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Letrozole

Letrozole disables an enzyme which enables androgens to be converted into estrogens. This conversion is the normal way that the body makes estrogen. The primary use of letrozole is in treatment of breast cancer.

A recent alternative to clomiphene citrate for ovulation inductions in patients with PCO is letrozole. It works on the pituitary in the same way as clomiphene to prevent the normal decrease in FSH which occurs as a follicle grows, but it does so without blocking estrogen receptors. This results in fewer infertility related side-effects.

We use this drug only in patient for whom clomiphene has not worked and only after they completely understand the risks and benefits of its use. The manufacturer of letrozole has stated that the drug should not be used for infertility because of concern about possible cardiac congenital anomalies in babies born to mothers who took the drug. There are a number of publications suggesting that this not a realistic problem. However, it is impossible to prove that a drug does not cause a given problem, and this risk will always be there and needs to be understood by a patient who wishes to use this drug rather than move to more advanced therapy.