title: Low-Dose Aspirin and Sporadic Anovulation in the EAGeR Randomized Trial.
abstract: Among women with a single, recent pregnancy loss, daily preconception low-dose aspirin (LDA) increased the live birth rate with no effect on pregnancy loss. Ovulation is a potential mechanism underlying this effect.
  
  
  
  We estimated the effect of LDA on the per-cycle risk of anovulation among eumenorrheic women.
  
  
  
  Multicenter, randomized, double-blind, placebo-controlled trial of daily LDA on reproductive outcomes. Preconception follow-up lasted 1 to 6 menstrual cycles (ClinicalTrials.gov, NCT00467363).
  
  
  
  Four US medical centers during 2007 to 2011.
  
  
  
  Healthy women (n = 1214), age 18 to 40, were attempting pregnancy, had regular menstrual cycles (21 to 42 days), and had a history of 1 to 2 documented pregnancy losses, ≤2 live births, and no infertility. All participants completed at least 1 menstrual cycle of follow-up; none withdrew due to adverse events.
  
  
  
  Aspirin (81 mg) daily for 1 to 6 menstrual cycles.
  
  
  
  Per-cycle risk of anovulation, defined as the absence of both a positive spot-urine pregnancy test and a luteinizing hormone (LH) peak (2.5-fold increase in daily urinary LH). Hypothesis formulation preceded data collection.
  
  
  
  Among 4340 cycles, LDA was not associated with anovulation (LDA: 13.4%, placebo: 11.1%; risk ratio = 1.16, 95% confidence interval, 0.88 to 1.52). Results were similar among women with a single, recent loss.
  
  
  
  Daily LDA had no effect on anovulation among women with a history of 1 to 2 pregnancy losses. LDA may affect fertility via other pathways, and these warrant further study.
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20817.
authors.forename: Rose G
authors.initials: RG
authors.lastname: Radin
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20817.
authors.forename: Lindsey A
authors.initials: LA
authors.lastname: Sjaarda
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20817.
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Perkins
authors.affiliation: Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, School of Medicine, Salt Lake City, Utah 84132.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Silver
authors.affiliation: Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20817.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, School of Medicine, Salt Lake City, Utah 84132.
authors.forename: Laurie L
authors.initials: LL
authors.lastname: Lesher
authors.affiliation: Department of Statistics, University of Haifa, Haifa, 3498838 Israel; and.
authors.forename: Noya
authors.initials: N
authors.lastname: Galai
authors.affiliation: Department of Social and Preventive Medicine, University at Buffalo, Buffalo, New York 14228.
authors.forename: Jean
authors.initials: J
authors.lastname: Wactawski-Wende
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20817.
authors.forename: Sunni L
authors.initials: SL
authors.lastname: Mumford
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20817.
authors.forename: Enrique F
authors.initials: EF
authors.lastname: Schisterman
mesh_terms: D000293:Adolescent; D000328:Adult; D000858:Anovulation / Q000188:drug therapy*; D001241:Aspirin / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D050498:Live Birth; D007986:Luteinizing Hormone / Q000097:blood; D008597:Menstrual Cycle / Q000187:drug effects; D010060:Ovulation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011247:Pregnancy; D011256:Pregnancy Outcome; D055815:Young Adult
chemical_list: D010975:Platelet Aggregation Inhibitors; D007986:Luteinizing Hormone; D001241:Aspirin