Aspirin Does Not Help with Conception in Young, Healthy Females
No, aspirin should not be used to improve conception rates in young, healthy women attempting pregnancy. The available evidence demonstrates no benefit of low-dose aspirin on fertility outcomes in women without specific high-risk conditions.
Evidence Against Aspirin for General Fertility Enhancement
No Benefit in Assisted Reproductive Technology
- A comprehensive Cochrane review of 13 randomized controlled trials (2,653 participants) found no evidence that aspirin improves live birth rates in women undergoing IVF (RR 0.91,95% CI 0.72-1.15) 1
- Clinical pregnancy rates were similar between aspirin and placebo groups (RR 1.03,95% CI 0.91-1.17) in women undergoing assisted reproduction 1
- The review concluded there is no evidence favoring routine aspirin use to improve pregnancy rates in a general IVF population 1
No Effect on Ovulation in Healthy Women
- In the large EAGeR randomized trial of 1,214 women with regular menstrual cycles, daily low-dose aspirin (81 mg) had no effect on anovulation rates (aspirin: 13.4% vs placebo: 11.1%; RR 1.16,95% CI 0.88-1.52) 2
- This indicates aspirin does not improve fertility through ovulatory mechanisms in eumenorrheic women 2
When Aspirin IS Indicated: High-Risk Pregnancy Conditions Only
Aspirin is only recommended for specific high-risk populations to prevent pregnancy complications, not to aid conception:
Established Indications (Not for Fertility)
- History of preeclampsia, particularly early-onset preeclampsia with delivery <34 weeks 3, 4
- Chronic hypertension (though efficacy may be limited with standard 81 mg dosing) 5, 3
- Type 1 or type 2 diabetes (requires higher dose: 100-150 mg daily) 5, 3
- Renal disease or autoimmune disease 3
- Multifetal gestation 3
Proper Timing and Dosing for High-Risk Women
- Start between 12-16 weeks of gestation (not preconception for general fertility) 3, 4
- Standard dose: 81 mg daily for most high-risk women 3
- Higher dose: 100-150 mg daily for women with diabetes 5, 3
- Continue until delivery 3
Important Caveats and Potential Risks
Safety Concerns in Healthy Women
- Aspirin crosses the placenta and has been associated with increased risk of vascular disruptions, particularly gastroschisis 6
- Aspirin inhibits platelet function and can contribute to maternal and fetal bleeding 6
- Possible risk of premature closure of the ductus arteriosus 6
Lack of Evidence for Preconception Use
- While some studies suggest preconception aspirin may improve implantation rates in women undergoing IVF, current evidence does not exclude the possibility of adverse effects 1
- The mechanism by which aspirin might affect fertility remains unclear, as it had no effect on ovulation in healthy women 2
Clinical Bottom Line
For young, healthy females attempting conception without high-risk conditions, aspirin offers no proven benefit and should not be routinely recommended. The evidence is clear that aspirin does not improve fertility, ovulation, or pregnancy rates in this population 1, 2. Aspirin prophylaxis is reserved exclusively for pregnant women with specific high-risk factors for preeclampsia and related complications, initiated after 12 weeks of gestation—not as a fertility aid 3, 4.