H a T-score < -2.0 at the initiation of AI treatment should receive bisphosphonate therapy [68]. Vitamin D and calcium supplements should be given to all patients receiving AIs. AIs do not increase the risk of endometrial cancer, thromboembolism and cerebrovascular PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/25112874 eventsUsluogullari et al. Journal of Ovarian Research (2015) 8:Page 6 oflike tamoxifen [69]. Results of early studies suggest that aromatase inhibitors have adverse effect on the cardiovascular system and lipid profiles compared with tamoxifen. These effects are milder or have not been seen when comparing aromatase inhibitors with placebo but more meticulous study is required in this area.Conclusion AIs are promising agents in treatment of estrogen dependent disease. However lack of experience, side effects and cost are limiting factors for using these agents in infertility treatment. However there is need for larger, well designed randomized trials to generate robust data in order to establish the true potential of aromatase inhibitors.Competing interests The authors declare that they have no competing interests. Authors’ contributions BU designed and wrote the manuscript and searched articles. CD conceived of the study, and participated in its design and cordination. AU helped to wrote manuscript and helped to draft the manuscript. All authors read and approved the final manuscript. Author details 1 Cengiz Gokcek Obstetric and Gynecology State Hospital, Gaziantep, Turkey. 2 Obstetric and Gynecology Department of Turgut Ozal University, Ankara, Turkey. 3Endocrinology and Metabolism Department of Ersin Arslan State Hospital, Gaziantep, Turkey. Received: 30 October 2014 Accepted: 10 FebruaryReferences 1. Nelson LR, Bulun SE. Estrogen production and action. J Am Acad Dermatol. 2001;45:116?4. 2. Gruber CJ, Tschugguel W, Schneeberger C, Huber JC. Production and Actions of Estrogens. N Engl J Med. 2002;346:340?2. 3. Thompson EA, Siiteri PK. Utilization of oxygen and reduced nicotinamide adenine dinucleotide phosphate by human placental microsomes during aromatization of androstenedione. J Biol Chem. 1974;249:5364?2. 4. Chen SA, Besman MJ, Sparkes RS, Zollman S, Klisak I, Mohandas T, et al. Human aromatase: cDNA cloning, Southern blot analysis, and assignment of the gene to chromosome 15. DNA. 1988;7:27?8. 5. Santen RJ, Brodie H, Simpson ER, Siiteri PK, Brodie A. History of aromatase: saga of an important biological mediator PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/27484364 and therapeutic target. Endocr Rev. 2009;30:343?5. 6. McDonnell DP. The molecular pharmacology of SERMs Trends Endocrinol. Metab. 1999;10:301?1. 7. Brodie AM. Aromatase inhibitors in the treatment of breast cancer. J Steroid Biochem Mol Biol. 1994;49:281?. 8. Chumsri S, Howes T, Bao T, Sabnis G, Brodie A. Aromatase, aromatase inhibitors, and breast cancer. J Steroid Biochem Mol Biol. 2011;125:13?2. 9. Holzer H, Casper R, Tulandi T. A new era in ovulation induction. Fertil Steril. 2006;85:277?4. 10. Jansen RP. Russell PNonpigmented endometriosis: clinical, GLPG0187 web laparoscopic, and pathologic definition. Am J GLPG0187MedChemExpress GLPG0187 Obstet Gynecol. 1986;155:1154?. 11. Yanushpolsky EH. Effects of endometriomas on ooccyte quality, embryo quality, and pregnancy rates in in vitro fertilization cycles: a prospective, case-controlled study. J Assist Reprod Genet. 1998;15(4):193?. 12. Ferrero S. Letrozole and norethisterone acetate versus letrozole and triptorelin in the treatment of endometriosis related pain symptoms: a randomized controlled trial. Reprod Biol Endocrinol. 2011;21(9):88. 13. Bulun S.H a T-score < -2.0 at the initiation of AI treatment should receive bisphosphonate therapy [68]. Vitamin D and calcium supplements should be given to all patients receiving AIs. AIs do not increase the risk of endometrial cancer, thromboembolism and cerebrovascular PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/25112874 eventsUsluogullari et al. Journal of Ovarian Research (2015) 8:Page 6 oflike tamoxifen [69]. Results of early studies suggest that aromatase inhibitors have adverse effect on the cardiovascular system and lipid profiles compared with tamoxifen. These effects are milder or have not been seen when comparing aromatase inhibitors with placebo but more meticulous study is required in this area.Conclusion AIs are promising agents in treatment of estrogen dependent disease. However lack of experience, side effects and cost are limiting factors for using these agents in infertility treatment. However there is need for larger, well designed randomized trials to generate robust data in order to establish the true potential of aromatase inhibitors.Competing interests The authors declare that they have no competing interests. Authors’ contributions BU designed and wrote the manuscript and searched articles. CD conceived of the study, and participated in its design and cordination. AU helped to wrote manuscript and helped to draft the manuscript. All authors read and approved the final manuscript. Author details 1 Cengiz Gokcek Obstetric and Gynecology State Hospital, Gaziantep, Turkey. 2 Obstetric and Gynecology Department of Turgut Ozal University, Ankara, Turkey. 3Endocrinology and Metabolism Department of Ersin Arslan State Hospital, Gaziantep, Turkey. Received: 30 October 2014 Accepted: 10 FebruaryReferences 1. Nelson LR, Bulun SE. Estrogen production and action. J Am Acad Dermatol. 2001;45:116?4. 2. Gruber CJ, Tschugguel W, Schneeberger C, Huber JC. Production and Actions of Estrogens. N Engl J Med. 2002;346:340?2. 3. Thompson EA, Siiteri PK. Utilization of oxygen and reduced nicotinamide adenine dinucleotide phosphate by human placental microsomes during aromatization of androstenedione. J Biol Chem. 1974;249:5364?2. 4. Chen SA, Besman MJ, Sparkes RS, Zollman S, Klisak I, Mohandas T, et al. Human aromatase: cDNA cloning, Southern blot analysis, and assignment of the gene to chromosome 15. DNA. 1988;7:27?8. 5. Santen RJ, Brodie H, Simpson ER, Siiteri PK, Brodie A. History of aromatase: saga of an important biological mediator PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/27484364 and therapeutic target. Endocr Rev. 2009;30:343?5. 6. McDonnell DP. The molecular pharmacology of SERMs Trends Endocrinol. Metab. 1999;10:301?1. 7. Brodie AM. Aromatase inhibitors in the treatment of breast cancer. J Steroid Biochem Mol Biol. 1994;49:281?. 8. Chumsri S, Howes T, Bao T, Sabnis G, Brodie A. Aromatase, aromatase inhibitors, and breast cancer. J Steroid Biochem Mol Biol. 2011;125:13?2. 9. Holzer H, Casper R, Tulandi T. A new era in ovulation induction. Fertil Steril. 2006;85:277?4. 10. Jansen RP. Russell PNonpigmented endometriosis: clinical, laparoscopic, and pathologic definition. Am J Obstet Gynecol. 1986;155:1154?. 11. Yanushpolsky EH. Effects of endometriomas on ooccyte quality, embryo quality, and pregnancy rates in in vitro fertilization cycles: a prospective, case-controlled study. J Assist Reprod Genet. 1998;15(4):193?. 12. Ferrero S. Letrozole and norethisterone acetate versus letrozole and triptorelin in the treatment of endometriosis related pain symptoms: a randomized controlled trial. Reprod Biol Endocrinol. 2011;21(9):88. 13. Bulun S.