Aromatase inhibitors for female infertility: a systematic review of the literature.
Ovulation induction remains a milestone in the treatment of women with anovulatory infertility. Clomiphene citrate (CC) is considered the first line treatment for induction of ovulation in women with polycystic ovary syndrome (PCOS), while it may be used for ovulation induction in unexplained infertility. Aromatase inhibitors (AI) have been introduced as a new treatment option that could challenge CC for ovulation induction. A systematic review of the literature was conducted in order to highlight the efficacy and safety of AI in female infertility. Current data from randomized and non-randomized trials suggest that AI may have a role in ovulation induction regimens in PCOS patients, as well as for ovarian stimulation, since they achieve comparable clinical pregnancy rates to CC. Furthermore, when combined with gonadotrophins, AI improve the ovarian response of poor responders and reduce the gonadotrophin dose required. However, the current review is based on small trials with a limited number of patients. If solid data from future large adequately powered randomized trials support current evidence regarding efficacy and safety, AI might offer a new treatment choice for infertile women.
Polyzos
Nikolaos P
NP
PACMeR (PanHellenic Association for Continual Medical Research), Section of Obstetrics and Gynaecology and Public Health, Athens 10438, Greece. n.polyzos@gmail.com
Tzioras
Spyridon
S
Badawy
Ahmed M
AM
Valachis
Antonis
A
Dritsas
Charalabos
C
Mauri
Davide
D
D000328:Adult; D000077384:Anastrozole; D047072:Aromatase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D002996:Clomiphene / Q000627:therapeutic use; D005260:Female; D005307:Fertilization in Vitro; D006062:Gonadotropins / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007247:Infertility, Female / Q000188:drug therapy*; D000077289:Letrozole; D009570:Nitriles / Q000627:therapeutic use; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy; D011247:Pregnancy; D018873:Pregnancy Rate; D016032:Randomized Controlled Trials as Topic; D014230:Triazoles / Q000627:therapeutic use
D047072:Aromatase Inhibitors; D006062:Gonadotropins; D009570:Nitriles; D014230:Triazoles; D002996:Clomiphene; D000077384:Anastrozole; D000077289:Letrozole