Low-dose aspirin and omega-3 fatty acids improve uterine artery blood flow velocity in women with recurrent miscarriage due to impaired uterine perfusion

Objective: To determine the effect of different therapeutic approaches on uterine artery blood flow in women with recurrent miscarriage (RM) and impaired uterine perfusion. Design: Prospective, randomized study. Setting: Department of Obstetrics and Gynecology, University of Rome "Tor Vergata," Italy. Patient(s): Sixty women with unexplained RM and impaired uterine perfusion. Intervention(s): Patients were randomly assigned to three different therapeutic regimens: 20 patients received a daily dose of 100 mg of aspirin (LDA); 20 patients were treated with omega-3 fatty acids (Omega(3)) 4 g daily; and 20 patients received LDA plus Omega(3). Main Outcome Measure(S): Doppler measurement of uterine artery pulsatility index (PI) was performed, in the midluteal phase of the cycle, before and after 2 months of therapy. Result(S): All therapeutic regimens induced an improvement in uterine perfusion with a significant reduction of uterine artery PI values. LDA alone or in combination with Omega(3) was found to achieve the highest improvement of uterine blood flow. Omega-3 supplementation was less effective, as reflected by the lower PI values. Conclusion(s): LDA and Omega(3) are effective in improving uterine artery blood flow velocity in women with RM due to abnormal uterine perfusion. Further studies are needed to determine whether the improvement of uterine perfusion may lead to a better pregnancy outcome. (Fertil Steril (R) 2009;92:296-300. (C) 2009 by American Society for Reproductive Medicine.)