PCOS Letrozole and IUI

PCOSat25

Hello Everyone! I am new to these boards but unfortunately not new to TTC.  I am a 25 year old insurance claims adjuster and my husband is a 26 year old military service member. We will have been married FIVE YEARS this coming January. Our TTC journey began in January of 2013. We weren't ACTIVELY trying to get pregnant at this time but we pulled the goalie and stopped using any type of birth control.  We were financially ready and would have been happy to welcome a child so we took on the wait and see mindset.

Our TTC was interrupted by a short 9 month deployment. Figures.  But by the time my husband was safe and home in December 2013 we were ready to start actively pursuing pregnancy. We got ourselves all amped up on fertility friendly lubricants, conception applications for our phones, and ovulation predictor kits...but there was a problem. NOTHING happened.  And when I say nothing I mean NOTHING. No period. No positive ovulation results. No positive pregnancy tests. NOTHING.

I was so positive about the situation that I think I actually convinced myself I might be pregnant. That I might just be one of those women that doesn't test positive on a home urine test. Why else would I be missing my period right??? That HAD to be the answer.  

So I headed off to my primary care provider and asked for a blood pregnancy test. They happily complied and also ran a few more tests for me. Hormones and what not.

When the results came back it was clear that I was not pregnant and that there was another explanation for my missed periods. My primary care provider let me know that my testosterone levels were high, that there was nothing to be concerned about, but that I would need to go to my OBGYN for additional testing. So off I went.  A few more blood tests and ultrasounds later and I was diagnosed with Polycystic Ovarian Syndrome.

At this time the OBGYN told me that the "wait and see" method of conception would probably never work for my husband and I. He would recommend that, to control any associated symptoms of PCOS, I remain on birth control pills unless I was ACTIVELY trying to conceive. If this were the case we would have to use medications to induce ovulation.

This was not the news I wanted and to be honest my husband and I took a few months to think about what we were ready for. We decided to pursue fertility treatments.

I was very lucky that my OBGYN was able to supervise the initial round of my treatments.  I went to six rounds of clomid at varying dosages.  My cycles were monitored via ultrasound and unfortunately I did not respond to the medication (I was unable to produce a follicle large enough to house a mature egg).  After six cycles, the last two being at the highest dose recommended, my OBGYN sent me on my merry little way to a fertility clinic. My ongoing treatment is with a Reproductive Endocrinologist. 

So that brings us to TODAY.

I had my first appointment with the RE two days ago. As the clomid was unsuccessful he is recommending one cycle with another oral medication, Letrozole. If I do not respond to Letrozole we will move on to the more expensive option of injectables.

In August I will complete a cycle of Letrozole at the highest dosage. My cycle will be monitored by 2-3 ultrasounds throughout and then I will undergo an IUI instead of timed intercourse.

My question to all of you is: what has been your experience with Letrozole? I know it is approved by the FDA for treatment of breast cancer but that it is also commonly used in fertility treatments.  Did anyone experience symptoms/side effects from this medication?  

Also this will be my first IUI. I would love to hear about others' experiences with IUI.

Thanks!

KidShrink

I've undergone three rounds of treatments with 5mg of Letrozole CD 3-7, which were then followed by Ovidrel injection, and progesterone suppositories. I reacted really well to all meds (no side effects except for some weird feelings on the ovary that was ovulating, no pain). No side effects from the Ovidrel, but some fatigue the first day or two of progesterone. It didn't work for me, but we don't have the same diagnosis (I just had a transvaginal endoscopy and laparoscopy and was found to have a small anomaly in the shape of my uterus and severe endometriosis on my bowels, bladder, and then all over my right ovary and up the right side to my liver and diaphragm). Because I reacted so well to those meds, we'll be doing the same plus IUI for a max of two cycles starting next month before we move on to IVF if nothing has worked. What I've read is that many people who don't respond or don't respond well to Clomid do a lot better on Letrozole/Femara. Good luck!

jennamarie05

I also started with 5 mg of Letrozole CD 3-7, and had no measurable maturation to any follicles. They upped my dosage to 7.5 mg of Letrozole, and I produced 4 mature follies! Then, they prescribed an Ovidrel injection and timed intercourse, which caused me to ovulate, but no BFP this time. I'm starting again with 7.5 mg letrozole soon. Fingers crossed for this time!! 

Good luck to you!!

jdl330

Good luck during this process! I just went to my RE for a follow up visit after two rounds of clomid, and I am starting Letrozole with FSH injections next cycle. I've heard that it has fewer side effects than clomid. I hope we both get our BFPs!

PCOSat25

Thanks for the information on letrozole everyone!! Unfortunately my IUI cycle was just canceled before we even started

My doctor is recommending a water sonogram for further diagnostics...

KidShrink

That's too bad, but at the same time, you're better off taking the time now to make sure everything is right rather than jumping into another cycle that might lead to more disappointment.
Let us know how it goes!

PCOSat25

This is so true! It is just unfortunate that every test has to have its own cycle and sets you back another month...

KidShrink

I hear ya! We waited two months to get results from our investigative cycle. Then benched for another two months because I had liver/gallbladder issues to tend to before we could start treatments. Then 3 cycles of meds that went nowhere: decision to go ahead with surgery. Wait another 2-3 months. And just now if all goes well we'll back in the game starting next week (that's almost 11 months after we first set foot at the fertility clinic, after a 3 months wait). I have absolutely no patience, and this infertility business is seriously testing my limits! I'm not even going to dare telling you that 'it'll all come in due time' as I feel just about ready to punch in the face the next person who tells me that

rdoc

I have pcos and had a great reaction to letrozole. I had few side effects and produced large follicles each cycle. I also used ovadril for ovulation, no side effects w that either. Some women respond better to different meds, I have a friend who conceived using clomid and one who did not and is about to switch to leterzole. Good luck! You aren't alone. I found this to be a great place for support and information!