility that aspirin will make a difference and get you your BFP sooner, I hope this makes sense. I do think it is worth discussing in detail with your FS, and keep in mind some FS are pro or anti it as a rule so depends on what yours thinks. GL and wishing you all the best. xx

[Daisie]

Thanks BDT

It's hard to know when to keeping trying the way the FS wants, or when to start making decsisions for yourself. I think the FS can be too cautious, whereas I"m more likely to throw everything at it and hope something works. I might have a look on a few UK sites - thanks for the tip.

Daisie

[Cuddlepie]

Hi ladies,

Just read the thread, very interesting. Im just about to begin my 2nd cycle with Pred and Clexane to treat my high NK cell issue.

Last night, I just realized my left wrist has not feel right for a long time. I have always suspect that I have some kind of mild case of arthritis but not much symptoms, this could be one reason contributed to my high NK cell level - autoimmune disease.

I did a Rheumatoid Factor b/t last year which rule out the possibility, at the same time, I also test ANA, it says Titre, Pattern 80 Homogeneous (screened at a titre of 80). Reading what BDT posted, does it mean that it is over 1:40?

The reason Im asking this is I am wondering if I should add low dose aspirin to the mix of Pred and clexane for this coming cycle. I did share this result with my FS, given the treatment is pretty standard, he asked me not to worry about it, just standard Pred and Clexane.

Hope to hear from you guys.

Cuddlepie x

[butterfly_warrior]

Cuddlepie, the aspirin is simply going to thin the blood - something the clexane is already doing for you. I'd be inclined not to worry about it - especially as you already have something to prevent clots and your FS says not to.

I was guilty of self-medicating aspirin. But my FS refused to admit that there was a problem, despite three miscarriages - two of which were very early. I was already on prednisone for arthritis and possibly NK cell problems, and had borderline results with lupus anticoagulants. It was on the advice of the woman I saw for acupuncture after first confirming with an OB that it would do no harm if I took it but didn't need it. I started the day after EPU and the cycle where that was added was the cycle that resulted in my first successful pregnancy.

BW