This chapter focuses on the strategies that seek to either improve endometrial blood flow or to encourage healing or growth through increased oxygenation. The variable nature of many patients in their response to in vitro fertilization (IVF) stimulation suggests that many women could have developed an appropriate endometrium irrespective of sildenafil. A recent study suggested a deceased incidence of natural killer cells in the endometrium of women with recurrent miscarriage as a result of sildenafil therapy, but the study was purely observational in nature. Commonly employed in the management of barotrauma that can result from undersea diving accidents, hyperbaric oxygen has also been used to promote healing in diseased or ischemic tissues. For women with scarred endometrium, there is a rationale for considering adjuvant therapy although logically the presence of some competent endometrium would be required for treatment to be successful.