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The following will cover the advancements of female fertility agents, major causes of female infertility. Next, it emphasizes on common female fertility agents in terms of their mechanism of action, side effects, fetal consideration and clinical application and ended up by the introduction of supplements and herbal medicines for female infertility.
Letrozole, sold under the brand name Femara among others, is an aromatase inhibitor medication that is used in the treatment of breast cancer for post-menopausal women. [ 1 ] It was patented in 1986 and approved for medical use in 1996. [ 4 ]
Ovarian stimulation with the aromatase inhibitor letrozole has been proposed for ovulation induction in order to treat unexplained female infertility. In a multi-center study funded by the National Institute of Child Health and Development, ovarian stimulation with letrozole resulted in a significantly lower frequency of multiple gestation (i.e., twins or triplets) but also a lower frequency ...
Aromatase inhibitors are a common fertility treatment to treat women with PCOS. A meta-analysis analyzing live birth rates for women with PCOS treated with clomiphene compared to letrozole found that letrozole resulted in higher live birth rates. [11] However, ovulation induction remains an off-label indication, which affects use.
The first aromatase inhibitor that was discovered was aminoglutethimide, classified as first-generation AIs. It is still used today despite causing side effects such as lack of target enzyme specificity which also has effects on other cytochrome P450 enzymes. [12] Furthermore, it affects the synthesis of aldosterone, thyroid hormone and ...
Breast Cancer Survivors: Chemotherapy, selective estrogen receptor modulators (e.g. Tamoxifen and Raloxifene), or aromatase inhibitors (e.g. Letrozole, Anastrozole, and Exemestane) can lead to decreased estrogen levels and therefore side effects that include atrophic vaginitis. [6] [13] Cigarette smoking [14]
Reproductive toxicants may adversely affect sexual function, ovarian failure, fertility as well as causing developmental toxicity in the offspring. [2] [3] Lowered effective fertility related to reproductive toxicity relates to both male and female effects alike and is reflected in decreased sperm counts, semen quality and ovarian failure.
No other insulin sensitizers have evidence of effective and safe use of fertility treatment. [10] Previously, metformin was recommended as treatment for anovulation in polycystic ovary syndrome , but in the largest trial to date, comparing clomiphene with metformin, clomiphene was more effective than metformin alone. [ 5 ]