# Aspirin for over 40s



## Caroline1759 (Sep 10, 2009)

Hi
Apologies if this has been asked before. Have any over 40s pregnant ladies been advised to take baby aspirin? 

Thanks
C xxx


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## MandyPandy (May 10, 2010)

Yep. 75mg a day (taken at night before bed).


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## ScaryButExciting (Jan 29, 2015)

I am on 1 aspirin and 2 clexane injections a day for bloodthinning...


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## Kitty71 (Apr 14, 2010)

Me too. I'm thinking It was 75mg up to 32 weeks. 

Wishing you the best X


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## Rabbit100 (Oct 26, 2010)

Me too I'm on aspirin 75mg & 1 ckexane injection a day

Rx


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## Caroline1759 (Sep 10, 2009)

Hi ladies

Thanks for your replies. Can I ask if aspirin was prescribed purely because of your age or did you have other health reasons that it was for? I don't have any known health reasons for taking it (not been tested) but I know some clinics advise women over 40 to take it to reduce clotting risk. My clinic says there is no benefit in me taking it. Just wondering what others experience of this is.

Thanks

C xxx


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## Rabbit100 (Oct 26, 2010)

I was already on clexane & other immune meds to prevent miscarriage but they hadn't worked out in previous pregnancies so my doctor had advised aspirin.

A friend who was I think 42 was recommended just to try  asprin by her doctor with no known issues.  If you don't have any problems ie where your blood fails to clot its quite low risk to give it a try isn't it? I was told take from ovulation onwards, if period arrives stop until next ovulation, if bfp continue until end of first trimester.

Rx


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## Rosalind73 (Apr 25, 2012)

In women with no known clotting factors, there is evidence that baby aspirin increases the risk of an early miscarriage, so it's not advisable (even though many fertility experts are unaware of this).

Once you are pregnant, I think some hospitals recommend it to over 40s - but I think after about 12 weeks. I would ask at your booking appointment.


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## Rabbit100 (Oct 26, 2010)

I guess this shows the variances in treatments between hospitals/doctors.  I was advised to take it while TTC at 39 after a period of infertility. I got pregnant 2nd month of taking (as per my previous post). I was then advised to continue until 12 weeks to prevent miscarrying.  I had no known clotting issues, had been tested for pretty much everything both under my NHS local gynaecologist & Raj Rai at St Mary's recurrent miscarriage clinic plus had done all the immune / Chicago tests privately and nothing had shown up with those. My issues was high natural killer cells not clotting issues. The pregnancy with my son was my 5th one, the first one on low dose aspirin & the first I didn't miscarry.  So I believe in my case prevented rather than caused a miscarriage but given Rosalinds comment perhaps you should seek further medical trained opinion rather than trying empirically 

Good luck 
Rx


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## Caroline1759 (Sep 10, 2009)

Hi ladies

Thanks, that's really interesting. Rosalind may i ask where you got that information that it increases the risk from? 

I read the NICE guidance and it says it you have more than 2 moderate risk factors - I have 3, being over 40, having fertility treatment and family history of per-eclampsia, that you should have an assessment for clotting risks and seems to imply that anticoagulant therapy should be recommended. Trouble is there doesn't seem to be any studies on when you should start (or stop) Aspirin. There does seem to be a lot of conflicting professional opinion on this topic.

C xxx


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## Rabbit100 (Oct 26, 2010)

Caroline,

If I were in your shoes with pre eclampsia risk in the family I would be pushing hard for a Doppler scan which they do at the end of the first trimester beginning of 2nd, if you can't persuade your NHS consultant to do it I would try and get it done privately. This will assess the blood flow between you and the placenta and will give early indications of your pre eclampsia risk (I think), but with that info they can look at whether you need aspirin and or Clexane to help prevent it. Apologies I hadn't spotted that you are already pregnant (so congratulations) but don't know what tests you could get done between now & then to diagnose.

Rx


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## star17 (Oct 31, 2012)

I am not over 40 - a baby at a mere 38 !!!  However I was told to take baby aspirin by both my clinic and my consultant.  They both said it promotes blood flow through the placenta.


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## Rosalind73 (Apr 25, 2012)

Hi Caroline,

I got that information directly from Professor Regan (in case you don't know her, she's a world authority on miscarriage and runs the Recurrent Miscarriage Clinic at St. Mary's in London). As well as telling me in person she also wrote it in her letter to me after I was diagnosed with a raised TEG (a clotting factor) and recommended to take 150mg of aspirin daily from a positive pregnancy test. I quote: "...there is no evidence that starting the medication before the pregnancy test is positive brings any benefits and indeed it may be counter-productive. Certainly there is evidence that Aspirin pre-conceptually can have an adverse effect on implantation and on-going development". 

She said pretty much the same thing to a friend of mine who was also seeing her for recurrent miscarriage (but was not diagnosed with any clotting factors - in both a non-pregnant and pregnant state). My friend then later asked her in an email whether she should take baby aspirin. Prof Regan's response was this:
"There have now been several studies demonstrating that women who take aspirin empirically or without any underlying reason, may be increasing their risk of miscarriage or bleeding and since it doesn’t offer any benefit, I certainly do not want to expose you to a potential risk."

So it seems it's not a good idea to use it empirically in very early pregnancy. However later on is a different thing, and I'm sorry I don't know much about its use in the general population (as I'm taking it to treat a known clotting factor), other than the haemotologist I'm seeing in my current pregnancy did say something about it being a reasonable thing for over 40s to take later on in their pregnancy.

Sounds like you should be assessed for clotting risks - when is your booking appointment? If I were you I would ask your midwife to refer you to a haemotology maternity clinic or an obstetrician (high risk). Because of the factors you mention this will probably happen anyway. 

P.s. Congratulations on the pregnancy by the way!! Wonderful news


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## nashipai (Dec 18, 2014)

Hi Caroline

This is the current trial looking at aspirin use for pre-eclampsia prevention http://www.controlled-trials.com/ISRCTN13633058 with trial website http://www.aspre.eu . It is being conducted by the Fetal Medical Centre ie Niccolaides but participants are from all over the EU. The secondary outcomes it is measuring are also interesting. The aspirin dose is taken up to 36 weeks.

The trial has increased the dosage up to 150mg as 75mg is thought to be ineffective due to the increased circulating volume of a pregnant woman, ie she has about a 50% increase in blood volume and early results tended to agree with this . The dose is 150mg as in the UK we can only get a dose of 75mg or 300mg. It is only a clinical trial with the evidence being collated and is not proven as yet.

Perhaps you could print off the study information and discuss with your clinic or if you are to be referred to a consultant obstetrician with them, a midwife may be aware of aspirin in pregnancy but probably won't be able to direct you to take it however the midwife may be able to refer you to a pre-eclampsia consultant led clinic to discuss it's use.

I am on 100mg of aspirin prescribed by my overseas obstetrician however I do receive maternity care in the UK from a consultant obstetrician who is more than happy for me to continue with the aspirin until 36 weeks however my UK consultant is heavily involved with research so is probably more confident and familiar with aspirin use in pregnancy and what the unpublished evidence shows. The current published evidence for aspirin use is poor so as in all things precious it is sensible advice to err on the side of caution but the choice is yours just try to make sure you are fully informed before making a decision. My advice would be to google "aspirin use in pregnancy Niccolaides" and look at the medical papers rather than forums, the NICE policy will also have sources listed and have a read of those too.

Good luck and I hope you find an appropriate medical professional who is willing to sit down and discuss the issue with you x

This post contains an unconfirmed link/information and readers are reminded that FertilityFriends.co.uk or its owners are not responsible for the content of external internet sites[/size]


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## Altai (Aug 18, 2013)

Hi

Very interesting reading as I've been debating whether to take aspirin 75m on a daily basis or not.
I've been prescribed from 18 weeks (that's when I first saw a consultant) because am at moderate risk òf developing pre-eclampsia: being over 40 & it's my first child. No other factors, IVF hasn't been cited as a risk factor.  I had to stop aspirin after couple of weeks as started getting very light brownish spotting. Freaked out, started googling and found that it increases risk of mc & implantation failures but likely in early pregnancy. 
Anyway, consultant still is of an opinion that over 40 should take mini aspirin in a later pregnancy. I've started taking mini dose again, well sort ...maybe every other day. I know that in some other countries aspirin is not being prescribed as preeclampsia  prevention for over 40. 

Also, of all my IVF cycles, this is the second one when I didn't take aspirin and it was successful. I did take clexane but had to stop at 5 ish weeks as was spotting non stop & bleeding. 
But maybe it's just only me not having luck with blood thinning medication. 

Best of luck and congratulations on your pregnancy.

A.


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## Caroline1759 (Sep 10, 2009)

Hi all
Thanks for your replies (and congrats!). Really interesting. Gosh there are some intelligent ladies on here! I'm 9w currently but not heard from MW for booking appointment yet. But when I do see them I certainly will ask about risk factors and if further assessment is possible. I've decided to take 75mg Aspirin myself. Been taking it nightly for 2 weeks. I've tried to weigh up risks vs benefits and feel mostly OK with this decision. But it would be good to have further testing if possible.

X


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