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Results taking Clomid and Letrozole together w/ PCOS and Anovulation (Clomid 100mg, Letrozole 7.5mg)

nursettcnursettc member
in Trying to Get Pregnant

So, my husband and I are both nurses. Throughout my TTC/fertility treatment experiences I have been a bit OCD (sound familiar?!) about researching everything fertility related.. including success stories, fertility medication side effects, and outcomes on the medications that I have been put on to help us conceive. Sometimes there just is not enough information on topics I am searching for, so I promised I would document my experience/outcomes in hopes that it helps someone else throughout their journey who may stumble upon this post.

Little bit of a quick rundown:

I am 31, my husband is 33. I have two children (2003, 2009). History of PCOS x13 years, anovulation (only get 2-3 periods/year), and hyperglycemia (thanks PCOS). I am overweight (BMI 27), but not obese or anything.. just fluffy. J I have never been on birth control, never tried to prevent pregnancy, and have been actively trying harder to conceive for 1 year. I am followed by a PCP, RE, and an OBGYN who is a fertility specialist. I also work for the Army Nurse Corps and have access to all kinds of providers who give me solicited education and advice when I need it. :)

Last month I went through my first round of fertility treatment that was a more aggressive start than some. Disclaimer: Again, I am a nurse and well educated in fertility/side effects to look out for (as is my husband) and was medically monitored by an RE AND an OBGYN fertility specialist throughout the cycle. Here was my protocol:

Transvaginal ultrasound reconfirmed PCOS.

Hubs had sperm analysis (everything A-okay).  

***My labs were as follows:

AMH 6.57 ng/mL

FSH 7.7 mIU/mL

LH 16.7 mIU/mL

Estradiol 30.9 pg/mL

Progesterone 0.2ng/mL

Prolactin 6.6ng/mL

17-OH-Progesterone, Serum 48ng/dL

SHBG 16 nmol/L

Testosterone, Serum 51 ng/dL


***Treatment as follows:

Provera 10mg x10 days (Period started 3rd day after completing Provera)

CD2-6 took Clomid 100mg at noon and Letrozole 7.5mg at bedtime

CD14 had a transvaginal ultrasound showing only one decent sized 15mm follicle on the left ovary (where I had been having some discomfort). 8.6mm uterine lining.

CD15 took the HCG 10,000 trigger shot.

CD26 (10DPO) negative Dollar Tree and First Response Early Test pregnancy tests, so the HCG trigger shot was out of my system.

CD30 (14DPO) BFN. L

BD on CD 6, 7, 8, 12, 13 (2x), 15, 16, 19, 21, 24 (2x), 25, 26.

CD33 period started.  


***Side effects were as follows:

Provera Day (PD) 1: Mild ovarian cramps.

PD2: Mild ovarian cramps, hot flashes 1-2x.

PD3: Mild ovarian cramps, hot flashes 1x, extreme drowsiness.

PD4: Sex. Nausea x1hr, breast enlargement, shooting breast feelings, extreme drowsiness.

PD5: Breast enlargement, shooting breast feelings, constant headache 3/10 x12hrs. UTI. Started Macrobid.

PD6: Breast enlargement, woke w/ same headache 3/10 that lasted all day. Extreme muscle aches in the afternoon/evening. UTI.

PD7: No symptoms

PD8: No symptoms.

PD9: Easily irritated, angry and emotional (tearful) which is not normal for me. Felt like I could not control the feeling.

PD10: Easily irritated and angry. Symptoms resolved. Slightly crampy.

Day 11: No symptoms.

Day 12: No symptoms.

Cycle Day (CD) 1: Period began.

CD2: Started Clomid 100mg at noon, Letrozole 7.5mg at bedtime. 2-3/10 pain from ovarian cramping a few hours after taking Clomid.  No symptoms after Letrozole.

CD3: Drowsy. Heavier period today. Heart palpitations.

CD4: Drowsy. Irritation, anger outburst.  Slight ovarian discomfort. Heart palpitations.

CD5: Hot flashes. Drowsy. Slight ovarian discomfort. Quick onset/resolve of blurry vision in the distance. Heart palpitations.

CD6: Last day taking Clomid and Letrozole. 0710 hot flashes and sharp midsternal chest pain, radiated to back of left shoulder and lasted 5sec. Was standing screening a patient when it started. Intermittent heart palpitations throughout the day. After taking the last dose at noon, heat flashes w/ interscapular pain x1-1.5hrs.

CD7: No symptoms.

CD8: Period ended. No symptoms.

CD9-11: No symptoms. Started taking OPK’s on CD10-14, all negative.

CD12: Slight ovarian cramps after sex.

CD13: Sex 2x. Irritable today.

CD14: Follicular U/S shows 15x14.5mm follicle on L ovary, very small ones on R ovary. 8.6mm endometrial thickness.

CD 15: Sex. 10am: HCG 10,000units IM injected. 1215pm: Positive OPK. 1pm: Slight L sided ovarian discomfort. 9pm: Emotional/tearful.

CD16: Sex. Mild ovarian cramping in the evening.

CD17/1DPO: Mild ovarian cramping, only in the early morning.

CD18/2DPO: Diarrhea. Slight shooting breast pains. Drowsiness.

CD19/3DPO: Sex. Constipation.

CD20/4DPO: Constipation and drowsiness.

CD21/5DPO: Sex. Heartburn. Drowsy.

CD22/6DPO: Heartburn. Drowsy. Minor L sided discomforts. Negative Quick Vue PT at noon, Positive First Response PT at 5:30pm.

CD23/7DPO: Negative Dollar Tree PT in the AM. Positive first response in the PM. Drowsy. Minor cramp-like feelings.

CD24/8DPO: Sex 2x. No symptoms.

CD25/9DPO: Sex. Nausea. Drowsy.

CD26/10DPO: Sex. Drowsy. Moments of crampiness. Negative dollar tree and First Response Early Pregnancy tests, so the HCG trigger shot was out of my system.

CD27/11DPO: Drowsy. Negative First Response Early Pregnancy test.

CD28/12DPO: No symptoms.

CD29/13DPO: Slight cramping. Breast enlargement.

CD30/14DPO: Period expected. Didn't come. Neg pregnancy test.

CD33/17DPO: Period began in the morning at 5am. Negative pregnancy test. No period symptoms at all.

So, obviously this regimen did not work to help me conceive. But I hope the breakdown (while overkill lol) helps someone who is researching out there for these symptoms, or medication combinations, etc. Due to the chest pain symptoms I experienced specifically, my provider decided we would move on to FSH injections (Follistim). I am currently on my first round of Follistim 150iu every morning x14d (or until needed) starting CD 3 and Letrozole 5mg at bedtime CD 3-7. I have my CD8 follicular ultrasound tomorrow, w/ another one again on CD13 and CD14. If anyone is interested, I have had NO side effects w/ the Follistim and Letrozole combination whatsoever except for mild bloating. So wonderful compared to the Clomid/Letrozole combination! The chance of multiples on Follistim is approximately 30%, but we would absolutely welcome them with open hearts! Best of luck to everyone reading this!

------------------------------------------------------------------------------------------------------------------------

Me (31, a nurse) – PCOS, Anovulatory (2-3 periods/year), Hyperglycemia.

DH (33, also a nurse) – No health or fertility issues.

G2P2 - DS (2003), DD (2009)

- Never been on birth control or tried to prevent pregnancy.

- TTC naturally again since 8/2017. 

- Followed by RE, OBGYN fertility specialist, and PCP.

Fertility treatments:

1. 7/2018: CD 2-6 Clomid 100mg at noon + Letrozole 7.5mg at bedtime x5d + HCG trigger shot on CD 15 = BFN

  - CD14 transvaginal ultrasound showed a 15mm follicle on the left ovary

2. 8/2018: Starting CD3, Follistim 150iu (units) every morning + CD 3-7 Letrozole 7.5mg at bedtime + HCG trigger shot (CD TBD) = TBD

  - Transvaginal ultrasounds scheduled for CD 8, CD 13 & CD 14 to monitor for follicle growth and rule out OHSS.

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Re: Results taking Clomid and Letrozole together w/ PCOS and Anovulation (Clomid 100mg, Letrozole 7.5mg)

  • tamalahoopstamalahoops member
    edited August 2018
    nursettc said:

    So, my husband and I are both nurses. Throughout my TTC/fertility treatment experiences I have been a bit OCD (sound familiar?!) about researching everything fertility related.. including success stories, fertility medication side effects, and outcomes on the medications that I have been put on to help us conceive. Sometimes there just is not enough information on topics I am searching for, so I promised I would document my experience/outcomes in hopes that it helps someone else throughout their journey who may stumble upon this post.

    Little bit of a quick rundown:

    I am 31, my husband is 33. I have two children (2003, 2009). History of PCOS x13 years, anovulation (only get 2-3 periods/year), and hyperglycemia (thanks PCOS). I am overweight (BMI 27), but not obese or anything.. just fluffy. J I have never been on birth control, never tried to prevent pregnancy, and have been actively trying harder to conceive for 1 year. I am followed by a PCP, RE, and an OBGYN who is a fertility specialist. I also work for the Army Nurse Corps and have access to all kinds of providers who give me solicited education and advice when I need it. :)

    Last month I went through my first round of fertility treatment that was a more aggressive start than some. Disclaimer: Again, I am a nurse and well educated in fertility/side effects to look out for (as is my husband) and was medically monitored by an RE AND an OBGYN fertility specialist throughout the cycle. Here was my protocol:

    Transvaginal ultrasound reconfirmed PCOS.

    Hubs had sperm analysis (everything A-okay).  

    ***My labs were as follows:

    AMH 6.57 ng/mL

    FSH 7.7 mIU/mL

    LH 16.7 mIU/mL

    Estradiol 30.9 pg/mL

    Progesterone 0.2ng/mL

    Prolactin 6.6ng/mL

    17-OH-Progesterone, Serum 48ng/dL

    SHBG 16 nmol/L

    Testosterone, Serum 51 ng/dL


    ***Treatment as follows:

    Provera 10mg x10 days (Period started 3rd day after completing Provera)

    CD2-6 took Clomid 100mg at noon and Letrozole 7.5mg at bedtime

    CD14 had a transvaginal ultrasound showing only one decent sized 15mm follicle on the left ovary (where I had been having some discomfort). 8.6mm uterine lining.

    CD15 took the HCG 10,000 trigger shot.

    CD26 (10DPO) negative Dollar Tree and First Response Early Test pregnancy tests, so the HCG trigger shot was out of my system.

    CD30 (14DPO) BFN. L

    BD on CD 6, 7, 8, 12, 13 (2x), 15, 16, 19, 21, 24 (2x), 25, 26.

    CD33 period started.  


    ***Side effects were as follows:

    Provera Day (PD) 1: Mild ovarian cramps.

    PD2: Mild ovarian cramps, hot flashes 1-2x.

    PD3: Mild ovarian cramps, hot flashes 1x, extreme drowsiness.

    PD4: Sex. Nausea x1hr, breast enlargement, shooting breast feelings, extreme drowsiness.

    PD5: Breast enlargement, shooting breast feelings, constant headache 3/10 x12hrs. UTI. Started Macrobid.

    PD6: Breast enlargement, woke w/ same headache 3/10 that lasted all day. Extreme muscle aches in the afternoon/evening. UTI.

    PD7: No symptoms

    PD8: No symptoms.

    PD9: Easily irritated, angry and emotional (tearful) which is not normal for me. Felt like I could not control the feeling.

    PD10: Easily irritated and angry. Symptoms resolved. Slightly crampy.

    Day 11: No symptoms.

    Day 12: No symptoms.

    Cycle Day (CD) 1: Period began.

    CD2: Started Clomid 100mg at noon, Letrozole 7.5mg at bedtime. 2-3/10 pain from ovarian cramping a few hours after taking Clomid.  No symptoms after Letrozole.

    CD3: Drowsy. Heavier period today. Heart palpitations.

    CD4: Drowsy. Irritation, anger outburst.  Slight ovarian discomfort. Heart palpitations.

    CD5: Hot flashes. Drowsy. Slight ovarian discomfort. Quick onset/resolve of blurry vision in the distance. Heart palpitations.

    CD6: Last day taking Clomid and Letrozole. 0710 hot flashes and sharp midsternal chest pain, radiated to back of left shoulder and lasted 5sec. Was standing screening a patient when it started. Intermittent heart palpitations throughout the day. After taking the last dose at noon, heat flashes w/ interscapular pain x1-1.5hrs.

    CD7: No symptoms.

    CD8: Period ended. No symptoms.

    CD9-11: No symptoms. Started taking OPK’s on CD10-14, all negative.

    CD12: Slight ovarian cramps after sex.

    CD13: Sex 2x. Irritable today.

    CD14: Follicular U/S shows 15x14.5mm follicle on L ovary, very small ones on R ovary. 8.6mm endometrial thickness.

    CD 15: Sex. 10am: HCG 10,000units IM injected. 1215pm: Positive OPK. 1pm: Slight L sided ovarian discomfort. 9pm: Emotional/tearful.

    CD16: Sex. Mild ovarian cramping in the evening.

    CD17/1DPO: Mild ovarian cramping, only in the early morning.

    CD18/2DPO: Diarrhea. Slight shooting breast pains. Drowsiness.

    CD19/3DPO: Sex. Constipation.

    CD20/4DPO: Constipation and drowsiness.

    CD21/5DPO: Sex. Heartburn. Drowsy.

    CD22/6DPO: Heartburn. Drowsy. Minor L sided discomforts. Negative Quick Vue PT at noon, Positive First Response PT at 5:30pm.

    CD23/7DPO: Negative Dollar Tree PT in the AM. Positive first response in the PM. Drowsy. Minor cramp-like feelings.

    CD24/8DPO: Sex 2x. No symptoms.

    CD25/9DPO: Sex. Nausea. Drowsy.

    CD26/10DPO: Sex. Drowsy. Moments of crampiness. Negative dollar tree and First Response Early Pregnancy tests, so the HCG trigger shot was out of my system.

    CD27/11DPO: Drowsy. Negative First Response Early Pregnancy test.

    CD28/12DPO: No symptoms.

    CD29/13DPO: Slight cramping. Breast enlargement.

    CD30/14DPO: Period expected. Didn't come. Neg pregnancy test.

    CD33/17DPO: Period began in the morning at 5am. Negative pregnancy test. No period symptoms at all.

    So, obviously this regimen did not work to help me conceive. But I hope the breakdown (while overkill lol) helps someone who is researching out there for these symptoms, or medication combinations, etc. Due to the chest pain symptoms I experienced specifically, my provider decided we would move on to FSH injections (Follistim). I am currently on my first round of Follistim 150iu every morning x14d (or until needed) starting CD 3 and Letrozole 5mg at bedtime CD 3-7. I have my CD8 follicular ultrasound tomorrow, w/ another one again on CD13 and CD14. If anyone is interested, I have had NO side effects w/ the Follistim and Letrozole combination whatsoever except for mild bloating. So wonderful compared to the Clomid/Letrozole combination! The chance of multiples on Follistim is approximately 30%, but we would absolutely welcome them with open hearts! Best of luck to everyone reading this!

    Qfp
    Me: 31 Husby: 36
    Married May 2014
    TTC # 2  Since December 2021
    Baby girl W born 2/2021
    Our journey so far...
    (tw loss & infertility)
    Diagnosis: Poor Egg Quality 
    Working with an RE since March 2016
    2 failed TI cycles
    3 failed IUI cycles

    IVF Feb - April 2017
    23 eggs collected, 20 mature, 14 fertilized with ICSI, 4 day 3 blasts, 3 day 5 blasts, 1 PGS normal
    Transferred 1 PGS normal embryo 4.12.17
    BFP 4.21.17
    MMC due to small gestational sac 6.8.17

    Our adoption journey:
    12.25.18 Agency picked and apps submitted!
    5.1.19 Adoption on hold so we can buy a house! 
    1.1.20 Homestudy process started
    3.14.20 First social worker visit
    5.25.20 Homestudy Approved & Submitted to Agency

    6.1.20 Surprise! Positive pregnancy test!
    Healthy baby girl born 2/10/2021


    Report Reply
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  • thegirlwhowaited_thegirlwhowaited_ member
    edited August 2018
    meatballs37 said:
    *SNIP*
    Please read the newbie intro and the board there, stick around and offer some support that way. It would be better received. 

    The Ultimate TTGP Guide Newbies Read This First

    @nursettc Hello! As meatballs 37 said, one off post are discouraged here because it is preferred to keep things organized. Please read the stickied posts at the top to familiarize yourself with our rules, guidelines, and board culture.
    Part of your post would be a great intro in the "Newbie Intro Thread" and the rest would go well in the IF thread that meatballs37 mentioned. Also I think you cycle details/symptoms would all be easier for the group to comprehend if it was in a chart and attached as an image. If you use FF, Glow, Kindara, etc you can attach a photo/screen shot of your chart by using the Attach Image icon (mountains picture).

    *Edited to add links
    Report Reply
  • nursettcnursettc member
    Thank you for the welcome! It was not a "dear diary" post that I was planning on ghosting out of. If it was not posted in the correct category, my apologies. I used the link for "Clomid", so I thought it was appropriate an appropriate topic. Also, I was not insulting anyone else's knowledge or experiences.. simply sharing my own. :) Thanks for the redirect!

    ------------------------------------------------------------------------------------------------------------------------

    Me (31, a nurse) – PCOS, Anovulatory (2-3 periods/year), Hyperglycemia.

    DH (33, also a nurse) – No health or fertility issues.

    G2P2 - DS (2003), DD (2009)

    - Never been on birth control or tried to prevent pregnancy.

    - TTC naturally again since 8/2017. 

    - Followed by RE, OBGYN fertility specialist, and PCP.

    Fertility treatments:

    1. 7/2018: CD 2-6 Clomid 100mg at noon + Letrozole 7.5mg at bedtime x5d + HCG trigger shot on CD 15 = BFN

      - CD14 transvaginal ultrasound showed a 15mm follicle on the left ovary

    2. 8/2018: Starting CD3, Follistim 150iu (units) every morning + CD 3-7 Letrozole 7.5mg at bedtime + HCG trigger shot (CD TBD) = TBD

      - Transvaginal ultrasounds scheduled for CD 8, CD 13 & CD 14 to monitor for follicle growth and rule out OHSS.

    Report Reply
  • SwiftletSwiftlet member
    @nursettc Another "board culture" thing: people generally have their signatures (especially with that amount of information and including mention of living children) in a spoiler.
    Report Reply
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