Q&A: Can aspirin help TTC with ANA?

by Dr. Gerard M. DiLeo

Can you please give me your opinion on aspirin therapy for positive Antinuclear Antibody (ANA). I'm in a unique situation in that I happened to discover my ANA several years ago when I had a bad bout of mono. It was 1:160 speckled. (had Epstein Barr Virus) My Dr. had me see a Rheumatologist to rule out lupus - I do not have lupus or any other autoimmune disease that I know of.

My OBGYN at the time told me to get it rechecked when I decided to start a family as it could cause complications. So, three+ years later, I had the test and it's still 1:160. After reading so many posts of women who've had miscarriages because of it and gotten on aspirin - I asked my dr if I could get on aspirin and he and my OBGYN said that was fine. (low dose 81mg). I've been on it several months now and haven't gotten PG yet. Now I'm starting to rethink this after reading some of the risks of aspirin therapy. Is it wise to be on it as a precaution - when I've never even been pregnant or had a single miscarriage? Are there any studies of women with positive ANA's that have had successful pregnancies, without aspirin? Furthermore, the more I read - it seems that aspirin is really more for if you have the cardiolipin anibodies, which I don't. Am I putting myself at uneeded risk? I'm thinking maybe I should stop the asprin and see how I do once I get pregnant. Of course, if I get PG and have a miscarriage and I'm not on aspirin - then I'm going to kick myself.

Any advice is appreciated. (I also have mild Mitral Valve Prolapse if that makes any difference.) p.s. I read there are certain foods that act as a natural blood thinner - would those work instead?

ANA falls into a group of autoimmune conditions that together raise the risk of miscarriage and difficulty with fertility. Aspirin, being an anti-inflammatory, tends to cool down autoimmune responses, hence its use in such individuals. Many people do just fine with their pregnancies in spite of positive ANA titers, and we have to wonder how many women out there have positive titers and normal pregnancies who have never been tested! Your questions are all good ones, and the one to pose them to would be a fertility specialist your own OB can refer you to for an opinion. These are the guys who deal with autoimmune conditions as they relate to pregnancy.

In any event, I don't see how such low dose aspirin could do any harm--research on the Internet tending to be anecdotal and alarmist. The mitral valve thing is unrelated and irrelevant. I would stay away from health food "treatments" that aren't FDA regulated, poorly studied, sold by unqualified individuals, and which may mix with pharmaceuticals in unpredictable ways.

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