Letrozole 25mg/Monitored Ultrasounds/ Trigger Shot (HCG 10,000)

Knottie1467155066

This is my first cycle trying Letrozole (2.5mg x 10 at once at bedtime around CD5?), followed by ultra sounds then Trigger Shot (HCG 10,000).

I have been through alot the past 15months of trying, last month (2nd cycle after surgery to unblock tubes) & they said I ovulated really good on my own but I didn't ovulate till cycle day 28, my cycle was 45 days long! 
So this month we paid the money for them to monitor and control my cycle.

We are trying to go for twins, well that is if my body can ovulate 3 mature follicles before releasing. When I say trying, just means trying, I don't know if it will work out. But at the end of the day doctors don't know if I can do this again after achieving this pregnancy.

Anyways....

I was put on BC for 2 weeks, tomorrow I stop taking it, they expect me to bleed (they are mimicking my period) for 2 days then I take the Letrozole next Thursday, then the following Tuesday I go in every other day for an ultra sounds for them to monitor me, once we are happy with the follicles and their sizes, we will do the trigger shot.

She said there is a 25% chance of it working first time and if my body does make 3 good follicles I have a 15% chance of twins.

Has anyone done this route? Has it worked first time? Singleton or twins?
Since I ovulated very well by myself last month (which I never ovulated before surgery ever), do you think it's possible for me to get 3 good size follicles?

TIA!

Bababatty

Hello!  Your treatment is pretty standard; lots of people on this board have done it or are doing it now, so hopefully that gives you some confidence in it.    Is your RE having you take the letrozole everyday for 5 days (fairly standard) or just once?  And are you planning to do IUI or TI?  

I myself did 5 IUIs with letrozole.  Of course none of it worked, but we have MFI issues so our chances were apparently lower anyway.  I'm not sure you'll get 3 follies, though.  Typically they're going for at least two, and people tend to respond less powerfully to letrozole than clomid.  For instance, I got four follies on clomid, and two every time on letrozole.  In my experience, REs are trying to get a singleton so they don't want you to grow too many follies and increase your chances of high order multiples.  Of course even then people do end up with twins.  

Anyway, I hope you'll join the board.  I definitely recommend changing your UN to something easy for us to remember, and introducing yourself on the weekly check-in thread.  Welcome!

Knottie1467155066

Thank you.
Which board should I join?

And to answer your questions,
Taking them all at once, and doing TI.

My doctor doesn't like to use Clomid, she said that they have gotten better results using Letrozole and less side effects. I don't know, this is my first time doing medicine for this.

I asked about an IUI, but she said IUI's are more for if something is wrong with the guy's sperm, so she wouldn't suggest it for me because apparently my husband has "perfect" sperm, is what they told him lol

One question, after the trigger shot, how long should you wait to take a home pregnancy test? Like how long does it stay in your system?

Thank you so much!

Bababatty

Oh I meant this board, haha.   

I've also heard letrozole has less side effects. I had no problems with either drug, but I know a lot of women handle clomid better. 

Are you working with an RE or an OB? I'm surprised she said IUIs are only good for MFI because it's used to get around female factor issues, too. But TI is also a common first step, as far as I've seen. Glad you don't have to deal with MFI, though! 

For the trigger, I think I've heard that you should really hold out to 14 days past O to avoid a false positive. That said, a lot of people "test out the trigger" every day if they have some cheap Wondfos or other internet cheapy tests. Once you get a negative test, you know the trigger is out of your system and any BFP after that shouldn't be false. 

Knottie1467155066

I am seeing an RE. This is my second RE.

I am just going to tell you my story if you don't mind, (by the way thank you so much for replying back, I haven't had the best luck with these boards lol)

I have been pregnant twice, 1st- I was 19yrs condom broke (first time that has ever happened to me), I was so scared, I peed on a stick everyday even the night it happened sure enough 6 days later positive hpt, I ended up miscarrying at 7wks (which was fine, because that pregnancy was an accident).
Then, 2 years later my exhusband & I decided to try for another baby, now that we were "married", literally tried ONE time (meaning just one intercourse with no condom), 2 weeks later I knew I was pregnant didn't even need to pee on a stick, called the doctor and sure enough they confirmed it. They were surprise I didn't take a hpt before calling them.

*I gave birth to my most wonderful son, he was born 10lbs!, he is turning 5 in January*

Well after having him and being so small, I had health issues for a year after him because my body couldn't adjust not having such a big baby anymore, I had emergency surgery for a large bowel obstruction when he was 3 months and hospitalized 9 times after that with more issues, never thinking issues that would effect infertility down the road.

I got remarried this past April, and my husband is 38 years old and I am not 26 years old. We were trying for about a year before the wedding because really wanted a child of our own, but it was more "if it happened, it happens, if it doesn't, it doesn't" kind of thing since we weren't married yet and because I had a mermaid fitted dress.

Once we tied the knot in April 2017, we looked for help, because I knew something was up because I got pregnant so easily the first 2 times, I was thinking maybe it was him. He hasn't fathered a child before and he is 12 years older than me... I thought fore-sure it was him. 

The FIRST RE tested him, he was "perfect", then they did an HCG on my, sure enough both tubes were blocked, I was completely crushed because that doctor was telling me IVF was my ONLY option, broke my heart. We really can't afford $15k-$20k to fork out for something that might not work because he was saying I had only a 25% chance of it working. Long story short, the HCG had a glitch and they lost the images, I requested for him to do another one just so I can physically see my tubes blocked verses just him telling me that, he said no and that he wasn't going to do another HCG.

I didn't feel comfortable, I didn't feel like that was right.

So I went to the only other RE in my area, who DOESN'T take my insurance, but I didn't care I needed a second opinion. By the way SHE IS AMAZING! Well she ended up doing another HCG since she never saw the previous scan's images, this one showed only 1 tube was blocked, with some fluid that wasn't supposed to be in it (don't know the term for it off of my head), and the other was was semi blocked but the fluid they pushed was coming out.

SO THERE WAS HOPE!

Before doing anything else, we decided to do the Lap/Hysteroscopy surgery, we didn't think the left tube was going to be savable because over all it just look horrible she said, well she ended up SAVING BOTH TUBES, she sewed the ends back of both tubes open so they would never closed again, turned out I had alot of endometriosis, which she removed all of it she said, she cut it a certain way to have a minimal chance of it coming back, I also had alot of scare tissue from previous surgery and pregnancy, which was able to remove all of that as well, along with a 4cm polyp she found.

I was extremely happy with the results of surgery, she went above and beyond for me, she was working on me for 6 hours when it was supposed to be a 2hr surgery, you can tell she truly cared.

Well 1 week after surgery she gave me the OK to start trying naturally, she thought for-sure I was going to get pregnant that cycle by ourselves. But then about a week after that I got a call that the biopsy for the polyp she found came back positive for Chronic Endometritis.

Chronic Endometritis- means very inflamed uterine wall which means my chances of implanting would be very low, close to nothing.

I got super depressed. So she put me on 2 different antibiotics, twice a day for 3 weeks.

We had to wait for last month's cycle to end before we can proceed to get another Biopsy done so we can continue for them to control my cycle, last month's cycle was 45 DAYS LONG!
They ended up putting me on birth control so they can control my cycle.
I got the biopsy done last Monday, results came back NEGATIVE! *YAY* 
So yesterday I went in for my baseline ultrasound, everything looked "quiet" the way they wanted it too, so tomorrow will be my last birth control pill.

They expect me to have a small bleed the 29th-30th of this month then I take my Letrozole next Thursday, all 10 pills at once.
Then I go in for my first ultra sound for ovulation the following Tuesday.

I am just really nervous it's not going to work first try, the doctor emails me all the time, she is so excited for us, she is convinced it's going to work, but I have kinda lost hope.

One thing that's great about my Doctor and her Nurse Practitioner, they both dealt with infertility themselves, so they are very understanding of my feelings, and very compassionate with what I am going through. They are doing everything in their power to make this happen for my hubby and I.

tops-2

Wow, lots to read haha

So, I have PCOS and am on Letrozole cycles too. For my first one I had to take Provera for a week, then a week later had bleeding (like a period) to be able to start. I was having cycles around 90 days long so wasn't willing to wait for a new cycle to start
Your Letrozole protocol surprised me - taking 25mg all at once! The protocol I'm on is 5mg of Letrozole, once a day for 5 days (day 3-7 of the cycle). I then have monitoring for the next week to pinpoint ovulation, then timed intercourse (TI), and then the TWW.

**TW**
In regards to success, I am similar in age to you (I'll be 26 quite soon) and I had my first ever pregnancy on my second cycle of Letrozole. Unfortunately I had a miscarriage at around 8 weeks. I'm now on day 4 of Letrozole for my first cycle post-miscarriage.
Don't be disappointed if you don't get pregnant on your first round - it might not happen straight away but it sounds like you've got a good chance of it happening sooner rather than later

Knottie1467155066

Thank you.

Do you mind me asking what PCOS is?
Is Provera a Birth Control?

Also, I know miscarriages happen naturally but did they say about about why they think it happened? I am assuming it was a singleton?

tops-2

PCOS is polycystic ovarian syndrome.
Provera is synthetic progesterone. According to google: "Normally the level of progesterone in your blood increases about a week before your period. If provera is taken for 5 to 10 days each month at this time it mimics the natural rise in your progesterone levels."
I don't believe it is used for contraception though.

And no, no particular reason was given to me for the mc. Sadly sometimes it's just not quite right.

Knottie1467155066

Ya, I had a miscarriage before, but I was 19 and it was an accident so I didn't really care too much.
But it definitely scares me if this works for me about miscarrying. I would be so crushed, we have been working so hard on this.

They have me taking baby aspirin, they say studies show that taking aspirin moves more blood flow to your uterus so it increases your chances of implanting better.

Knottie1467155066

bump.

hoffmanr7

Welcome, I am sorry you find yourself here but glad you joined us.  It sounds like your second doctor is very good at keeping in contact and keeping you informed.  I do find it odd that she said that about IUI's though.  My DH also has been deemed to have "perfect sperm".  We tried just medication for a few cycles, and then moved on to do three IUI's to try and increase the chances of more sperm reaching where they need to go.  It is definitely something to keep in mind on the back burner, but with everything cleared up and your DH's good sperm, its probably worth trying just some medicated cycles.  If you are lucky, you'll be KU soon and can avoid any more expensive types of treatments.  I will be keeping my FX for you.

Knottie1467155066

Thank you!
@hoffmanr7
Have you had any success yet?

I asked my doctor about the IUI again, she said lets try this cycle with just Timed Intercourse, and if it doesn't work then next cycle we will do IUI.

I am feeling very hopeful.

Knottie1467155066

bump.

hoffmanr7

@Knottie1458416769 In terms of positive pregnancy tests, no I have not.  I always ovulated on my own, but they had me on the meds to try and increase the odds of fertilization.  I did respond really well to the meds and usually had at least 2-3 mature follies when it was time to BD or, in the last several attempts, before our IUIs.  I did end up having a number of cysts that were most likely medication related, but they pretty much subsided on their own after a month off.

Knottie1467155066

Tonight I take my Letrozole. Kinda excited to really start this process.
First ultrasound Tuesday!

Knottie1467155066

Hey Tops, was just checking in to see how you are doing with your cycle?

Knottie1467155066

Hey ladies, just got done with my first ultrasound.

I have 4 folicules, a 13,10,9,8. She doesn't think the last two will mature, but we are planning on doing another ultrasound Friday and trigger shot in the office. I am really hoping that I'll get 3 to mature but I'll be happy with 2.

thought I would update ya'll ❤️

Bababatty

@knottie1467155066 You should update us in the weekly check-in threads so it’s easier for us to keep track.   

Great news on your follies!

tops-2

@Knottie1467155066 - great news about your follies
My cycle is going well - I'm 2DPO with 2 mature follies and 1 smaller one, so hopefully a good chance this month

And I second @Bababatty - you should post in the weekly check in for these regular updates as it's easier for us to keep track

Knottie1467155066

@Bababatty
@tops-2

Weekly check in?
Do you have a link to that board?

Bababatty

It’s the TTTC Checkin thread on this board. @GoldenKeys starts one every week.