Aspirin and Getting Pregnant

Aspirin is a cure-all. Seriously. It's great for preventing heart attacks or mitigating an incipient heart attack, and it helps prevent colon polyps in people with a family history. Oh, and it's great for menstrual cramps and headaches!

But does it do anything for conception? No, not really. It is anti-inflammatory, and if you have antibodies that impair implantation, it might help. Recognize, though, that the discussion about antibodies is controversial.

I have a friend who had two miscarriages before her successful pregnancy. For her third pregnancy, she took aspirin and heparin because they suspected that she might have a clotting disorder. Did that make the difference? Who knows? She did have a baby, but the aspirin and heparin might not have mattered.

As I said, the discussion about clotting disorders and anti-phospholipid antibodies affecting pregnancy is controversial. Some doctors believe in it, but many others don't. The reason that this is not a "slam-dunk" theory is that antibodies have been found on routine blood tests in normal fertile women. Also, studies have not shown that heparin and aspirin helped improve pregnancy rates in patients diagnosed with antibodies undergoing IVF. Still, some doctors will prescribe the regimen in women with recurrent miscarriages because it probably doesn't hurt. Patients are also eager to "do something," so it makes everybody happy.

Some theorize that because aspirin "thins the blood," it may increase blood flow to the reproductive organs. It may also calm any inflammation that impairs implantation. It might prevent clumping of platelets in the blood vessels supplying the uterus. It might, it might, it might...none of these ideas is proven.

The net-net is that low-dose aspirin probably does little if anything for conception, but it might possibly do something for implantation and maintenance of pregnancy in patients with anti-phospholipid antibodies. If you have recurrent pregnancy losses, rather than try to diagnose and treat yourself, get to a reproductive endocrinologist. It's more expensive than low-dose aspirin self-treatment, but it's probably a more effective plan. And in the end, a take-home baby is the goal.