1. Aromatase inhibitors: the next generation of therapeutics for endometriosis? 
Erkut Attar, M.D., Serdar E. Bulun, M.D. 
Fertility and Sterility 
Volume 85, Issue 5, Pages (May 2006)
DOI: /j.fertnstert
Copyright © 2006 American Society for Reproductive Medicine Terms and Conditions

2. FIGURE 1
Ovarian steroidogenesis. The key steps appear to be entry of cholesterol into mitochondrion, facilitated by StAR for P production and by the conversion of androstenedione to estrone, catalyzed by aromatase (P450arom), for estrogen production. P450scc = side-chain cleavage enzyme cytochrome P450; P450c17 = 17-hydroxylase (17/20-lyase) cytochrome P450; 3β-HSD-2 = 3β-hydroxysteroid dehydrogenase type 2; 17β-HSD-1 = 17β-hydroxysteroid dehydrogenase type 1.
Attar. Aromatase inhibitors and endometriosis. Fertil Steril 2006
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2006 American Society for Reproductive Medicine Terms and Conditions

3. FIGURE 2
Molecular basis of extraovarian steroidogenesis in endometriotic tissues and endometrium of patients with endometriosis. Both endometriotic and endometrial stromal cells contain intact PGE2 receptors that give rise to intracellular cyclic adenosine monophosphate (cAMP) formation. Cyclic adenosine monophosphate induces binding of the transcription factor steroidogenic factor-1 (SF-1) to the proximal promoter II (PII) of the aromatase gene in endometriotic cells. Steroidogenic factor-1 is primarily responsible for starting transcription of the aromatase gene. AA = arachidonic acid; COX-2, cyclooxygenase-2; NRHS = nuclear receptor half site.
Attar. Aromatase inhibitors and endometriosis. Fertil Steril 2006
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2006 American Society for Reproductive Medicine Terms and Conditions

4. FIGURE 3
The mechanism of aromatase enzyme inhibitors. PSt = precursor steroid; Arom = aromatase enzyme; Pr = product; E = estrogen; CI = competitive inhibitor; IAc = inactivator.
Attar. Aromatase inhibitors and endometriosis. Fertil Steril 2006
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2006 American Society for Reproductive Medicine Terms and Conditions

5. FIGURE 4
The effect of aromatase inhibitors in four critical body sites.
Attar. Aromatase inhibitors and endometriosis. Fertil Steril 2006
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2006 American Society for Reproductive Medicine Terms and Conditions

6. FIGURE 5
Pretreatment and posttreatment disease stages, based on American Society for Reproductive Medicine (ASRM) scores, for individual patients (n = 10). (A) Baseline: first-look laparoscopy, 1 month before treatment. (B) Second-look laparoscopy 1 month after treatment. Determinations for each patient before and after treatment are interconnected (49). Mean pretreatment ASRM score: 44.1 ± 29.7; mean posttreatment ASRM score: 5.4 ± 5.64 (P=.013).
Attar. Aromatase inhibitors and endometriosis. Fertil Steril 2006
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2006 American Society for Reproductive Medicine Terms and Conditions

7. FIGURE 6
Kaplan-Meier curves for pain-free (recurrence-free) periods in patients treated with goserelin-only (dotted line) vs. goserelin plus anastrozole (solid line) (50).
Attar. Aromatase inhibitors and endometriosis. Fertil Steril 2006
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2006 American Society for Reproductive Medicine Terms and Conditions