• Azam Mohammad-Akbari, Arash Mohazzab, Maryam Tavakoli, Atousa Karimi, Simin Zafardoust, Zhaleh Zolghadri, Shadab Shahali, Reyhane Tokhmechi, and Soheila Ansaripour.
• Reproductive Biotechnology Research Center, ACECR, Avicenna Research Institute, Tehran, Iran.
• J Res Med Sci. 2022 Jan 1; 27: 7878.

BackgroundThe effect of anticoagulant medication in unexplained early recurrent pregnancy loss (RPL) patients is controversial. This clinical trial evaluated the effect of low-molecular-weight heparin (LMWH) on pregnancy outcomes in these patients.Materials And MethodsThe study was performed as a single-blind randomized clinical trial between 2016 and 2018. Samples were selected from patients who were referred to Avicenna RPL clinic with a history of at least two previously happened early unexplained miscarriages. The eligibility was defined strictly to select unexplained RPL patients homogenously. One hundred and seventy-three patients who got pregnant recently were allocated randomly into two groups LMWH plus low-dose aspirin treatment (Group A = 85) and low-dose aspirin treatment only (Group B = 88)) and were followed up till their pregnancy termination (delivery/abortion). A per-protocol analysis was carried out and all statistical tests were two-sided with a P < 0.05 significance level.ResultsThe live birth rates (LBRs) in Groups A and B were 78% and 77.1%, respectively, which did not show any statistically significant difference between the two groups, neither in rates nor in time of abortion. In subgroup analysis for polycystic ovary syndrome (PCOS) patients, the odds ratio for study outcome (intervention/control) was 2.25 (95% confidence interval: 0.65-7.73). There was no major adverse event whereas minor bleeding was observed in 18% of patients in Group A.ConclusionLMWH does not improve the LBR in unexplained RPL patients, however, it is recommended to evaluate its effect separately in PCOS patients.Copyright: © 2022 Journal of Research in Medical Sciences.

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