Aromatase inhibitors don't work as well while taking SERMs because they don't block intratesticular aromatization within the testes. Our advisors have seen lab work of high doses of both non-steroidal and steroidal AIs and they usually do not lower estradiol very much while taking a SERM. If estradiol is elevated AND causing side effects while on a SERM, the best practice with enclomiphene is to dial the dose back instead of adding an AI.