Editing Infertility: Nonsurgical Management (section)

== Aromatase inhibitors (anastrazole or letrozole) ==

* '''MOA: inhibit aromatase from converting testosterone to estradiol''' (E2)
** Estradiol is an indirect mediator of testosterone feedback inhibition of the HPT axis. Therefore, aromatase inhibition in men can '''result in decreased estrogen levels and ultimately increased gonadotropin production'''
* '''May restore FSH, LH, and testosterone levels in patients with elevated estradiol (T/E ratios <10)''', such as those with obesity or Klinefelter syndrome (tend to have more adipose tissue)
* '''Limited data to improve sperm parameters'''
* '''Adverse events'''
** '''Theoretical risk of decreasing bone mineral density as they decrease E2.'''
** '''Same theoretical risk of testosterone replacement exists'''