Baby aspirin: the secret pregnancy pill?

23 Jun Baby aspirin: the secret pregnancy pill?

Can baby aspirin help you get pregnant – and stay pregnant? Hot topic. Studies suggest it may benefit certain women, but not all. So here’s the lowdown on how and why baby aspirin could help with fertility and pregnancy.

First, the general rule. For most women, taking aspirin during conception and pregnancy is not advised. It could increase the risk of miscarriage, affect your baby’s weight, delay the onset of labour and cause bleeding problems. But for a small group, including some fertility patients, a daily baby aspirin pill might be a good idea.

Baby aspirin is a lower dose of an ‘adult’ aspirin tablet. One pill typically contains 75 to 100 mg of aspirin (a standard pill is 300 mg). Aspirin has long been used as a painkiller and anti-inflammatory drug, soothing many a hangover and general aches and pains.

Taking a lower dose of aspirin can help various health conditions, from slashing the odds of a heart attack to minimising stroke. Like paracetamol, aspirin has qualities even doctors don’t completely understand. It was only a matter of time before researchers looked at its role in fertility and pregnancy.

In 2019, the National Institute for Health and Care Excellence (NICE) recommended the use of low-dose aspirin from 12 weeks pregnant to guard against pre-eclampsia. This is a placental disorder with potentially life-threatening consequences.

Pre-eclampsia is more likely to occur if you’re over 40, have a BMI of 35 or more, or are expecting twins. If you had high blood pressure before getting pregnant, or have another chronic health condition like severe diabetes, the risk is higher too. And if you had pre-eclampsia before, you’re more likely to get it again.

If you’ve got a known blood disorder, there’s clearer evidence baby aspirin helps. Women with Factor V Leiden or antiphospholipid syndrome) are routinely prescribed blood thinners like baby aspirin or Clexane. These may be taken throughout pregnancy.

So could baby aspirin help with fertility? Studies are inconclusive. But there’s a growing pro-aspirin approach by clinics for patients with a history of miscarriage, recent pregnancy loss or implantation failure. Typically, baby aspirin is taken when a fertility patient begins her stimulating medication. But starting on transfer day is not uncommon.

Some doctors are sniffy about baby aspirin. They think Clexane is the only blood thinner that makes a difference to fertility patients. It’s true that, in 2016, a fairly comprehensive study into IVF and aspirin found no evidence it improved IVF outcomes.

But newer studies beg to differ. A 2017 study into IVF and low-dose aspirin found it may increase clinical pregnancy rates. And research from 2019 into frozen embryo transfers and low-dose aspirin found it increased pregnancy and live birth rates. Both studies were small and said larger trials were needed.

And what of the benefits of giving fertility patients a combination of low-dose aspirin and low-dose steroid Prednisone? A 2016 study found that taking both improved pregnancy rates for certain IVF patients. And research in 2020 suggested that for women with recurrent pregnancy loss, a triple dose of low-dose aspirin, Prednisone and multi-vitamins increased pregnancy rates. This applied to general patients, not fertility patients.

Our summary? The evidence is contradictory. But many of our patients’ FET protocols do include low-dose aspirin. A psychological placebo? Possibly. Talk to your doctor, and don’t self-prescribe. Baby aspirin is widely available over the counter, but that doesn’t mean fertility patients should take it like a vitamin.