Should I take low-dose aspirin to help me conceive?

For most women, no: the evidence does not show that aspirin helps conception.

The largest trial, EAGeR in the United States, gave daily low-dose aspirin or a dummy tablet to women trying to conceive after one or two earlier losses. Overall, aspirin did not increase live births. A smaller group, women with one recent early loss, conceived somewhat sooner on aspirin, but the researchers themselves said general recommendations were premature. One subgroup finding is a question for more research, not advice for everyone.

Mainly to lower the risk of pre-eclampsia in women at high risk, started after the first scan, not before conception.

The UK's NICE advises aspirin 75 to 150 mg a day from 12 weeks until birth for women at high risk of pre-eclampsia, such as those with high blood pressure in a past pregnancy, chronic kidney disease, lupus or antiphospholipid syndrome, diabetes, or long-standing high blood pressure. The American College of Obstetricians and Gynecologists (ACOG) gives similar advice, starting between 12 and 28 weeks and ideally before 16. Your obstetrician decides this in pregnancy, based on your risk.

Only in one group: women with antiphospholipid syndrome, where aspirin is given with heparin in pregnancy.

Antiphospholipid syndrome is a blood-clotting condition found by blood tests repeated weeks apart. For these women, the RCOG and ESHRE guidelines advise low-dose aspirin with heparin in the next pregnancy. For recurrent miscarriage with no cause found, neither guideline recommends aspirin. That is why tests come first, then treatment.

A Cochrane review of the trials found no good evidence that aspirin improves live births after IVF.

Aspirin has been tried to improve blood flow to the womb and help implantation. When the trials were pooled, the chance of a live birth was no different with or without it. Some clinics still add it in selected situations; at Jananam, it is used only where there is a specific reason. [CONFIRM: Jananam practice] Add-ons must earn their place with evidence.

No. Aspirin is a medicine with side effects, and it should be taken only when a doctor prescribes it.

Even at a low dose, aspirin can cause stomach irritation and bleeding, and it can trigger allergic reactions or asthma in some people. It matters before egg collection, surgery or a dental extraction, and with other medicines that thin the blood. It is sold without a prescription in India, which is exactly why this needs saying. If you are already taking it, do not stop a prescribed dose without asking the doctor who prescribed it.

Things with better evidence than aspirin: your weight, not smoking, less alcohol, sleep, folic acid, and treating medical problems.

Dr Vani's list of what couples can influence: "Lifestyle, led by a healthy weight. Then smoking, alcohol, about seven hours of sleep, stress, folic acid, and correcting thyroid, diabetes, blood pressure and vitamin D." If you have been trying for 12 months, or 6 months if you are 35 or over, the next step is tests for both of you, not a tablet.