Step away from the Nurofen

by dee armstrong

Every week I meet new patients in my clinic who are trying to conceive and run through a detailed assessment with them.  And every week I am surprised by the number of women who don't know of the risks of ibuprofen (and other non-steroidal anti inflammatory drugs or NSAIDS) while trying to conceive and during pregnancy.  

The vast majority of them have not been asked whether they are taking these drugs and have not been told either by their GP or by staff in fertility clinics that they should not be using them for backache, headaches, menstrual cramps or indeed any aches and pains.  

I have noticed when talking to people about painkillers how ibuprofen seems to be by far the most popular choice - probably this is down to packaging, advertising and marketing, with the leading brand, Nurofen, having a far sexier image than boring old paracetamol.  There are exceptions but usually people say they just reach for whatever's in the cupboard rather than maintaining that ibuprofen actually works better.

The studies on NSAIDs and infertility suggest that they may impair ovulation (by leading to greater incidence of luteinizing unruptured follicle syndrome - where the egg is not successfully released from the follicle) and interfere with the implantation process.  In addition, other studies suggest that their use in early pregnancy leads to double the risk of miscarriage.  As far as infertility goes the majority of studies do relate to women who have been using NSAIDS long term (sometimes for conditions like rheumatoid arthritis) but even so it would seem wise to avoid them. This is all the more important since you can find stories all over the internet about women who have successfully become pregnant after starting to take aspirin - if you've been trying for a while it's easy to think that anything's worth a shot and anyway what harm is a little aspirin going to do?   Aspirin or other blood thinning drugs can be very helpful for some women who have been diagnosed with blood clotting issues and are usually used in conjunction with steroids, however, this should only be done after the appropriate blood tests and under the supervision of a consultant.