Aromatase Inhibitors for Endometriosis-Associated Infertility; Do We Have Sufficient Evidence?

Hatem Abu Hashim
International journal of fertility & sterility · 2016 · vol. 10(3) , pp. 270–277 · doi:10.22074/ijfs.2016.5040 · PMID:27695608 · PMC5023037 · W3026988095
review OA: gold CC0 ⤵ 18 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study found that letrozole reduced estradiol production and aromatase expression in granulosa cells from women with endometriosis, but more trials are needed to confirm clinical efficacy for infertility.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This review critically appraised evidence on orally active aromatase inhibitors for managing endometriosis-associated infertility, prioritizing randomized controlled trials while also including other study designs, using a PubMed search through May 2015. Across six included original articles, two RCTs found no benefit of letrozole after surgery for improving spontaneous pregnancy rates and no superiority of letrozole superovulation over clomiphene citrate (each combined with intrauterine insemination) in minimal-mild endometriosis, while lab and culture work reported anastrozole inhibiting endometriotic cell growth and estrogen production; a pilot ART study reported a 45% pregnancy rate with dual suppression but a 30% high pregnancy loss, and a retrospective IVF study suggested potential improvement in endometrial receptivity while other in vitro work found reduced estradiol production and aromatase expression with letrozole. The paper explicitly concludes that evidence is limited and that more trials are needed. This paper is centrally about endometriosis — specifically evaluating the sufficiency of evidence for aromatase inhibitors in endometriosis-associated infertility.

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Abstract

study showed lower estradiol production and aromatase expression in cultured granulosa cells from endometriotic women undergoing IVF and marked reduction under letrozole. In conclusion, current evidence is limited. More trials are warranted to enhance our knowledge and provide a clear and unequivocal evidence to guide our clinical management of infertile women with endometriosis using AIs.

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endometriosisinfertility

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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