Are aromatase inhibitors effective in aiding reproduction in polycystic ovary syndrome?

This paper reviewed the safety and effectiveness of aromatase inhibitors in women with polycystic ovary syndrome, a condition that resulting in lack of egg release in the female. 

Polycystic ovary syndrome is associated with infrequent or absent periods. Many women with polycystic ovary syndrome have less than optimum levels of fertility. While it is harder for these women to become pregnant, only a small number of women need fertility treatment.

There are various types of treatment. Clomiphene citrate (Clomid) is commonly used and is safe and effective. Aromatase inhibitors such as letrozole (Femara) and anastrozole (Arimidex) are also used. Aromatase inhibitors induce ovulation (release of eggs). Studies are unclear about whether aromatase inhibitors are as effective as clomiphene citrate. 

The authors looked at 26 studies.

Patients who received letrozole were 1.64 times more likely to have live birth than patients receiving clomiphene citrate after intercourse. There was no difference in birth rate when letrozole was compared to laparoscopic ovarian drilling (surgery to stimulate ovulation).

There was no difference in ovarian hyperstimulation syndrome (swollen and painful ovaries) when letrozole was compared with clomiphene citrate. Ovarian hyperstimulation syndrome occurred rarely.

Patients receiving letrozole were 1.4 times more likely to get pregnant than patients taking clomiphene citrate after intercourse. There was no difference in pregnancy rate when letrozole was compared to laparoscopic ovarian drilling. There was no difference in pregnancy rate when letrozole was compared to anastrozole. 

The authors concluded that letrozole is better than clomiphene citrate for the treatment of women with polycystic ovary syndrome who do not ovulate. 

The authors suggested that there was a low quality of evidence. 

Consider letrozole if you have polycystic ovaryian syndrom and are evaluating reproductive aids.