Does taking a daily baby aspirin (acetylsalicylic acid) due to In Vitro Fertilization (IVF) transfer in the first 6 weeks of pregnancy affect omega-3 supplementation?

Omega-3 Supplementation During Pregnancy with Low-Dose Aspirin

Low-dose aspirin therapy during early pregnancy does not negatively impact omega-3 supplementation, and both can be safely used together during pregnancy. 1

Safety of Combined Use

• Low-dose aspirin (81-100mg daily) used during IVF and early pregnancy does not contraindicate omega-3 fatty acid supplementation 1
• Maternal aspirin ingestion is associated with excretion of salicylates into breast milk, but low-dose aspirin (<100mg/day) has not been shown to have significant effects on neonatal platelet function 1
• For lactating women using low-dose aspirin for vascular indications who wish to breastfeed, guidelines suggest continuing this medication (Grade 2C recommendation) 1

Benefits of Combined Therapy

• Omega-3 fatty acids are essential nutrients that can only be obtained from diet and are critical for fetal neurodevelopment 2

• Omega-3 supplementation during pregnancy is associated with:

  • Reduced risk of preterm birth <37 weeks (RR 0.89) 3
  • Significantly reduced risk of early preterm birth <34 weeks (RR 0.58) 3, 4
  • Increased mean gestational age by 1.95 weeks 4
  • Increased mean birth weight by 122.1g 4

• The combination of low-dose aspirin with omega-3 has been shown to be more effective than aspirin alone in:

  • Increasing fetal weight in cases of intrauterine growth restriction 5
  • Improving uteroplacental blood flow 5

Recommendations for Use

• For women undergoing IVF who are taking low-dose aspirin, omega-3 supplementation can be safely continued throughout pregnancy 1, 3
• Low-dose aspirin (50-100 mg/day) is recommended throughout pregnancy for women at risk of preeclampsia 1
• Omega-3 supplementation should be considered as it has been associated with increased probability of conception (1.51 times higher) 6

Special Considerations

• If delivery is planned, aspirin should be discontinued one week prior to surgical procedures (including delivery) and restarted 24 hours after surgery when bleeding risk is acceptable 1
• For women at high risk of preeclampsia, low-dose aspirin should be started in the first trimester 1
• In cases of high-risk pregnancy, consider continuing low-dose aspirin throughout pregnancy and for six weeks postpartum 1

Dosing Considerations

• Most studies used omega-3 doses ranging from 600mg to 2.7g daily during pregnancy 3
• Low-dose aspirin (81-100mg daily) is the standard dose used during pregnancy 1
• The combination appears safe and may have synergistic benefits for pregnancy outcomes 5

Potential Pitfalls and Caveats

• Aspirin should be discontinued 1-2 weeks prior to delivery to reduce bleeding risk 1
• High-dose aspirin (several grams per day) should be avoided as it has been associated with metabolic acidosis in breastfed infants 1
• While omega-3 supplementation reduces preterm birth risk, it may slightly increase the risk of prolonged gestation >42 weeks (RR 1.61) 3
• Monitor for any signs of bleeding, though studies show no increased risk of postpartum hemorrhage with low-dose aspirin use 1