LOW COST INTERVENTION TO AUGMENT FIRST-LINE INFERTILITY TREATMENT SUCCESS: A RANDOMIZED CLINICAL TRIAL IN WOMEN WITH INFLAMMATION

University Of Utah, Salt Lake City UT

Investigators

Abstract

Recent evidence from the DIPHR effects of Aspirin in Gestation and Reproduction (EAGeR) trial indicates that low grade inflammation, as indicated by elevated high sensitivity C-reactive protein (hsCRP), may contribute to a reduction in spontaneous conceptions among fecund women. However, low dose aspirin (LOA, 81 mg), appeared to restore normal rates of pregnancy and live birth among women with higher hsCRP. Because low-grade inflammation is also linked to several disorders that contribute to infertility, aspirin therapy may be a viable approach to help improve infertility treatment outcomes at a low cost. Furthermore, among women with higher hsCRP, LOA was associated with a substantial increase in pregnancy rates among lean women, more so than women with excess adiposity who may be plagued with greater inflammatory burden and metabolic disturbances. Indeed, higher circulating lipid levels are also associated with a decreased chance of pregnancy in women in the EAGeR trial and in prior studies. Given these collective results, we hypothesize tat improving pregnancy rates among women with low-grade inflammation coupled with greater adiposity may require a dual treatment that provides a stronger anti-inflammatory effect and a supplemental lipid-lowering effect by using a combined aspirin + statin therapy. Evaluating a potential intervention effect interaction by race-ethnicity may be important for successful clinical translation, given evidence of somewhat lower effectiveness of some statin drugs in black patients with hyperlipidemia, and of lower infertility treatment success rates and higher hsCRP observed among certain minority groups.