Intro & HSG & Letrozole Questions

lsimmers83

Hi! I am new to the board and just created my signature!  TTC since 2012, and after 2 years of trying on our own, I started this journey of infertility over the summer.  Long story short, we are at the point where I am to do an HSG this cycle and start Letrozole once my cycle restarts.  I see lots of testing that others have had prior to taking Letrozole, and I have only had CD21 Progesterone level checked which indicated that I had not ovulated (3.3).  Hubby also did the whole SA which was a bit confusing - they said his results were low according to standards, but they weren't going to take any action with him at this time. 

Being new to all of this, I was wondering what the HSG experience is like if anyone has been through it before.  Also, just curious what your experience has been with Clomid vs Letrozole.  My doctor seemed to think Letrozole has less side effects, but I found it odd that it's used as a breast cancer drug for post-menopausal women.

Thanks so much! Really appreciate the advice and looking forward to "meeting" you all!

tlc35

Welcome. For me, the HSG was not painful at all.  I took 500 mg of naprosyn beforehand, but some ladies do experience cramping.
Yes, letrozole is commonly used for this purpose but is only FDA approved as a breast cancer medication.
I would ask about CD 3 bloodwork which includes FSH, E2 and LH.  I would also ask about having your prolactin checked as well.
Are you working with a RE or an OB?

SND1231

Welcome.. I took Letrozole and it wasn't great but not terrible either.  Headaches, Nausea, etc but nothing I couldn't deal with. I am surprised you haven't had a baseline u/s and b/w. Are you working with a RE or OB? If you are working with an OB, most of the ladies around here will tell you to stop wasting your time with an OB and ask for a referral to a RE especially with trying for 2 years. OB are great at keeping you pregnant and RE are great at getting you pregnant. If you are seeing an OB make sure you have proper monitoring even with Letrozole, even though it has a smaller chance of multiple follicles like Clomid.

Rachaeleigh

Welcome
I had a pretty crappy HSG experience. It was pretty painful, but not everyone has the same experience
I had minimal side effects with letrozole, only hot flashes. I also had slightly higher progesterone 7dpo on letrozole vs clomid
Overall though, I didn't respond well to oral meds (1 follicle, low progesterone)
I hope all goes well, good luck!

BandM14

Hi, and welcome! PP have given you some great input, especially about the need to see an RE for proper testing/treatment (hopefully you already are). I had two HSGs done, and both were fairly painful but nothing I couldn't handle. I also have a blockage so I think that could have contributed to the cramping I had. I've done two cycles of letrozole, about to start my third, and for me it's been pretty easy. Some minor hot flashes and a few headaches, that's really it. Good luck with everything moving forward! I hope you stick around here, it's a great community.

redandblue

Welcome and sorry you find yourself here. I had an HSG done at least twice over the past 4 years. I did not find it bad at all. Minor cramping, but I also took tylenol before. I have done 3 rounds with letrozole and have also not found it bad. I don't think I had really any side effects. Just good effects, such as good follicles. Good luck to you!

BunnyBerry

Welcome, though I'm sorry you have to be here!

I would venture a guess that the doctor you are working with is not an RE? Or perhaps the RE just wants to wait and share the big picture of all your results at a consult after testing is complete?

Did you have CD3 ultrasound and bloodtests? Or perhaps they are scheduled for your HSG cycle? 

No reason to keep the SA results from you. I would call and request the details. If they are "low" and not just "low normal" I would expect an RE to send YH to a urologist, and discuss IUI.

Letrozole works by blocking estrogen receptors in the brain so that your brain doesn't realize follicles are growing and shut off follicle stimulating hormone, giving follies more time and stimulation to develop. That's why it helps post-breast cancer. It's true that it would be harmful to a developing fetus, but it is completely out of your system before implantation. It also has less side effects than Clomid because Clomid actually binds to estrogen in your body and takes it out of play, while with Letrozole the estrogen is still there doing its thing in your body (including thickening the uterine lining and making cervical mucous).

juneroses

Welcome, & sorry that you find yourself here. I'm also on Letrozole, and aside from some mood swings & crazy "I'm totally pregnant I have all the signs" pms the first month, I've been pretty side effect free. I do cry pretty easily, but I think that is more due to the IF stress. @BunnyBerry‌ , great description! I had forgotten the mechanics & was glad for the refresher! 

My HSG was pretty painful, but fast - three cramps, one with each push of the dye. Kind of like the intense cramps you have if you are suffering abdominal cramps due to a stomach bug. Bad, but you know it is going to pass in a few moments. Try to relax as much as possible - it makes it easier to insert the catheter into your cervix.

 Good luck on your next steps!

MissK23

Welcome! My HSG was painful but nothing unbearable, the pain was gone as soon as the procedure was over AND it is a really quick test, which is great! I think mine was 10 mins in and out!

I'm stating my first Letrozole cycle tomorrow, so I don't have anything to offer there, but GL!

mshandlebar

Welcome! HSG experiences really depend on the individual. For some women it hurts like a bitch, but for others it is a piece of cake. I was somewhere in between. Don't psych yourself out about it too much.

Otherwise, everything else the other gals said, I second. Good luck!

eener817

Welcome and sorry you have had to join us!

My HSG really wasn't bad. I took Tylenol about 45 minutes before (the RE's office said that was best bc other pain meds may cause more bleeding). It was really quick and not too painful at all - just like a couple of period cramps. I had a little bit of lingering cramping for a couple hours after. I did not have any blockages (I have heard it's more painful if you have any blockage). Good luck!

Sorry - no advice about the meds.

lsimmers83

Thanks! Working with an OB right now.

lsimmers83

Thanks everyone for the support and education! I'm starting to feel like my OB doesn't know what he's doing. I agree that I want to know WHY I'm not ovulating versus trying so many things at once. I have very regular cycles, and according to my test strips (Wondflo), I am ovulating. However, my progesterone test indicated otherwise. I am going to see if my insurance will allow me to see an RE without a referral, too. Thanks again and looking forward to being a part of this group (although I wish it were under different circumstances).

lsimmers83

Thanks! I've been second guessing the fertility drugs, so you've definitely confirmed how I'm feeling. I'll go ahead w the HSG and check into seeing a RE.

AnonymousNurse

Experiences with HSGs vary widely.  Mine pretty much felt like a pap smear, others have had a lot of pain.  It's impossible to tell how yours will go.  Take some ibuprofen beforehand and just try to relax!  My RE told me that most people experience pain comparable to your menstrual cramps.  I rarely have any cramps, and I had no pain at all.  So that might be something to take into consideration.

Femara is an aromatase inhibitor.  When aromatase is inhibited, your estrogen levels are suppressed. So essentially, Femara blocks estrogen.  Many types of breast cancer tumors are estrogen-receptive, basically meaning they are fed by estrogen.  That's why it helps - it's not some cytotoxic chemotherapy drug.  Femara will help you ovulate because as your estrogen decreases, you produce more FSH which results in the production of not only more follicles but also better quality follicles.  Additionally, Femara has a very short half-life and if you do conceive during a cycle with it, you will not have any left to cause any potential harm.

Definitely get in with an RE asap.  The HSG is fine (although I've heard sometimes the RE will want to repeat it anyway), but I do not recommend going through treatment with an OB.