Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Anti-aromatase agents, such as letrozole and anastrozole, are supported by scientific evidence for use in treating certain types of infertility, particularly in women with ovulatory disorders like polycystic ovary syndrome (PCOS). Aromatase inhibitors work by blocking the conversion of androgens to estrogens, leading to a temporary reduction in estrogen levels. This decrease in estrogen triggers the hypothalamus and pituitary to increase secretion of gonadotropins (FSH and LH), thereby stimulating follicular development and ovulation. Numerous randomized controlled trials and meta-analyses have demonstrated that letrozole is at least as effective as the standard ovulation induction agent, clomiphene citrate, in inducing ovulation and achieving pregnancy in women with PCOS. Some studies suggest letrozole may have higher live birth and ovulation rates compared to clomiphene, with fewer adverse effects on the endometrium and cervical mucus. As a result, major guidelines such as those from the American College of Obstetricians and Gynecologists and the American Society for Reproductive Medicine recommend letrozole as a first-line agent for ovulation induction in women with PCOS. In men, anti-aromatase agents have been explored to treat infertility related to hypogonadism or imbalanced estrogen/testosterone ratios, but evidence is less robust and these uses are less common. Overall, the use of anti-aromatase agents for female infertility, especially in PCOS, is well-supported by scientific research.

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