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However, the role and mechanism of letrozole in follicular development remain unclear.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We treated mouse preantral follicles with various treatments; we found no significant difference in follicle survival rates in the letrozole (LET) group compared with the control group, but the average diameter of follicles in the LET group tended to be larger (CTRL vs. LET 30, <jats:italic>p<\/jats:italic>\u2009=\u20090.064; CTRL vs. LET 100, <jats:italic>p<\/jats:italic>\u2009=\u20090.025). The estradiol concentrations in culture media of the LET group were significantly lower than those observed in the control group (CTRL vs. LET 30, <jats:italic>p<\/jats:italic>\u2009=\u20090.038; CTRL vs. LET 100, <jats:italic>p<\/jats:italic>\u2009=\u20090.025). We further found a marked increase in follicle-stimulating hormone receptor (FSHR) gene expression in response to letrozole treatment (CTRL vs. LET 30, <jats:italic>p<\/jats:italic>\u2009=\u20090.075; CTRL vs. LET 100, <jats:italic>p<\/jats:italic>\u2009=\u20090.034). This result suggested that increased FSHR expression promotes follicle development. Letrozole inhibited aromatase activity, but the effect was limited. Letrozole did not significantly reduce vascular endothelial growth factor (VEGF) gene expression.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Letrozole may promote follicle development by increasing the expression of FSHR. Letrozole may be useful for fertility preservation of patients with estrogen-dependent cancers such as breast cancer and various other cancers. Whether letrozole has a direct effect in reducing OHSS requires further investigation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13048-022-01073-2","type":"journal-article","created":{"date-parts":[[2022,12,24]],"date-time":"2022-12-24T02:02:33Z","timestamp":1671847353000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Letrozole increases preantral follicle growth and decreases estradiol production without impairing follicle survival"],"prefix":"10.1186","volume":"15","author":[{"given":"Fukiko","family":"Kasuga-Yamashita","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Baba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachiko","family":"Nagao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuya","family":"Fujibe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miyuki","family":"Morishita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshika","family":"Kuno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tasuku","family":"Mariya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Honnma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiaki","family":"Endo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamotsu","family":"Kiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Saito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,12,24]]},"reference":[{"key":"1073_CR1","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1093\/humrep\/dep399","volume":"25","author":"WA March","year":"2010","unstructured":"March WA, Moore VM, Willson KJ, Phillips DI, Norman RJ, Davies MJ. 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The Institutional Animal Care and Use Committee approved the study protocols (approval number: 20\u2013033).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"136"}}