Abstract
Introduction: About 10–25% of infertility patients are poor responders to gonadotropins and their management includes increasing FSH dosage ± cotreatment with estrogens, growth hormone, contraceptive pills, and/or clomiphene citrate (CC). New reversible aromatase inhibitors (AI), including letrozole, have been developed for treatment of advanced breast cancer. Our hypothesis was that blockade of estrogen synthesis by an AI in the early part of the menstrual cycle would decrease estrogen negative feedback centrally resulting in increased gonadotropin secretion. Moreover, by blocking conversion of androgens to estrogens in the ovary, the accumulating androgens may increase follicular sensitivity through amplification of FSH receptor gene expression. The objective of this pilot study was to examine the use of letrozole with FSH for poor responders undergoing ovarian superovulation and intrauterine insemination (IUI).
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