Letrozole question — The Bump
Trouble TTC

Letrozole question

I just wanted clarification about what Letrozole (femara) does exactly.. Surprisingly I can't find it on Dr. Google. I get that it helps the follicles grow... Is the whole purpose to help with just that, to improve ovulation, or does it also improve the quality of the egg?

I'm in the 2ww from IUI #3 but my RE said if this doesn't work he recommends one more IUI so we can give the Letrozole three tries (first IUI was unmedicated). I'm just wondering what the benefit of Letrozole is other than helping make more follies.

Me: 32  DH: 33  Married: March 2004

July 2006: started TTC
2008: HSG (normal), couple rounds of clomid through gyno

2008 - 2010: dragging my feet out of fear and procrastination
October 2010: first consultation with RE, dx PCOS and fibroids (DH slightly low count/motility)
Oct. 2010 - Dec. 2012:  In DENIAL! avoided the issue because I was scared of surgery
January 2013: returned to RE, fibroids grew significantly
February 2013: second HSG, fibroids pushed on tubes which blocked them somewhat
March 2013: MRI to determine what type of surgery may be necessary
July 29, 2013: fibroids (5) removed via robotic laparascopy
August 2013 - Nov 2013 : benched due to recent surgery

IUI #1, Dec. 24, 2013, BFN 
IUI #2, Jan. 25, 2014, BFN
IUI #3, Feb. 25, 2014  BFN
IUI #4 canceled due to lack of response to letrozole
IUI #4.1 April 28, 2014, BFN
May 16, 2014: wtf consult, start prepping for IVF in June and add injects for one last IUI in the meantime
IUI #5 started letrozole and bravelle but canceled after HSG led to new diagnosis
May 21, 2014: third HSG, tubes blocked, one at the beginning, one hydrosalpinx??
June 11, 2014: consult, approved to move on to IVF because the hydro is not completely blocked therefore allowing fluid to move through slowly rather than backwards
IVF #1 August 8, 2014 - 3dt of 2 embryos, BFN
September 17, 2014 - 4th HSG, the right tube is very patent (open!!) dye went straight through this time. Weird!
October 2, 2014 - started metformin treatment
November 14, 2014 - blood work, brought A1C down from 5.8 to 5.5
November 26, 2014 - RE finally back from vaca and reviewed my chart, no more IVFs for rest of calendar year
December 1, 2014 - Right after Thanksgiving, I called a new clinic and got in right away! Plan for IVF
December 17, 2014 - ER! 29 retrieved (!!), 16 mature, all 16 fertilized (ICSI)
IVF #2 December 20, 2014 - 3dt of 3 embryos, BFN

We are done with treatment unsuccessfully. :(

PAIF/SAIF/All Welcome!

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Re: Letrozole question

  • I am on my second cycle with Femera, and I did three with clomid. I believe for me it is a quantity issue, these drugs help me release more eggs, I average 5. Last cycle I had 3 big ones, and 2 medium size follies. For my age they are concerned about quality, and by releasing more eggs, we are upping the chances that one is healthy. My Dr. said if I was 28 and healthy, they would not do an IUI with 5, but at my age 4-6 is ideal. We also found that clomid thinned my lining, but Femera does not.
    Me: 40, Hypothyroidism, well managed, TSH 1.99
    DH: 44 Fine except for low morphology
    TTC since 02/2013  
    08/13: Day 3 tests (ESTRADIOL 20.8; AMH 1.1; FSH 6.2)
    12/13 HSG, all clear
    11/13-5/14 - IUIs #1-3, BFNs, 
    6/14 to present: Taking a break, getting healthier, researching IVF
    Planning for IVF in late summer 2015

  • Femara is used off-label in IF. It is normally for women who had breast cancer. It suppresses estrogen which then tricks the body into creating FH and LSH (the hormones needed to create follies). I have been using Femara 7.5/day since the start. I only experience head aches and hot flashes, much better than the side effects of Clomid. I usually produce 1-2 mature follies but haven't had any success yet. I just started with a hybrid cycle, my first shot of Follistim was tonight! Hope this helps.
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