Editing Infertility: Management (section)

====Aromatase inhibitors (anastrazole or letrozole)====
*'''<span style="color:#ff0000">MOA: inhibit the enzyme aromatase from converting testosterone to estradiol (E2)</span>'''
**'''Estradiol is an indirect mediator of testosterone feedback inhibition of the hypothalamus-pituitary-testis axis.''' 
**'''<span style="color:#ff0000">Aromatase inhibition can result in decreased estrogen levels and ultimately increased gonadotropin production</span>'''
*'''May decrease estradiol and and 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'''
*'''<span style="color:#ff0000">Indications</span>'''
**'''<span style="color:#ff0000">May be considered for men with testosterone deficiency and elevated estradiol levels</span>[https://pubmed.ncbi.nlm.nih.gov/33295257/ ★]'''
**'''<span style="color:#ff0000">Not FDA-approved for use in males</span>'''
*Administration
**Available orally
*'''Adverse events'''
**'''Theoretical risk of decreasing bone mineral density as they decrease E2.'''
**'''Same theoretical risk of testosterone replacement exists'''