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Viagra as a Treatment to Thicken Uterine Lining

by Dr. Geoffrey Sher on April 11, 2016

About seventeen years ago, after reporting on the benefit of vaginal Sildenafil (Viagra) for women who had implantation dysfunction due to thin endometrial linings, I was proud to announce the birth of the world’s first “Viagra baby.”  For those of you who aren’t familiar with the use of Viagra in IVF, allow me to provide some context.

It was as far back as 1989 when I first published a study that examined the correlation between the thickness of a woman’s uterine lining (the endometrium), and the subsequent successful implantation of embryos in IVF patients. This study revealed that when the uterine lining measured <8mm in thickness by the day of the “hCG trigger” (in fresh IVF cycles), or at the time of initiating progesterone therapy (in embryo recipient cycles, e.g.  frozen embryo transfers, egg donation-IVF etc.), pregnancy and birth rates were substantially improved. Currently, it is my opinion, that an ideal estrogen-promoted endometrial lining should ideally measure at least 9mm in thickness and that an endometrial lining measuring 8-9mm is “intermediate”. An estrogenic lining of <8mm is in most cases unlikely to yield a viable pregnancy.

A “poor” uterine lining is usually the result of the innermost layer of endometrium (the basal or germinal endometrium from which endometrium grows) not being able to respond to estrogen by propagating an outer, “functional,” layer thick enough  to support optimal embryo implantation and development of a healthy placenta (placentation). The “functional” layer ultimately comprises 2/3 of the full endometrial thickness and is the layer that sheds with menstruation in the event that no pregnancy occurs.

The main causes of a “poor” uterine lining are:

  • Damage to the basal endometrium as a result of either
      1. Inflammation of the endometrium (endometritis) most commonly resulting from infected products left over following abortion, miscarriage or birth
  • Surgical trauma due to traumatic uterine scraping, (i.e. due to an over-aggressive D & C)
  • Insensitivity of the basal endometrium to estrogen due to either
      1. Prolonged, overuse/misuse of clomiphene citrate
      2. Prenatal exposure to diethylstilbestrol (DES). This drug was given to pregnant women in the 1960s to help prevent miscarriage
  • Over-exposure of the uterine lining to ovarian male hormones (mainly testosterone): Older women, women with diminished ovarian reserve (poor responders) and women with polycystic ovarian syndrome -PCOS tend to have raised LH biological activity.. This causes the connective tissue in the ovary (stroma/theca) to overproduce testosterone. The effect can be further exaggerated when certain methods for ovarian stimulation such as agonist (Lupron/Buserelin) “flare” protocols and high dosages of menotropins such as Menopur are used in such cases.
  1. Reduced blood flow to the basal endometrium:

Examples include:

    1. Multiple uterine fibroids – especially when these are present under the endometrium (submucosal)
  1. Uterine adenomyosis (excessive, abnormal invasion of the uterine muscle by endometrial glands).

“The Viagra Connection”

Treatments such as supplementary estrogen therapy, aspirin administration and/or administration of high dosage gonadotropin fertility drugs, aimed at improving endometrial development have all yielded disappointing results.

It was in the 90s that Sildenafil (brand named Viagra) was gaining popularity as a treatment for erectile dysfunction. The mechanism by which it acted was through increasing penile blood flow through increasing nitric oxide activity. This prompted me to investigate whether Viagra administered vaginally, might similarly improve uterine blood flow and in the process cause more estrogen to be delivered to the basal endometrium and thereby increase endometrial thickening. We found that when Viagra was administered vaginally it did just that! However oral administration was without any significant benefit in this regard.  We enlisted the services of a compound pharmacy to produce vaginal Viagra suppositories. Initially, four (4) women with chronic histories of poor endometrial development and failure to conceive following several advanced fertility treatments were evaluated for a period of 4-6 weeks and then underwent IVF with concomitant Viagra therapy. Viagra suppositories were administered four times daily for 8-11 days and were discontinued 5-7 days prior to embryo transfer in all cases.

Our findings clearly demonstrated that vaginal Viagra produced a rapid and profound improvement in uterine blood flow and that was followed by enhanced endometrial development in all four cases. Three (3) of the four women subsequently conceived. I expanded the trial in 2002 and became the first to report on the administration of vaginal Viagra to 105 women with repeated IVF failure due to persistently thin endometrial linings. All of the women had experienced at least two (2) prior IVF failures attributed to intractably thin uterine linings. About 70% of these women responded to treatment with Viagra suppositories with a marked improvement in endometrial thickness. 45% achieved live births following a single cycle of IVF treatment with Viagra The miscarriage rate was 9%. None of the women who had failed to show an improvement in endometrial thickness following Viagra treatment achieved viable pregnancies.

Following vaginal administration, Viagra is rapidly absorbed and quickly reaches the uterine blood system in high concentrations. Thereupon it dilutes out as it is absorbed into the systemic circulation. This phenomenon probably explains why treatment is virtually devoid of systemic side effects

Since the introduction of this form of treatment, thousands of women with thin uterine linings have been reported to be treated, and many have gone on to have babies after repeated prior IVF failure.

It is important to recognize that Viagra will NOT be effective in improving endometrial thickness in all cases. In fact, about one third of women treated fail to show any improvement. This is because in certain cases of thin uterine linings, the basal endometrium will have been permanently damaged and left unresponsive to estrogen. This happens in cases of severe endometrial damage due mainly to post-pregnancy endometritis (inflammation), chronic granulomatous inflammation due to uterine tuberculosis (hardly ever seen in the United States) or following extensive surgical injury to the basal endometrium (as sometimes occurs following over-zealous D&C’s).

To be effective, Viagra must be administered vaginally. It is NOT effective when taken orally. We prescribe 20mg vaginal suppositories to be inserted four times per day. Treatment is commenced soon after menstruation ceases and is continued until the day of the “hCG trigger.”  While ideally the treatment should be sustained throughout the first half of the cycle, most women will respond within 48-72 hours. For this reason, Viagra can be used to “rescue” a poor lining after the cycle has already started, provided that there is enough time remaining prior to ovulation, egg retrieval or progesterone administration.

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  • Zuza - August 20, 2017 reply

    Hello Dr Sher,
    While taking Viagra “four times per day” is it important to take it equally every 6 hours? – or is it OK to just take it before bed, then in the morning with the other two times spread during the day?
    Thank you,
    Zuza

    Dr. Geoffrey Sher

    Dr. Geoffrey Sher - August 20, 2017 reply

    The latter is in fact preferred!

    Geoff Sher

    Zuza - August 21, 2017 reply

    Thank you!

    Dr. Geoffrey Sher

    Dr. Geoffrey Sher - August 21, 2017 reply

    You are welcome!

    Geoff Sher

  • Anabel - July 18, 2017 reply

    I tried the vaginal viagra with no luck. Any other suggestions?

    Dr. Geoffrey Sher

    Dr. Geoffrey Sher - July 18, 2017 reply

    I would need much more information to be able to respond informatively!

    Geoff Sher

  • Jenny - May 26, 2017 reply

    Hello,

    I was wondering if vaginal Viagra would be effective, even without IUI or IVF. I just finished my 3rd IUI, and it appears that everything is completely normal (antral follicle count, sperm count, all blood tests), aside from my endometrial lining, which has been persistently thin. On the day of HCG trigger over my last 3 cycles, it was 6.6mm the first month, 5.9mm the second, and 6.7mm the third. If my upcoming hysteroscopy rules out any uterine damage from fibroids, scarring, etc (I am anticipating it will, as I’ve never experienced any problems up to this point), would it make sense to try Viagra therapy, without any further fertility treatments?

    Dr. Geoffrey Sher

    Dr. Geoffrey Sher - May 27, 2017 reply

    Yes! It could be effective without being used in conjunction with IVF.

    About seventeen years ago, after reporting on the benefit of vaginal Sildenafil (Viagra) for to women who had implantation dysfunction due to thin endometrial linings I was proud to announce the birth of the world’s first “Viagra baby.” For those of you who aren’t familiar with the use of Viagra in IVF, allow me to provide some context.

    It was as far back as 1989, when I first published a study that examined the correlation between the thickness of a woman’s uterine lining (the endometrium), and the subsequent successful implantation of embryos in IVF patients. This study revealed that when the uterine lining measured <8mm in thickness by the day of the “hCG trigger” (in fresh IVF cycles), or at the time of initiating progesterone therapy (in embryo recipient cycles, e.g. frozen embryo transfers, egg donation-IVF etc.) , pregnancy and birth rates were substantially improved. Currently, it is my opinion, that an ideal estrogen-promoted endometrial lining should ideally measure at least 9mm in thickness and that an endometrial lining measuring 8-9mm is “intermediate”. An estrogenic lining of <8mm is in most cases unlikely to yield a viable pregnancy.

    A “poor” uterine lining is usually the result of the innermost layer of endometrium (the basal or germinal endometrium from which endometrium grows) ) not being able to respond to estrogen by propagating an outer, “functional” layer thick enough to support optimal embryo implantation and development of a healthy placenta (placentation). The “functional” layer ultimately comprises 2/3 of the full endometrial thickness and is the layer that sheds with menstruation in the event that no pregnancy occurs.

    The main causes of a “poor” uterine lining are:

    1. Damage to the basal endometrium as a result of:
    a. Inflammation of the endometrium (endometritis) most commonly resulting from infected products left over following abortion, miscarriage or birth
    b. Surgical trauma due to traumatic uterine scraping, (i.e. due to an over-aggressive D & C)
    2. Insensitivity of the basal endometrium to estrogen due to:
    a. Prolonged , over-use/misuse of clomiphene citrate
    b. Prenatal exposure to diethylstilbestrol (DES). This is a drug that was given to pregnant women in the 1960’s to help prevent miscarriage
    3. Over-exposure of the uterine lining to ovarian male hormones (mainly testosterone): Older women, women with diminished ovarian reserve (poor responders) and women with polycystic ovarian syndrome -PCOS tend to have raised LH biological activity.. This causes the connective tissue in the ovary (stroma/theca) to overproduce testosterone. The effect can be further exaggerated when certain methods for ovarian stimulation such as agonist (Lupron/Buserelin) “flare” protocols and high dosages of menotropins such as Menopur are used in such cases.
    4. Reduced blood flow to the basal endometrium:
    Examples include;
    a. Multiple uterine fibroids - especially when these are present under the endometrium (submucosal)
    b. Uterine adenomyosis (excessive, abnormal invasion of the uterine muscle by endometrial glands).

    “The Viagra Connection”

    Treatments such supplementary estrogen therapy, aspirin administration and/or administration of high dosage gonadotropin fertility drugs, aimed at improving endometrial development have all yielded disappointing results.

    It was in the 90’s that Sildenafil (brand named Viagra) was gaining popularity as a treatment for erectile dysfunction. The mechanism by which it acted was through increasing penile blood flow through increasing nitric oxide activity. This prompted me to investigate whether Viagra administered vaginally, might similarly improve uterine blood flow and in the process cause more estrogen to be delivered to the basal endometrium and thereby increase endometrial thickening. We found that when Viagra was administered vaginally it did just that! However oral administration was without any significant benefit in this regard. We enlisted the services of a compound pharmacy to produce vaginal Viagra suppositories. Initially, four (4) women with chronic histories of poor endometrial development and failure to conceive following several advanced fertility treatments were evaluated for a period of 4-6 weeks and then underwent IVF with concomitant Viagra therapy. Viagra suppositories were administered four times daily for 8-11 days and were discontinued 5-7 days prior to embryo transfer in all cases.

    Our findings clearly demonstrated that vaginal Viagra produced a rapid and profound improvement in uterine blood flow and that was followed by enhanced endometrial development in all four cases. Three (3) of the four women subsequently conceived. . I expanded the trial in 2002 and became the first to report on the administration of vaginal Viagra to 105 women with repeated IVF failure due to persistently thin endometrial linings. All of the women had experienced at least two (2) prior IVF failures attributed to intractably thin uterine linings. About 70% of these women responded to treatment with Viagra suppositories with a marked improvement in endometrial thickness. Forty five percent (45%) achieved live births following a single cycle of IVF treatment with Viagra The miscarriage rate was 9%. None of the women who had failed to show an improvement in endometrial thickness following Viagra treatment achieved viable pregnancies.
    Following vaginal administration, Viagra is rapidly absorbed and quickly reaches the uterine blood system in high concentrations. Thereupon it dilutes out as it is absorbed into the systemic circulation. This probably explains why treatment is virtually devoid of systemic side effects

    Since the introduction of this form of treatment, thousands of women with thin uterine linings have been reported treated and many have gone on to have babies after repeated prior IVF failure.

    It is important to recognize that Viagra will NOT be effective in improving endometrial thickness in all cases. In fact, about one third of women treated fail to show any improvement. This is because in certain cases of thin uterine linings, the basal endometrium will have been permanently damaged and left unresponsive to estrogen. This happens in cases of severe endometrial damage due mainly to post-pregnancy endometritis (inflammation), chronic granulomatous inflammation due to uterine tuberculosis (hardly ever seen in the United States) and following extensive surgical injury to the basal endometrium (as sometimes occurs following over-zealous D&C’s).

    To be effective, Viagra must be administered vaginally. It is NOT effective when taken orally. We prescribe 20mg vaginal suppositories to be inserted four times per day. Treatment is commenced soon after menstruation ceases and is continued until the day of the “hCG trigger.” While ideally the treatment should be sustained throughout the first half of the cycle, most women will respond within 48-72 hours. For this reason, Viagra can be used to “rescue” a poor lining after the cycle has already started, provided that there is enough time remaining prior to ovulation, egg retrieval or progesterone administration.

    .

    Good luck!

    Geoff Sher

    Jenny - May 27, 2017 reply

    Great to hear! I truly appreciate your response!

    Just out of curiosity, in your experience, how common is a persistently thin uterine lining the main cause of infertility for women? There seems to be so much emphasis on testing for and treating ovulation problems, but not a lot focusing on the uterus itself. Is this because uterine lining issues are uncommon?

    Dr. Geoffrey Sher

    Dr. Geoffrey Sher - May 28, 2017 reply

    A persistently thin lining (<8mm) is very commonly associated with absent or dysfunctional implantation, presenting as "infertility, early pregnancy loss" and sometimes with placental insufficiency with intrauterine growth retardation (IUGR)".

    Geoff Sher

  • Teauna Krajacic - April 26, 2017 reply

    Hello Dr. Sher I’ve heard great things about you! I wish I were closer to you. We are about to start our 3rd and final FET. The two prior were BFN. My doctor is putting me on Viagra as my last cycle was almost canceled because it took me an added 3 weeks just to get to 7.84mm! I am scheduled for a saline sonogram to check my endometrial lining, I suspect I have scarring. My question is, has Viagra therapy been shown to work in women with uterine scarring?

    Dr. Geoffrey Sher

    Dr. Geoffrey Sher - April 26, 2017 reply

    It could help but often in such cases it unfortunately does not!

    About seventeen years ago, after reporting on the benefit of vaginal Sildenafil (Viagra) for to women who had implantation dysfunction due to thin endometrial linings I was proud to announce the birth of the world’s first “Viagra baby.” For those of you who aren’t familiar with the use of Viagra in IVF, allow me to provide some context.

    It was as far back as 1989, when I first published a study that examined the correlation between the thickness of a woman’s uterine lining (the endometrium), and the subsequent successful implantation of embryos in IVF patients. This study revealed that when the uterine lining measured <8mm in thickness by the day of the “hCG trigger” (in fresh IVF cycles), or at the time of initiating progesterone therapy (in embryo recipient cycles, e.g. frozen embryo transfers, egg donation-IVF etc.) , pregnancy and birth rates were substantially improved. Currently, it is my opinion, that an ideal estrogen-promoted endometrial lining should ideally measure at least 9mm in thickness and that an endometrial lining measuring 8-9mm is “intermediate”. An estrogenic lining of <8mm is in most cases unlikely to yield a viable pregnancy.

    A “poor” uterine lining is usually the result of the innermost layer of endometrium (the basal or germinal endometrium from which endometrium grows) ) not being able to respond to estrogen by propagating an outer, “functional” layer thick enough to support optimal embryo implantation and development of a healthy placenta (placentation). The “functional” layer ultimately comprises 2/3 of the full endometrial thickness and is the layer that sheds with menstruation in the event that no pregnancy occurs.

    The main causes of a “poor” uterine lining are:

    1. Damage to the basal endometrium as a result of:
    a. Inflammation of the endometrium (endometritis) most commonly resulting from infected products left over following abortion, miscarriage or birth
    b. Surgical trauma due to traumatic uterine scraping, (i.e. due to an over-aggressive D & C)
    2. Insensitivity of the basal endometrium to estrogen due to:
    a. Prolonged , over-use/misuse of clomiphene citrate
    b. Prenatal exposure to diethylstilbestrol (DES). This is a drug that was given to pregnant women in the 1960’s to help prevent miscarriage
    3. Over-exposure of the uterine lining to ovarian male hormones (mainly testosterone): Older women, women with diminished ovarian reserve (poor responders) and women with polycystic ovarian syndrome -PCOS tend to have raised LH biological activity.. This causes the connective tissue in the ovary (stroma/theca) to overproduce testosterone. The effect can be further exaggerated when certain methods for ovarian stimulation such as agonist (Lupron/Buserelin) “flare” protocols and high dosages of menotropins such as Menopur are used in such cases.
    4. Reduced blood flow to the basal endometrium:
    Examples include;
    a. Multiple uterine fibroids - especially when these are present under the endometrium (submucosal)
    b. Uterine adenomyosis (excessive, abnormal invasion of the uterine muscle by endometrial glands).

    “The Viagra Connection”

    Treatments such supplementary estrogen therapy, aspirin administration and/or administration of high dosage gonadotropin fertility drugs, aimed at improving endometrial development have all yielded disappointing results.

    It was in the 90’s that Sildenafil (brand named Viagra) was gaining popularity as a treatment for erectile dysfunction. The mechanism by which it acted was through increasing penile blood flow through increasing nitric oxide activity. This prompted me to investigate whether Viagra administered vaginally, might similarly improve uterine blood flow and in the process cause more estrogen to be delivered to the basal endometrium and thereby increase endometrial thickening. We found that when Viagra was administered vaginally it did just that! However oral administration was without any significant benefit in this regard. We enlisted the services of a compound pharmacy to produce vaginal Viagra suppositories. Initially, four (4) women with chronic histories of poor endometrial development and failure to conceive following several advanced fertility treatments were evaluated for a period of 4-6 weeks and then underwent IVF with concomitant Viagra therapy. Viagra suppositories were administered four times daily for 8-11 days and were discontinued 5-7 days prior to embryo transfer in all cases.

    Our findings clearly demonstrated that vaginal Viagra produced a rapid and profound improvement in uterine blood flow and that was followed by enhanced endometrial development in all four cases. Three (3) of the four women subsequently conceived. . I expanded the trial in 2002 and became the first to report on the administration of vaginal Viagra to 105 women with repeated IVF failure due to persistently thin endometrial linings. All of the women had experienced at least two (2) prior IVF failures attributed to intractably thin uterine linings. About 70% of these women responded to treatment with Viagra suppositories with a marked improvement in endometrial thickness. Forty five percent (45%) achieved live births following a single cycle of IVF treatment with Viagra The miscarriage rate was 9%. None of the women who had failed to show an improvement in endometrial thickness following Viagra treatment achieved viable pregnancies.
    Following vaginal administration, Viagra is rapidly absorbed and quickly reaches the uterine blood system in high concentrations. Thereupon it dilutes out as it is absorbed into the systemic circulation. This probably explains why treatment is virtually devoid of systemic side effects

    Since the introduction of this form of treatment, thousands of women with thin uterine linings have been reported treated and many have gone on to have babies after repeated prior IVF failure.

    It is important to recognize that Viagra will NOT be effective in improving endometrial thickness in all cases. In fact, about one third of women treated fail to show any improvement. This is because in certain cases of thin uterine linings, the basal endometrium will have been permanently damaged and left unresponsive to estrogen. This happens in cases of severe endometrial damage due mainly to post-pregnancy endometritis (inflammation), chronic granulomatous inflammation due to uterine tuberculosis (hardly ever seen in the United States) and following extensive surgical injury to the basal endometrium (as sometimes occurs following over-zealous D&C’s).

    To be effective, Viagra must be administered vaginally. It is NOT effective when taken orally. We prescribe 20mg vaginal suppositories to be inserted four times per day. Treatment is commenced soon after menstruation ceases and is continued until the day of the “hCG trigger.” While ideally the treatment should be sustained throughout the first half of the cycle, most women will respond within 48-72 hours. For this reason, Viagra can be used to “rescue” a poor lining after the cycle has already started, provided that there is enough time remaining prior to ovulation, egg retrieval or progesterone administration.

    Good luck!

    Geoff Sher

  • Clare - February 21, 2017 reply

    Hi Dr. Geoffrey
    I had IUI yesterday my lining was 7mm. Is it safe to use 25mg viagra pessaries at this stage? I am taking 400mg vaginal progesterone pessaries as prescribed by my doctor.
    Many thanks

    Clare

    Dr. Geoffrey Sher

    Dr. Geoffrey Sher - February 21, 2017 reply

    There is no benefit stating Viagra at this stage. It is far too late.

    Geoff Sher

  • Zenab - December 11, 2016 reply

    Dear doctor,
    I am currently undergoing my first I’ve cycle and have been prescribed vaginal alivher for 14 days post 2 day embryo transfer. I am on day 6 of alivher – inserted 3 times a day. I am also using crinone gel twice a day. The problem is that the tablets Are getting collected down there and Iv tried washing them out. I’m also getting A burning sensation. What should I do?

    Dr. Geoffrey Sher

    Dr. Geoffrey Sher - December 11, 2016 reply

    Sildenafil (Viagra.Alivher) needs to be compounded for optimal vaginal absorbtion. The tablets are not adequate to improve uterine blood flow and thickening of the endometrium. Besides, in my opinion, to be effective the administration of vaginal sildenafil needs to be done prior to progesterone (e.g Crinone)…i.e. before ovulation and before progesterone administration.

    Geoff Sher

    Zenab - December 13, 2016 reply

    Thank you so much for your reply Doctor. Given my circumstances, I guess I have no choice right now but to proceed on my current doctor’s recommendations and hope for the best. I do wish I had looked you up sooner.
    Thank you.

    Dr. Geoffrey Sher

    Dr. Geoffrey Sher - December 13, 2016 reply

    Good luck and merry Xmas!

    Geoff Sher

  • Sharon - November 8, 2016 reply

    Hi Dr Sher, I deal with a ‘thin lining’ and have tired everything available but to no avail, my lining is always about 7mm at the time of trigger or progesterone. I have frozen embroys so due to have another FET soon and my lining does not get above 6mm on estrogen alone so I will be on a low dose stim as I respond a little better that way. My question is, do you think 150iu of Gonal F, adding in 75iu of Menopur from CD7 plus 2mg of estrofem is a good protocol? I have heard Menopur is more ‘lining friendly’ and the one time I used Menopur with Gonal F I had my best lining yet although this was a fresh cycle and I was on a much higher dose. Would love to hear your thoughts on Menopur! Thank you 🙂

    Dr. Geoffrey Sher

    Dr. Geoffrey Sher - November 8, 2016 reply

    No Sharon, I do not believe this would help.

    Please call or email Julie Dahan, my patient concierge. She will guide you on how to set up an in-person or Skype consultation with me. You can reach Julie at on her cell phone or via email at any time:
    Julie Dahan
    • Email: Julied@sherivf.com
    • Phone: 702-533-2691
     800-780-7437

    Geoff Sher

    I also suggest that you access the 4th edition of my book ,”In Vitro Fertilization, the ART of Making Babies”. It is available as a down-load through http://www.Amazon.com or from most bookstores and public libraries.

    Sharon - November 8, 2016 reply

    Thanks for your reply Dr. Sher! I am due to start my meds next week!! Out of interest can I ask why you do not believe this will help as my lining does respond better to a low dose stim?

    Dr. Geoffrey Sher

    Dr. Geoffrey Sher - November 8, 2016 reply

    We would need to talk Sharon!

    Geoff Sher

    Sharon - November 9, 2016

    Sorry Dr. Sher as I am staring my meds on Monday I will not have time to set up a consultation with you so I am very nervous now 🙁 my clinic has me on the low dose of Gonal F/Menopur with 2mg estrofem added from CD7 as this is how my lining responds best on a fresh cycle and I do not respond to estrogen pills alone so they have me on a much lower dose then a fresh cycle with the hope my lining will be >8mm this time. Would I be best just doing Gonal F on its own with the estrofem? Apologies for all the questions but this will be our 7th transfer (plus we had 4 transfers cancelled due to poor lining) so I am very worried and nervous 🙁

    Dr. Geoffrey Sher

    Dr. Geoffrey Sher - November 9, 2016

    Sorry Sharon,

    I cannot interject myself into a cycle where you are being treated by another doctor.

    Geoff Sher

  • Ashley - August 16, 2016 reply

    Hello,
    I am currently being treated with estrace tables vaginally BID, but my lining remains chronically thin. Although my RE does not typically use Viagra to help with lining, he has agreed to prescribe it for this cycle. Do you think that taking it QID from time of trigger shot until I start progesterone will be enough time to rescue my lining? In previous cycles my lining is about 6.5-7 mm at the time of trigger but am hoping to get to 8mm or above.

    Dr. Geoffrey Sher

    Dr. Geoffrey Sher - August 16, 2016 reply

    No! It will likely not help unless you have used it for >2 days prior to the b”trigger”.

    Sorry!

    Geoff Sher

    Ashley - August 16, 2016 reply

    Thank you for your prompt response! Given the timing of this cycle and my latest scan, I’m at least 3-5 days pre trigger and have 24 dose available, is it worth taking any doses now either BID/TID/QID? If so, can you make any recommendations for dose schedule and start to see some results?

    Dr. Geoffrey Sher

    Dr. Geoffrey Sher - August 16, 2016 reply

    I prescribe 20mg of compounded Viagra suppositories 4 times per day until the hCG trigger.

    Good luck!

    Geoff Sher

    Ashley - August 21, 2016

    Based on your suggestion, I have been taking 20mg QID for 3 days, but my uterus is feeling very tender/crampy. Is this a normal side effect?

    Dr. Geoffrey Sher

    Dr. Geoffrey Sher - August 21, 2016

    I do not think it is anything to be concerned about!

    Good luck!

    Geoff Sher

  • Jana Ernoult - August 14, 2016 reply

    Hi, is it possible to get Viagra suppositories shipped to UK
    ? Thank you Jana

    Dr. Geoffrey Sher

    Dr. Geoffrey Sher - August 14, 2016 reply

    I don’t think so, not unless you are being treated in the U.S.A.

    Geoff Sher

    Lowenna - August 27, 2016 reply

    As suppositories are not available in my country, could I use instead a third of a Generic Female Viagra tablet (100mg Sildenafil Citrate) and insert it vaginally?
    many thanks indeed for your work!
    L

    Dr. Geoffrey Sher

    Dr. Geoffrey Sher - August 28, 2016 reply

    It is not nearly as efficient as the compounded product but perhaps it is worth a try.

    Geoff Sher

    Lowenna - August 28, 2016

    thank you very much indeed for your fast reply!

    Dr. Geoffrey Sher

    Dr. Geoffrey Sher - August 29, 2016

    You are very welcome

    Geoff Sher

  • alicia - July 18, 2016 reply

    Dr. thanks for listening .
    In my country alone is achieved Viagra pills. tablets 50 mg and 100 mg Pfizer laboratory. These can be used by way of ovules . in my country I can not get viagra in ovules .

    Dr. Geoffrey Sher

    Dr. Geoffrey Sher - July 19, 2016 reply

    So sorry!. I understand.

    Geoff Sher

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