Ask The Expert - Vaginal Viagra and IVF

Q: Can vaginal Viagra increase my odds of having a successful IVF cycle? A: Some fertility physicians turn to vaginal Viagra as a tool to improve uterine function. However, there is a great deal of skepticism about the use of Viagra for fertility patients. One of the key parameters we monitor during a fertility treatment cycle is the development of the endometrial lining: both thickness and pattern. Our aim is to achieve a lining with a minimum thickness of >=7mm, and a trilaminar (or triple) pattern of the endometrial layers, by the day of HCG administration. For some patients, we cannot obtain this type of a lining, despite various hormonal manipulations. For these patients, and even many without endometrial lining issues, we will typically recommend that she take a baby aspirin per day (81 mg) starting with gonadotropin stimulation. The rational for the use of baby aspirin is that on a micro-vascular level, vasodilation and decreased blood platelet aggregation occurs and therefore improves blood flow to the uterine lining, providing a lining with functional improvement. Blood platelets are the blood cells, which promote blood clotting. Two well designed studies confirm the benefit of baby aspirin use in improving pregnancy rates for patients with endometrial linings <8mm. It is important to note that the lining does not necessarily thicken with the use of baby aspirin - this is a qualitative improvement. It is also important to take only a baby aspirin, NOT a full dose aspirin. Some fertility practitioners have suggested that Viagra vaginal suppositories for women, which are also a vasodilator, may provide improvements in pregnancy rates in the same way baby aspirin does. It needs to be noted however, that Viagra as a vasodilator works via a different mechanism compared to aspirin. While these claims have been made, well designed studies have yet to prove this. In the interim, Viagra should be used with caution.

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