Ashwagandha and fertility: what the evidence says

What does the evidence say about ashwagandha while trying to conceive?

1. Ashwagandha should be avoided during pregnancy and should not be used while breastfeeding, per NCCIH. 1
2. Ashwagandha may be safe for short-term use up to three months, with insufficient data beyond that, and reported side effects include drowsiness, stomach upset, diarrhea, and vomiting; it is also not advised for people with thyroid conditions or autoimmune disorders and may interact with thyroid, diabetes, and blood pressure medicines. 1
3. For male fertility, NCCIH describes limited evidence that two to four months of ashwagandha may increase testosterone levels and sperm quality. 1
4. Clinically apparent liver injury has been linked to commercial ashwagandha products, typically appearing 2 to 12 weeks after starting, with rare fatal cases or transplant need reported particularly in people with pre-existing liver disease. 2
5. A 2025 systematic and ethnobotanical review of ashwagandha's reported teratogenic and abortifacient potential concluded that the evidence for either remains inconclusive, and called for controlled research on fertility and developmental outcomes. 3

What to know about ashwagandha while trying to conceive

• The conflict is timing. NCCIH says ashwagandha should be avoided during pregnancy, but a pregnancy is typically not confirmed until several weeks in, so continuing while actively trying means continuing into an early pregnancy you do not yet know about. Stopping before the trying window closes that gap.
• Still off the list. A 2025 systematic review of the teratogenic and abortifacient claims concluded the evidence for either is inconclusive, which is not the same as evidence of safety. Absent good human pregnancy data, the NCCIH position stands.
• No change. If you are taking ashwagandha for sleep or stress and stopping leaves a gap, that is worth raising with your provider directly rather than swapping in another botanical, since several common sleep and stress herbs carry their own pregnancy uncertainty.