The role of aromatase inhibitors in ameliorating deleterious effects of ovarian stimulation on outcome of infertility treatment.
Clinical utilization of ovulation stimulation to facilitate the ability of a couple to conceive has not only provided a valuable therapeutic approach, but has also yielded extensive information on the physiology of ovarian follicular recruitment, endometrial receptivity and early embryo competency. One of the consequences of the use of fertility enhancing agents for ovarian stimulation has been the creation of a hyperestrogenic state, which may influence each of these parameters. Use of aromatase inhibitors reduces hyperestrogenism inevitably attained during ovarian stimulation. In addition, the adjunct use of aromatase inhibitors during ovarian stimulation reduces amount of gonadotropins required for optimum stimulation. The unique approach of reducing hyperestrogenism, as well as lowering amount of gonadotropins without affecting the number of mature ovarian follicles is an exciting strategy that could result in improvement in the treatment outcome by ameliorating the deleterious effects of the ovarian stimulation on follicular development, endometrial receptivity, as well as oocyte and embryo quality.
Mitwally
Mohamed F M
MF
Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Wayne State University, Detroit, Michigan, USA. mmitwally@yahoo.com
Casper
Robert F
RF
Diamond
Michael P
MP
D000818:Animals; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D006063:Chorionic Gonadotropin / Q000009:adverse effects; D002996:Clomiphene / Q000009:adverse effects; D003338:Corpus Luteum / Q000187:drug effects; D010064:Embryo Implantation / Q000187:drug effects; D004624:Embryo Transfer; D004622:Embryo, Mammalian / Q000187:drug effects; D004967:Estrogens / Q000009:adverse effects*; D005260:Female; D006062:Gonadotropins / Q000009:adverse effects; D006801:Humans; D007031:Hypothalamus / Q000187:drug effects; D007247:Infertility, Female / Q000188:drug therapy*; D006080:Ovarian Follicle / Q000187:drug effects; D010062:Ovulation Induction / Q000009:adverse effects* / Q000379:methods; D010902:Pituitary Gland / Q000187:drug effects; D027724:Reproductive Techniques, Assisted; D013084:Sperm-Ovum Interactions / Q000187:drug effects
D047072:Aromatase Inhibitors; D006063:Chorionic Gonadotropin; D004967:Estrogens; D006062:Gonadotropins; D002996:Clomiphene