Letrozole/Femara Start Day Question — The Bump
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Letrozole/Femara Start Day Question

RE prescribed Letrozole 5mg CD3-7 again. Unfortunately I couldn't go in for monitoring CD3 so nurse said I can take the meds CD4-8 instead. She mentioned that "since I'm young it should be okay." What does that mean? Dr. Google has been mute on the subject.

I cannot for the life of me figure out what effect it would have to start later vs. earlier.

Assuming it would be a similar situation with Clomid so if you have insight into the pros/cons of different Clomid start dates that would be helpful too. Thank you for your collective wisdom! :)
January 3T Siggy Challenge - New Year's Resolutions
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Me (29), DH (30) TTC actively 54 55+ cycles | All BFNs
MFI (low everything) | Endo Stage 1 & Stenotic Cervix (treated) | PCO
Married - July 2008 | Started TTC - Jan 2009 | RE Visit #1 - Mar 2014 
IUI #1 ICI #1 - June | IUI #1.1 Laparoscopy - Aug
IUIs #1.2, 2, 3 - Sept, Oct, Nov (Letrozole) - BFNs 
IUI #4 - Dec (Bravelle) | IUI #5 - Dec/Jan (Bravelle) - 5 follies + TI - BFNs
IUI #5.1 - Jan (Bravelle) Cancelled 
Planning to start IVF in March!
***All Welcome***

Re: Letrozole/Femara Start Day Question

  • I don't have much to offer, as I'll only be starting femara next month but my RE did mention before that I always had to start injectables on cd3, but orals are ok to start on cd4, if needed

    4 Losses (2003, 2008, Apr 2012, & Oct 2012)
    All RPL and IF testing with multiple REs = normal

    5 IUIs = BFN

    All AL are welcome
    Image and video hosting by TinyPic

    BunnyBerry
  • I've started on day 3 or 4 with my oral medication.  I'm really not sure the reason behind the different days, but apparntly my RE is ok with either day. 
    Me (29), DH (32)
    Aug 2011  - Married
    Jan 2013   - Started TTC
    Jan 2014   - OB started some testing 
                         - HSG - Normal
                         - Ultrasound - Normal
                         - SA - Normal, but tested positive for Ureaplasma
                         - Both of us on antibiotics to treat ureaplasma
                         - Blood work - progesterone: 15.9, TSH: 0.89, FT4: 1.2, Prolactin: 33.4 
    Feb 2014   - Endometrial Biopsy - Normal
    Mar 2014   - Prolactin: 22.9, referred to RE
    Apr 2014   - First RE appointment, put on medication for high prolactin levels 
                      - Clomid (50 mg) 1 follicle, Trigger shot - BFN
                      - Second SA - All Normal, borderline morph (5%) 
    May 2014   - Clomid (100mg) 2 follicles, Trigger shot - BFN
                      - blood work: Estradiol: 32.7, FSH: 5.3, Prolactin: 14.1
    June 2014  - IUI #1, Clomid (150 mg), 3 follicles, Trigger shot - BFN 
    July 2014   - IUI #2, Clomid (150 mg), 4 follicles, Trigger shot - BFN
    Aug 2014   - IUI #3, Femara 2.5, 3 follicles, Trigger shot (first time done by DH!!) - BFN
                      - Hysteroscopy - Normal
    Sept 2014 - IUI #4 Femara 2.5, 1 follicle, possibility of another one, Trigger shot - BFN
                       -Progesterone test 4 DPIUI - 7.8...started crinone.
    Oct 2014 - IUI #5 Follistim 150 3 possibly 4 follicles - Trigger Shot - BFN
    Oct/Nov 2014 - Follistim 150 with TI & Trigger shot - ???

    **October Siggy Challenge**

    I don't even know what he is supposed to be!
    image


    **EVERYONE WELCOME!! :)**

    BunnyBerry
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  • I have read that the earlier you start, the more follicles you produce. I guess it kind of makes sense because it gives them more time to develop?
    DH & I married 12/17/2012
    Me (31)-dx w/PCOS 2007, when married to ex-husband after MC
    DH (41)-no MFI
    07/2014-Femara 5mg + trigger + IUI= chem preg ;(
    08/2014-Femara 5mg + trigger + IUI + 2nd trigger= BFN
    09/2014-Clomid 100mg + trigger + IUI + 2nd trigger= BFN
    10/2014-benched due to RE out of town, tying naturally!
    11/2014-benched due to cyst
    12/2014-Femara 5mg + stair step with additional 5 days Femara 5mg + trigger + IUI=BFN
    01/2015-Femara 5mg + Gonal F 25 units + trigger (plus additional Gonal F 100 units on trigger night) + IUI= BFP!!! Twins due 10/2015
    09/28/2015- Surprise!  Conrad and Hudson born at 35w6d!  
    BunnyBerry
  • I just called my RE's office because today is CD1 - they scheduled me to do baseline monitoring and start Letrozole on Monday, CD4. Hopefully that works for us both!
    BunnyBerry
  • @lemonliz That is super helpful, thank you!

    @rachaeleigh Ah, good to know!

    @lisa89760 Thanks!

    @bslav23 That's what I was thinking too, which is annoying because I aaalmost had a second mature follie this month, and I guess starting on CD4 I will probably have to accept just 1.

    @typo31 That makes me feel better. Hopefully it does the trick for us both!


    January 3T Siggy Challenge - New Year's Resolutions
    image
    imageimage

    Me (29), DH (30) TTC actively 54 55+ cycles | All BFNs
    MFI (low everything) | Endo Stage 1 & Stenotic Cervix (treated) | PCO
    Married - July 2008 | Started TTC - Jan 2009 | RE Visit #1 - Mar 2014 
    IUI #1 ICI #1 - June | IUI #1.1 Laparoscopy - Aug
    IUIs #1.2, 2, 3 - Sept, Oct, Nov (Letrozole) - BFNs 
    IUI #4 - Dec (Bravelle) | IUI #5 - Dec/Jan (Bravelle) - 5 follies + TI - BFNs
    IUI #5.1 - Jan (Bravelle) Cancelled 
    Planning to start IVF in March!
    ***All Welcome***
    [Deleted User]
  • @hrushka That is super helpful, thanks!! I have O'ed CD18 and CD17 on Femara, but that's average for me anyway so hopefully starting CD4 won't push it much later. I don't want to deal with the stress of so much time off work if I keep needing repeat ultrasounds! :(
    January 3T Siggy Challenge - New Year's Resolutions
    image
    imageimage

    Me (29), DH (30) TTC actively 54 55+ cycles | All BFNs
    MFI (low everything) | Endo Stage 1 & Stenotic Cervix (treated) | PCO
    Married - July 2008 | Started TTC - Jan 2009 | RE Visit #1 - Mar 2014 
    IUI #1 ICI #1 - June | IUI #1.1 Laparoscopy - Aug
    IUIs #1.2, 2, 3 - Sept, Oct, Nov (Letrozole) - BFNs 
    IUI #4 - Dec (Bravelle) | IUI #5 - Dec/Jan (Bravelle) - 5 follies + TI - BFNs
    IUI #5.1 - Jan (Bravelle) Cancelled 
    Planning to start IVF in March!
    ***All Welcome***
    [Deleted User]
  • @daydreamsam Yes, it didn't make sense to me either! She seemed a little discombobulated overall on that phone call though. -_- Glad to know your RE feels a range is okay!
    January 3T Siggy Challenge - New Year's Resolutions
    image
    imageimage

    Me (29), DH (30) TTC actively 54 55+ cycles | All BFNs
    MFI (low everything) | Endo Stage 1 & Stenotic Cervix (treated) | PCO
    Married - July 2008 | Started TTC - Jan 2009 | RE Visit #1 - Mar 2014 
    IUI #1 ICI #1 - June | IUI #1.1 Laparoscopy - Aug
    IUIs #1.2, 2, 3 - Sept, Oct, Nov (Letrozole) - BFNs 
    IUI #4 - Dec (Bravelle) | IUI #5 - Dec/Jan (Bravelle) - 5 follies + TI - BFNs
    IUI #5.1 - Jan (Bravelle) Cancelled 
    Planning to start IVF in March!
    ***All Welcome***
    [Deleted User]
  • I was wondering this too! The Pharmacy I went to was out after a long debate with the insurance company but promised they would have it on the next day. (they didnt) so I didnt get mine til yesterday which was CD4. So I just did what I could and started it  yesterday so I am doing 7.5mg 4-8 (didnt O til CD19 ((with 2 small follies)) on 5mg so they increased it) Good Luck!!! =) 
    *** Siggy Warning ***
    Me:30 DH:33
    TTC since 10/12 
    HSG- Tubes Clear slight scarring on UTE (unexplained)
    DH SA- Normal
    10/12-6/13 Natural 
    Pcos Dx 7/13 Metformin 500mg x2 daily
    4/14 Provera  10days  then Clomid 50mg CD5-9 (BFN)
    5/14 Provera 10days then Clomid 50mg CD5-9  (BFN)
    6/14 (no provera yay!) Clomid 50mg CD5-9  (BFN)
    7/14 Natural Cycle Moving on to RE appt not til 7/31 (BFN)  
    8/14 Plan of action! Moved up to 1500mg Metformin, Femara 3-7 (Trigger canceled due to not big enough follies and holiday weekend) (BFN)
    9/14 7.5mg Femara CD3-7 +ovidrel  (BFN)
    10/14 5mg Femara(3-7) Follistim 75 (7-9) +Ovidrel +TI (last treatment cycle this year Breaking til after Holidays) (BFP! Beta #1 114, Beta #2 364)
    ~~~~~~~~~~~~ ALL ARE WELCOME! ~~~~~~~~~


    image




    BabyFetus Ticker
  • @autumnray Good luck to you too! I feel like comparing the results of those of us starting CD4 this month will about triple the data I've been able to find on the subject. :D
    January 3T Siggy Challenge - New Year's Resolutions
    image
    imageimage

    Me (29), DH (30) TTC actively 54 55+ cycles | All BFNs
    MFI (low everything) | Endo Stage 1 & Stenotic Cervix (treated) | PCO
    Married - July 2008 | Started TTC - Jan 2009 | RE Visit #1 - Mar 2014 
    IUI #1 ICI #1 - June | IUI #1.1 Laparoscopy - Aug
    IUIs #1.2, 2, 3 - Sept, Oct, Nov (Letrozole) - BFNs 
    IUI #4 - Dec (Bravelle) | IUI #5 - Dec/Jan (Bravelle) - 5 follies + TI - BFNs
    IUI #5.1 - Jan (Bravelle) Cancelled 
    Planning to start IVF in March!
    ***All Welcome***
  • I did cd3-7 on the past 3 cycles, and on this cycle I couldn't get in for my cd3 u/s till cd4 so I did my Letrozole on cd4-8.. For me there was no difference in progression and my follies matured just like they did before.
  • @kkeglar13 So interesting to know there were totally similar results! Thanks for sharing. :)
    January 3T Siggy Challenge - New Year's Resolutions
    image
    imageimage

    Me (29), DH (30) TTC actively 54 55+ cycles | All BFNs
    MFI (low everything) | Endo Stage 1 & Stenotic Cervix (treated) | PCO
    Married - July 2008 | Started TTC - Jan 2009 | RE Visit #1 - Mar 2014 
    IUI #1 ICI #1 - June | IUI #1.1 Laparoscopy - Aug
    IUIs #1.2, 2, 3 - Sept, Oct, Nov (Letrozole) - BFNs 
    IUI #4 - Dec (Bravelle) | IUI #5 - Dec/Jan (Bravelle) - 5 follies + TI - BFNs
    IUI #5.1 - Jan (Bravelle) Cancelled 
    Planning to start IVF in March!
    ***All Welcome***
  • I did clomid cycles taking it CD 3-7 and CD 5-9. Clomid can delay ovulation so the earlier you start it the earlier you O. For example, on nothing I would O around CD 12-14 (28 day cycle) taking clomid starting on CD 5 I would O CD 16 (30 day cycle) taking clomid starting CD 3 I would O CD 12 (28 day cycle). Starting on CD 3 more closely resembled my natural cycle which I liked and it also led to a shorter cycle so when I got my BFN I could try again sooner. My RE said the day 5-9 is more old school. Hope this helps!
    ***pregnancy and loss mentioned***

    Me: 31 DH: 31
    Dx: unexplained IF
    TTC since March 2013 
    IUI#1 with OB: BFN (April 2014 - clomid 50mg)
    IUI#2 with OB: BFN (June 2014 - clomid 50mg)
    IUI#3 with OB: BFN (July 2014 - clomid 50mg)
    IUI#4 with RE: BFN (August 2014 - clomid 50mg, ovidrel 250mcg, Crinone 8%)
    IVF #1 with pICSI in November
    ER 11/13 - 14R, 13M, 11F
    ET 11/19 - 2 grade AA hatched blasts transferred
    Beta #1: 58 - BFP!!, Beta #2: 140, Beta #3: 347, Beta #4: 931
    First u/s 12/19 - baby measuring 6w4d with HR of 116
    Second u/s 12/29 - baby measuring only 7 weeks, no heart beat detected
    01/02/15 - misoprostol administered vaginally

    image
    BunnyBerry
  • Thanks @stace2524!
    January 3T Siggy Challenge - New Year's Resolutions
    image
    imageimage

    Me (29), DH (30) TTC actively 54 55+ cycles | All BFNs
    MFI (low everything) | Endo Stage 1 & Stenotic Cervix (treated) | PCO
    Married - July 2008 | Started TTC - Jan 2009 | RE Visit #1 - Mar 2014 
    IUI #1 ICI #1 - June | IUI #1.1 Laparoscopy - Aug
    IUIs #1.2, 2, 3 - Sept, Oct, Nov (Letrozole) - BFNs 
    IUI #4 - Dec (Bravelle) | IUI #5 - Dec/Jan (Bravelle) - 5 follies + TI - BFNs
    IUI #5.1 - Jan (Bravelle) Cancelled 
    Planning to start IVF in March!
    ***All Welcome***
  • For both IUIs, I started letrozole on CD5. I'm not sure what the reasoning behind that start date is.


    image




    Me: 33, DH: 35
    Married 10/13, TTC since 7/13
    Dx: MFI
    IUI #1 7/14: BFN
    IUI #2 8/14: BFN
    IVF #1 11/14: 20R17M15F
    Transferred 1 three day embryo! 7 frosties!
    BFP!  EDD 7/27/15



                                                                      image

    BunnyBerry
  • I missed CD3 due to the weekend. And have started on day 4-8 there are a few factors but normally you have a "grace" period of starting from Cd3-5, unless you have short cycles. Then preferably CD3 again this is all according to my RE and my situation as my normal Cycles are 21-24 days so they prefer to start me on day 3 but due to timing it's been day 4 best of luck bunny!!
  • @steen9713 Thanks that's very helpful! My cycles are a bit long so hopefully day 4 doesn't hurt anything. Except giving me headaches. Ugh, I hate those headaches!  :)
    January 3T Siggy Challenge - New Year's Resolutions
    image
    imageimage

    Me (29), DH (30) TTC actively 54 55+ cycles | All BFNs
    MFI (low everything) | Endo Stage 1 & Stenotic Cervix (treated) | PCO
    Married - July 2008 | Started TTC - Jan 2009 | RE Visit #1 - Mar 2014 
    IUI #1 ICI #1 - June | IUI #1.1 Laparoscopy - Aug
    IUIs #1.2, 2, 3 - Sept, Oct, Nov (Letrozole) - BFNs 
    IUI #4 - Dec (Bravelle) | IUI #5 - Dec/Jan (Bravelle) - 5 follies + TI - BFNs
    IUI #5.1 - Jan (Bravelle) Cancelled 
    Planning to start IVF in March!
    ***All Welcome***
  • Seriously Bunny! I HATE the headaches! Lucky for me I only had a major one on day 2 of pills other than that one I havent had much issues this cycle =) 
    *** Siggy Warning ***
    Me:30 DH:33
    TTC since 10/12 
    HSG- Tubes Clear slight scarring on UTE (unexplained)
    DH SA- Normal
    10/12-6/13 Natural 
    Pcos Dx 7/13 Metformin 500mg x2 daily
    4/14 Provera  10days  then Clomid 50mg CD5-9 (BFN)
    5/14 Provera 10days then Clomid 50mg CD5-9  (BFN)
    6/14 (no provera yay!) Clomid 50mg CD5-9  (BFN)
    7/14 Natural Cycle Moving on to RE appt not til 7/31 (BFN)  
    8/14 Plan of action! Moved up to 1500mg Metformin, Femara 3-7 (Trigger canceled due to not big enough follies and holiday weekend) (BFN)
    9/14 7.5mg Femara CD3-7 +ovidrel  (BFN)
    10/14 5mg Femara(3-7) Follistim 75 (7-9) +Ovidrel +TI (last treatment cycle this year Breaking til after Holidays) (BFP! Beta #1 114, Beta #2 364)
    ~~~~~~~~~~~~ ALL ARE WELCOME! ~~~~~~~~~


    image




    BabyFetus Ticker
    BunnyBerry
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