Clinical use of aromatase inhibitors (AI) in premenopausal women
Détails
ID Serval
serval:BIB_F2C92985756A
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Clinical use of aromatase inhibitors (AI) in premenopausal women
Périodique
Journal of Steroid Biochemistry and Molecular Biology
ISSN
0960-0760
Statut éditorial
Publié
Date de publication
05/2005
Peer-reviewed
Oui
Volume
95
Numéro
1-5
Pages
121-7
Notes
Journal Article
Review --- Old month value: May
Review --- Old month value: May
Résumé
Aromatase inhibitors (AI) block the last enzymatic step of estrogen production, the aromatization of the A-cycle of aromatizable androgens and particularly, androstenedione (delta4) and testosterone (T). Molecules designed for interfering with aromatase activity have existed for many years. Yet the activity of products of the aminogluthetimide era was unspecific and these substances carried too many side effects for being used clinically. Newer third generation AIs, however, are highly specific and essentially devoid of side effects. These molecules have recently been approved for treating breast cancer in postmenopausal women either, in advanced forms or, as part of adjuvant therapy. In women whose ovaries are active, a temporary inhibition of E2 production will raise gonadotropins and in turn, stimulate follicular growth. In cancer patients, this property precludes the use of AIs in women whose ovaries are still active, unless gonadotropins are blocked. But in infertility patients, this property of AIs has been put to play for inducing ovulation. AIs have been used both in women who do not ovulate but whose hypothalamo-pituitary-gonadal (HPG) axis is active (oligo-anovulators of PCOD type) and those who ovulate regularly but in whom multiple ovulation is sought for treating unexplained infertility or as part of IVF. Like clomiphene citrate (CC), AIs are not usable in women whose gonadotropins are suppressed, as in the case of hypothalamic amenorrhea. The sum of data available on the use of AI for inducing ovulation remains however meager to this date and is mainly constituted of pilot and non-randomized trials. Yet mounting evidence tends to support AIs' advantages over CC for induction of ovulation. Hence, we think that the likelihood that these drugs will play a key role in induction of ovulation in the future is high. AIs appear particularly interesting for treating unexplained infertility because AI-FSH/hMG regimens are lighter than FSH-only regimens while retaining the high pregnancy rates of these latter treatments.
Mots-clé
Aromatase Inhibitors/pharmacology/*therapeutic use/toxicity
Clomiphene/pharmacology
Dinoprostone/pharmacology
Embryo, Mammalian/drug effects
Female
Humans
Infertility, Female/*drug therapy
Luteinizing Hormone/pharmacology
Ovulation/*drug effects
*Premenopause
Pubmed
Web of science
Création de la notice
28/02/2008 11:36
Dernière modification de la notice
20/08/2019 16:19