TTC After a Loss

Letrozole and IUI people...

This morning I received an email from my RE's nurse apologizing for not being in when I went in for progesterone blood work last Thurs (4dpo, progesterone was a 10, "good," she said), and that I am to go back in on 4/7/14 or CD1. I wrote back that since CD 1 would likely be Saturday, should I plan to show up Monday regardless. She answered yes, for blood work and u/s, and what would I like to do next cycle, Letrozole and IUI? My RE never mentioned this as an option, so I will speak with him Monday about it. I could've sworn he said because I'm ovulating regularly, most often between CD 13-15, and have had an EP, he didn't think we'd take that route. 

I know a few of you ladies use/have used letrozole. Just wondering what would prompt a Dr going this route. I'm wondering if it's to try something before jumping to IVF, especially side my insurance would cover it.

Thanks! Here's a drink on me:
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~ES~

~*~EVERYONE always welcome!!~*~
TTC #1 since October 2012
BFP #1 11/22/12 EDD 7/29/13 MMC 1/14/13, D&C 1/16/13
BFP #2 5/7/13 EDD 1/14/2014 Ectopic discovered 5/21/13, lost left tube
Referred to RE, blood work done August 2013, AMH 0.27, all else normal, HSG clear
BFP #3 12/1/13 EDD 8/8/14, MC 12/24/13
January 2014: RE #2, blood work repeated, homozygous MTHFR c677t, SHG clear
BFP #4 4/7/14 EDD 12/15/14 Our rainbow was born 12/6/14 at 4:26pm! <3 


Re: Letrozole and IUI people...

  • Based on my temps, it appears as if I ovulate regularly as well.  However, my RE believes that I have weak ovulation, i.e. the eggs that I'm ovulating are not mature.  I tried Letrozole as well to help my eggs mature.  Maybe this is what your RE is suspecting as well?
    TTC #3 since 8/2012 image
    DX Endometriosis 2/2002 (lost left tube due to a cyst), PCOS
    6/2010
     BFP - 10/18/2012, EDD - 6/26/2013, Baby Girl lost at 22 weeks (T21), D&E 2/15/2013
    BFP - 4/23/2014, EDD - 1/2/2015 Twin Boys lost at 12 weeks, M/C 6/25/2014

    My chart here  All ALers welcome!
    Baby Birthday Ticker Ticker
    Lilypie Angel and Memorial tickersLilypie Angel and Memorial tickers
    June 3Missing Our January Snowflake
  • HeyMrsPotterHeyMrsPotter member
    edited March 2014
    Hi there. I ovulate regularly as well, and I am also AMA with low AMH. My RE has us trying IUI with Letrozole/Femara (actually, a hybrid of Letrozole for 5 days followed by Follistim injects for 3 days). He wants us to try this for 3-6 cycles before moving on to IVF. I'm on #3 right now.

    His reasoning, I think, is that we can probably benefit from the medication getting us more than one follicle by the time of ovulation. In short, having more follies to work with each cycle ups our odds. Also, there's some belief that LP deficiency can be the result of things not happening properly during the follicular phase, and that treatment with meds to stimulate follicle growth can also help improve the LP.  

    All that said, I'm passing along what I think I recall from my RE's conversation with me. I'm sorry I'm not speaking with much expertise here. 

    We may ultimately end up at IVF as well. But I am glad to be trying this route first. It has at least confirmed for me that I can and do develop multiple follicles in response to the meds. If I didn't, then IFV probably would be off the table, as that procedure can't happen without a number of eggs to retrieve. 

    I'll also say that Letrozole is very affordable for me. I'm able to get it at Costco for $6 each cycle. I'm so glad my RE knew about this, as it would have been a few hundred dollars at Target, my normal pharmacy. And you don't have to be a Costco member to use the pharmacy. So, if you do go this route, and you have a Costco near you, that may be worth looking into. 
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  • I normally ovulate regularly. My RE has had me take it to increase my chance of a successful pregnancy. He said it would help make the follicle healthier and produce more, so we would have better odds.
    Multiple TTCAL 1image
    image
     TTC #1 since March 2011 
    BFP #1: EDD 4/16/13~~blighted ovum w/ 2 gestational sacs~~Loss on 9/18/12
    BFP #2: EDD 9/3/13~~Slow HB at 1st U/S~~MMC -Loss on 2/13/13
    9/13, 10/13, 1/14: letrozole + trigger + TI = All BFNs
    3/14: IUI#1 letrozole/Bravelle/Menopur + trigger = BFN
    BFP #3: EDD 1/27/15 Please be our rainbow! ...Team Green


  • no experience with IUIs or with EP but I am also taking letrozole (5mg) and I ovulate regularly.  My progesterone was low and I had short cycles before starting the meds.  My RE is thinking that the letrozole will give me a stronger ovulation so that I can carry a pregnancy. 

    Lilypie Angel and Memorial tickers

    8/12-Suprise BFP- Sweet Bunny Born Sleeping 11/21/12 (19 weeks)

    -5/7/13- MMC (8 Weeks)

    11/6/13- BO discovered at 7 weeks- natural MC 11/25/13

    8/14- Surpise IF dx...low AMH (.24)- moving on to IVF

    IVF #1- 11/14- 6R5M4F=2 perfect frosties

    12/19/14- FET of 2 embabies = BFP!!!  One Little Bean EDD: 9/3/15

    Everyone Welcome.

  • Thanks, guys! I had an inkling it would be to help with a stronger ovulation. I would like to try anything we can before making the leap to IVF, just curious why I felt like RE originally said that was most likely not on the table. It was so much to process at the time, so I may have mixed things up. I will meet with him Monday and if no BFP this cycle, I'll be glad for a new plan come next cycle.

    ~ES~

    ~*~EVERYONE always welcome!!~*~
    TTC #1 since October 2012
    BFP #1 11/22/12 EDD 7/29/13 MMC 1/14/13, D&C 1/16/13
    BFP #2 5/7/13 EDD 1/14/2014 Ectopic discovered 5/21/13, lost left tube
    Referred to RE, blood work done August 2013, AMH 0.27, all else normal, HSG clear
    BFP #3 12/1/13 EDD 8/8/14, MC 12/24/13
    January 2014: RE #2, blood work repeated, homozygous MTHFR c677t, SHG clear
    BFP #4 4/7/14 EDD 12/15/14 Our rainbow was born 12/6/14 at 4:26pm! <3 


  • The user and all related content has been deleted.
  • @GrailSeeker14 Thank you for sharing. I am sure my RE will monitor me closely considering he makes me come in on CD 1 so that we can be sure I am not missing anything. I also think he is suggesting letrozole/IUI as a stepping stone before IVF, to which I am definitely OK about. I guess I'll find out Monday!!

    ~ES~

    ~*~EVERYONE always welcome!!~*~
    TTC #1 since October 2012
    BFP #1 11/22/12 EDD 7/29/13 MMC 1/14/13, D&C 1/16/13
    BFP #2 5/7/13 EDD 1/14/2014 Ectopic discovered 5/21/13, lost left tube
    Referred to RE, blood work done August 2013, AMH 0.27, all else normal, HSG clear
    BFP #3 12/1/13 EDD 8/8/14, MC 12/24/13
    January 2014: RE #2, blood work repeated, homozygous MTHFR c677t, SHG clear
    BFP #4 4/7/14 EDD 12/15/14 Our rainbow was born 12/6/14 at 4:26pm! <3 


  • The user and all related content has been deleted.
  • Hey there Eliz. I'm on my third IUI, 2nd cycle taking Letrozole. I have no ovulation problems. They want to use the Letrozole to get decent size follicles and possibly more than one target. Clomid gave me headaches and thinned my lining so they switched me. Letrozole was great for my lining last cycle. 

    Since you've had an ectopic before you may want to bring up any risks and what would happen if the follicle(s) are on your left side. 

    "It's, not, where you are, it's where you're going,
    And it's, not, about the things you've done, it's what you're doing, now"

    TTC Journey Began 8/12
    BFP #1 11/9/12, MMC/D&C 12/21/12 @ 9w2d, EDD 7/24/13
    SAs: 2%-3% Morph - RE Official Diagnosis
    Unexplained
     BFN = IUI #1 (Clomid) | IUI #2 (Letrozole) 
    BFP #2 4/19/14 = IUI #3 (Letrozole)
    Expecting Our Elf 12/27/14
    ~All Welcome~

  • I don't have any advice because I'm a beginner too, but my new RE is going to be doing the exact same plan with me!  I'm currently in the middle of the weirdest cycle ever, I thought I was going in for CD 3 testing and they actually found a mature follie...if I get a BFN mid April then I'm starting the letrozole and IUI next cycle and progesterone 3dpo.  We can be newbie IUI buddies together!



    imageimageimage
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    My FF Chart:
    http://www.fertilityfriend.com/home/490dd7
    TTC #3 since June 2013
    BFP #1 7/21/2013--EDD 3/30/14--D&C 9/24/13
    BFP #2 1/28/14--MC 2/7/14

    IUI #1 5mg Femara + trigger = BFN
    IUI #2 5mg Femara + trigger = BFN
    IUI #3 5mg Femara + trigger = BFN
    IVF #1, Stimmed for 12 days, ER 8/22/14, 9 retrieved, 7M, 7F!!  Freeze all due to fluid in uterus.
    FET end of October 2014 cancelled due to fluid in uterus due to possible c-scar defect
    Surgery scheduled 12/12/14 to fix possible isthmocele
    3/26/15 transferred one 8 cell grade 4 embryo and one 6 cell grade 3 embryo = slow rising betas for 2+ weeks = ectopic MTX shot 4/29/15
    Repeat c-scar surgery June 2015
    2nd and last IVF cycle August 2015, stimmed for 12 days, 2 egg retrieved, both mature and both fertilized.  Transferred both 8-cell embryos on Day 3, beta 9/5/15 = BFFN
    MOVING TO ADOPTION!  


  • I think that same protocol might be the plan for me, too, once I am ready to get back to business.  I didn't know there was a correlation between EP and Femara & IUI.  I am googling like crazy, but I'm not finding anything helpful.  Can someone help?
  • Eliz77Eliz77 member
    edited April 2014
    @jenkellen I know both REs I have met with spoke of the concerns of meds/IUI post EP/tube loss. I am going to go over it with my current RE Monday and hopefully be clear on pros/cons and what is the best course of action for my situation. Thanks! 
    @frenchteachermama Sounds like a plan!
    @superwife425 I'm going to refrain from answering because I feel like I am mixing things my RE said up. However, I plan to ask him about the risks of IUI/letrozole with one functioning tube on Monday and will be glad to report back to you!

    ~ES~

    ~*~EVERYONE always welcome!!~*~
    TTC #1 since October 2012
    BFP #1 11/22/12 EDD 7/29/13 MMC 1/14/13, D&C 1/16/13
    BFP #2 5/7/13 EDD 1/14/2014 Ectopic discovered 5/21/13, lost left tube
    Referred to RE, blood work done August 2013, AMH 0.27, all else normal, HSG clear
    BFP #3 12/1/13 EDD 8/8/14, MC 12/24/13
    January 2014: RE #2, blood work repeated, homozygous MTHFR c677t, SHG clear
    BFP #4 4/7/14 EDD 12/15/14 Our rainbow was born 12/6/14 at 4:26pm! <3 


  • Based on my bloodwork I do ovulate....but maybe not really well.

    I was put on clomid and letrozole because of that...

    We have discussed doing the letrzole and IUI next cycle but seeing the RE Friday to discuss all our options

    Lilypie Angel and Memorial tickers

    TTC: Started May 2012
    Bloodwork - potential ovulation issue which seemed to be fixed by clomid.
    SA - Mot (36%) and count low 9.3 mil (updated) 
    HSG - Oct 16 2013 - came back clear
    Clomid #1 - Nov. 2013 - BFN
    BFP#1 =  Clomid #2, Dec. 2013 - EDD 9.9.14 Loss Jan 9
    Femara #1 + Trigger (2/21) Feb. 2014 +ruptured ovarian cyst - BFN
    SIS clear
    April 2014: 50IU Follistim CD3-CD9 + 25IU CD10-CD13+CD13 trigger 1 mature follie= BFN
    IUI #1: May 2014 50IU Follistim + trigger + IUI = BFN
    IUI #2: June 2014 50IU Follistim + IUI (3 mil sperm)=  BFN
    TI #2: June 2014 50IU Follistim  + Trigger = BFN
    BFP#2 = IUI# 3: Aug 2014 75IU Follistim+ Trigger + IUI (2 mil sperm) EDD May 15

    BabyFruit Ticker


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  • Eliz77 said:
    @jenkellen I know both REs I have met with spoke of the concerns of meds/IUI post EP/tube loss. I am going to go over it with my current RE Monday and hopefully be clear on pros/cons and what is the best course of action for my situation. Thanks! 
    @frenchteachermama Sounds like a plan!
    @superwife425 I'm going to refrain from answering because I feel like I am mixing things my RE said up. However, I plan to ask him about the risks of IUI/letrozole with one functioning tube on Monday and will be glad to report back to you!
    That would be great! :)  I'm interested to hear what the report is!
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