Researchers Geoffrey Sher and Jeffrey Fisch gave Viagra, also known as sildenafil, to women undergoing fertility treatment to test whether the medication could improve fertility and pregnancy rates. The researchers proposed that Viagra, typically indicated to treat erectile dysfunction in men, would help women with a history of failed past fertility treatments by thickening their endometrial lining, which is the layer of tissue in the uterus where an embryo implants during pregnancy. Sher and Fisch gave the women Viagra during in vitro fertilization, or IVF, an assisted reproductive technology. They summarized their findings in the article “Effect of Vaginal Sildenafil on the Outcome of In Vitro Fertilization (IVF) After Multiple IVF Failures Attributed to Poor Endometrial Development,” published in Fertility and Sterility in 2002. Although they noted additional research was needed, Sher and Fisch concluded that the prescribed combination treatment of Viagra and IVF resulted in an increased thickening of the endometrium lining which enabled the embryo to implant and result in a pregnancy.

In 2017, Julie Carré, Nicolas Gatimel, Jessika Moreau, Jean Parinaud, and Roger Léandri published “Does Air Pollution Play a Role in Infertility?: a Systematic Review,” hereafter “Does Air Pollution Play a Role,” in the journal Environmental Health. The authors completed a systematic literature review to investigate the effects of air pollutants on fertility in exposed populations. Since air quality has an impact on overall health as well as on reproductive function, the authors sought to increase the awareness of the importance of environmental protection issues among the general public and the authorities. The article “Does Air Pollution Play a Role” provided the foundation for further research on how air pollution can contribute to low reproductive capacity in areas with high exposure.

Ovarian hyperstimulation syndrome, abbreviated OHSS, is an atypical reaction that women may experience in response to excessive hormones, and often occurs during fertility treatments. OHSS is typically triggered by hormonal medications designed to mature eggs in the ovaries, which can cause blood vessels within the ovaries to leak fluid. Sometimes that can lead to painful tenderness or swelling. In severe cases of OHSS, that fluid can leak into the abdominal cavity in large amounts, causing vomiting, blood clots, and severe pain. As many as one out of three women undergoing fertility treatment will experience some form of OHSS, although more severe presentations are rare. While the exact cause of OHSS is not fully understood as of 2020, researchers continue to discover various risk factors, prevention techniques, and treatments that may lead to decreased risks associated with OHSS and better fertility outcomes.