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24 - Aromatase Inhibitors for Assisted Reproduction

from PART II - INFERTILITY EVALUATION AND TREATMENT

Published online by Cambridge University Press:  04 August 2010

By
Mohamed F. M. Mitwally  and
Robert F. Casper
Edited by
Botros R. M. B. Rizk ,
Juan A. Garcia-Velasco ,
Hassan N. Sallam  and
Antonis Makrigiannakis
Botros R. M. B. Rizk
Affiliation:
University of South Alabama
Juan A. Garcia-Velasco
Affiliation:
Rey Juan Carlos University School of Medicine,
Hassan N. Sallam
Affiliation:
University of Alexandria School of Medicine
Antonis Makrigiannakis
Affiliation:
University of Crete
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Summary

This chapter discusses the potential role of the new group of medications called “aromatase inhibitors” in assisted reproduction. In the past few years, aromatase inhibitors have emerged as promising agents for infertility treatment, particularly ovarian stimulation. We reported the first series in the literature of the successful application of an aromatase inhibitor for induction of ovulation in women with polycystic ovarian syndrome (PCOS) (1) and ovarian stimulation in women with ovulatory infertility, for example, unexplained infertility (2). Following this report, we showed the success of aromatase inhibition for controlled ovarian hyperstimulation (COH) (3–5), whether as a single- or multiple-dose administration (6), and suggested the potential application in various infertility treatments including assisted reproduction (7–13), with data on safety of the pregnancy outcome (14).

Since these first reports, more than a hundred clinical trials have been presented in international meetings, confirming our original findings, by investigators from all over the globe. Many peer-reviewed manuscripts (15–33) have already confirmed the success of aromatase inhibitors in various infertility applications. Currently, several multicenter clinical trials are running testing the clinical efficacy of aromatase inhibitors for infertility treatment including ovarian stimulation. In this chapter, we will discuss the potential role of aromatase inhibitors for assisted reproduction, presenting the theoretical benefits and the available evidence.

AROMATASE INHIBITORS

Blocking estrogen production by inhibiting the enzyme catalyzing its synthesis from androgens (aromatase enzyme) is a treatment modality that has been in clinical application for more than half a century since the development of the first generations of aromatase inhibitors including aminoglutethimide.

Keywords

aromatase inhibitorsassisted reproductioncontrolled ovarian hyperstimulationendometriosispolycystic ovarian syndromeestrogen-dependant malignancies
Type
Chapter
Information
Infertility and Assisted Reproduction , pp. 220 - 227
Publisher: Cambridge University Press
Print publication year: 2008

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References

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