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Understanding Anastrozole and its Role in Fertility

Anastrozole is a medication that is commonly used as a treatment for breast cancer in postmenopausal women. It belongs to a class of drugs known as aromatase inhibitors, which work by blocking the production of estrogen - a hormone that can stimulate the growth of certain types of breast cancer. However, its role in fertility is lesser known. In recent years, anastrozole has been increasingly studied and used as an alternative to traditional fertility medications like clomiphene citrate (Clomid).

In this section, we will discuss the basics of anastrozole, its mechanism of action, and how it may be beneficial in the context of fertility. By understanding how anastrozole works and its potential benefits for those struggling with infertility, you can make more informed decisions about your treatment options.

Anastrozole as an Alternative to Clomiphene Citrate

Clomiphene citrate has long been the gold standard for fertility treatments, particularly for women with ovulatory disorders like polycystic ovary syndrome (PCOS). Clomiphene works by blocking estrogen receptors in the brain, which in turn stimulates the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These hormones then stimulate the ovaries to produce and release eggs.

While clomiphene is effective for many women, some may not respond well to the medication or may experience significant side effects. Anastrozole has emerged as a potential alternative to clomiphene, particularly for women who do not respond well to clomiphene or have a contraindication to its use. Like clomiphene, anastrozole works by indirectly increasing the levels of FSH and LH, leading to ovulation. However, it does so by blocking the production of estrogen, rather than blocking its receptors.

Benefits of Anastrozole in Fertility Treatments

There are several potential benefits to using anastrozole in fertility treatments, especially for women who have not had success with clomiphene citrate. These benefits include:

Lower Incidence of Multiple Pregnancies

One of the risks associated with clomiphene citrate is the increased likelihood of multiple pregnancies, such as twins or triplets. This is because clomiphene can sometimes stimulate the ovaries to release multiple eggs at once. Anastrozole, on the other hand, has been shown to be associated with a lower incidence of multiple pregnancies, making it a potentially safer option for some women.

Better Ovarian Response

Some studies have shown that women who do not respond well to clomiphene may have a better ovarian response when treated with anastrozole. This can result in a higher chance of successful ovulation and ultimately, a higher chance of pregnancy.

Fewer Side Effects

While both clomiphene and anastrozole can cause side effects, some women may tolerate anastrozole better. Common side effects of clomiphene include hot flashes, mood swings, and visual disturbances, while anastrozole is more commonly associated with joint pain and stiffness. The side effect profile of anastrozole may be more tolerable for some women, making it a more appealing option.

How Anastrozole is Used in Fertility Treatments

Anastrozole is typically prescribed in a similar manner to clomiphene citrate. It is usually taken in pill form, starting on the third day of the menstrual cycle and continuing for a total of five days. The dosage of anastrozole can vary, but it is generally lower than the dosage used for breast cancer treatment. Your healthcare provider will closely monitor your response to the medication through blood tests and ultrasounds, adjusting the dosage as necessary.

It is important to note that anastrozole is not approved by the U.S. Food and Drug Administration (FDA) for use in fertility treatments. However, it is often prescribed off-label by healthcare providers who believe it may be beneficial for certain patients.

Who Should Consider Anastrozole for Fertility Treatments

Anastrozole may be a suitable option for women who:

  • Have not responded well to clomiphene citrate
  • Have a contraindication to the use of clomiphene
  • Are at a higher risk for multiple pregnancies
  • Prefer a medication with a potentially more tolerable side effect profile

However, it is essential to discuss your specific situation and medical history with your healthcare provider before deciding to use anastrozole for fertility treatments. They will help you weigh the potential benefits and risks, and determine if anastrozole is the right choice for you.


Anastrozole is an aromatase inhibitor that has shown promise as an alternative to clomiphene citrate for certain women undergoing fertility treatments. With its potential benefits, such as a lower incidence of multiple pregnancies and a more tolerable side effect profile, it may be a suitable option for some women struggling with infertility. If you're considering anastrozole for fertility treatments, be sure to consult with your healthcare provider to determine if it is the right choice for you.