Infertility

Letrozole Round 2--Feeling Discouraged

I just had an ultrasound today, which is CD11, after finishing a 5 day cycle with 7.5 mg of letrozole. This is the second time I've used letrozole. The first time, I produced 4 follicles, had an ovidrel injection, and timed intercourse. It "worked," meaning I got a period, but no BFP. 

Today's ultrasound showed only 2 follicles this time. I'm feeling like it didn't work as well? I know if only takes ONE to get a BFP, but still! I'll speak with my doctor this afternoon to see if I'll again proceed with Ovidrel and timed intercourse.

Ugh! I think I need some support/encouragement/success stories!!


Re: Letrozole Round 2--Feeling Discouraged

  • edited July 2015
    I am on my first cycle on letrozole after 3 failed clomid cycles. I take ovidrel tonight and iui is saturday morning. I had 1 big follicle and 3 little ones (not mature enough around 12mm). How many mm were yours if you don't mind me asking?
    Me 30 Hubby 32
    TTC#1
    1.) IUI Cycle 1 April 2015- 50mg clomid days 5-9, U/S cycle day 12 at 9:30am showed two follicles (17mm and 19mm), Ovidrel trigger shot cycle day 13 at 9:30pm, IUI cycle day 15 at 10:30 am. BFN
    2.) IUI Cycle 2 May 2015-50mg clomid days 5-9, U/S cycle day 12 at 3:30pm showed three follicles!!! (17mm, 20mm and 22mm), Ovidrel trigger shot cycle day 13 at 9:30pm, IUI cycle day 15 at 10:30 am. BFN
    3.) IUI Cycle 3 June 2015-50mg clomid days 5-9, U/S cycle day 12 showed one follicle, Ovidrel trigger shot cycle day 13 at 9:30pm, IUI cycle day 15 at 10:30 am. BFN
    Month break and switched RE's.
    4.) IUI Cycle 4 July 2015-5mg letrozole/femara days 3-7, U/S day 12 showed one follicle (18mm), Ovidrel trigger shot cycle day 12 10:00pm, IUI cycle day 14 10:30 am. BFN
    5.) IUI Cycle 5 August 2015-100mg clomid days 3-7, U/S day 12 showed 2 follicles (18mm each), Ovidrel trigger shot cycle day 12 10:00pm, IUI cycle day 14 10:30 am. BFN
    Taking a break and trying acupuncture before continuing another 3 IUI/clomid cycles. I also went back to my original RE; because of my age and normal tests, RE wants to try another 3 IUI and Clomid cycles before considering injectables or IVF. 
    6.) IUI Cycle 6 October 2015-100mg clomid days 3-7, U/S day 12 showed 3 follicles!!!( 18mm, 19mm, and 20mm), Ovidrel trigger shot cycle day 13 at 9:30pm, IUI cycle day 15 at 9:30 am. Did acupuncture with this cycle too. BFN
    Took a break and ttc naturally
    7.) IUI Cycle 7 February 2016-100mg clomid days 3-7, U/S day 12 showed 2 follicles (22mm and 24mm), Ovidrel trigger shot day 12 at 9:00pm, IUI cycle day 14 at 10:00am. BFN
    Meeting scheduled for 2/29/2016 to discuss iui with injectables vs. IVF
    8.) IUI Cycle 8 March 2016-Injectables (Gonal F), U/S showed 2 mature follicles, Ovidrel Trigger BFN
    April-May I lost my mind.
    IVF#1 July 2016-Transferred 2 fair blasts. 9dp5dt BFP 129 BETA, 13dp5dt 944 BETA, 20dp5dpt 8776 BETA, 8/19/2016-1 beautiful heartbeat  of 100 BPM at 6 weeks 1 day! Growing baby grow!! 8/25/2016-another ultrasound at 7 weeks and baby has a heart beat of 129 BPM and is 10mm/1cm! Grow baby grow some more!! Graduated from RE at 10 weeks and had ObGyn appointment at 13 weeks. It's a girl (found out via panorama test)  EDD 4/13/2017


    Lilypie Maternity tickers
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  • I haven't actually been through that yet, getting there though! I've read posts though of people who only had one follicle that was good and got a BFP, so there is hope. FX for you.

    Me: 31

    DH: 29, SA - Great

    Married: June 12,2011

    TTC #1: 1/2014

    Diagnosis: Hypothalamic Amenorrhea

    Treatment: Clomid:  50mg, 100mg, 150mg - not successful and not monitored

                      Menopur 75ml (upped to 112.5ml), Ovidrel, & IUI  IUI #1 8/31/2015

    9/15/2015: BFP HCG - 400, 9/17/2015: HCG - 827, 9/21/2015 - HCG 3,327!
    Heartbeat 10/2/2015: 118bpm
    DS: 5/27/2016

    TTC# 2: 12/2017
    BFP: 4/20/2018
    EDD: 12/29/2018
  • My 2 follicles were 15 and 17, which the ultrasound tech said were "medium sized." 

    Last time, they were 12.5, 15, 15.5 and 16, with 3 of those 4 on the right ovary. This time, my right had nothing and the left had 2. Not sure if that means anything, but I found it interesting! 
  • Were they that size right before your Ovidrel injection? Ideal size follies are 18-22mm. Below that, they may not be mature enough. I've taken Letrozole and Ovidrel for 3 cycles and responded really well (2 to 3 follies is that size range), but it didn't work for other reasons we now know. On my investigative cycle, I had one at 14mm, which wasn't big enough to lead to anything.

    I'm waiting for AF any minute now, and we're moving on to Letrozole plus Puregon (Follistim), Ovidrel, and an IUI followed by Prometrium. This will be my first cycle with injectables, but we are doing this to increase the number and quality of follies. Maybe worth looking into?
  • Last time I had my ultrasound on CD10, with the Ovidrel on CD12. This time, I had ultrasound on CD11, with the injection tentatively scheduled for CD13 (tentative because I'm still waiting for the official word from my doctor, which will shortly).

    I'm on cycle 2 out of 3 using letrozole, ovidrel, and timed intercourse 12 and 36 hours post-ovidrel injection. After 3 cycles, if there's still no BFP, we'll move to more aggressive approaches, such as injectibles and IUI. 
  • I'm still pretty new to this, but I agree with KidShrink , I think the size is the important part.  Also you can risk multiples with lots of mature follicles.  My RE won't trigger unless they are over 1.8 (or 18).  Seems like he should up the dose  or add another round of Letrozole in the same cycle to get bigger follicles. 

  • If your last US isn't on the day of your trigger though, it makes it hard to know exactly what size they were. My RE (keep in mind I'm in Canada, and so all US are covered) gets me in for US and BW every day from day 9, until I get my LH surge. Then they call and tell me to trigger that night (for me, usually on day 12). It could be that the trigger isn't well timed?
  • edited July 2015
    My doctor is doing letrozole for 2 cycles and if they don't work I am having a laparoscopy done. That's his plan. I switched RE's after 3 failed clomid 50mg/ovidrel/ and iui cycles with the previous RE. It wasn't that they failed that made me switch, it was the fact that he wanted me to continue cycle 4 the EXACT same way. I think after 3 failed cycles it's time for an evaluation to do something different...up the clomid dosage...change the day for trigger shot...something...or maybe I'm just a difficult patient...but regardless it was enough to make me look elsewhere. 

    I like my new RE so far. He's more expensive because he's not affiliated with a hospital which sucks. I do know my new RE specializes in getting women pregnant without IVF. He said only 10% of his patients end up needing IVF and that doctors are quick to jump there without looking at other options...case in point: the other RE didn't even consider a laparoscopy...new RE said straight from the beginning after 2 failed cycles on letrozole it's time for surgery.

    Anyways ladies you know you body and if you feel something isn't right with your treatment or when they are wanting you to trigger/get the iui...say something. I'm getting my insemination done a whole 48 hours earlier than all the other ones the previous doctor scheduled. 48 hours is a HUGE difference! I don't know if it will work-but it definitely raises questions about the other clinic I was going to.
    Me 30 Hubby 32
    TTC#1
    1.) IUI Cycle 1 April 2015- 50mg clomid days 5-9, U/S cycle day 12 at 9:30am showed two follicles (17mm and 19mm), Ovidrel trigger shot cycle day 13 at 9:30pm, IUI cycle day 15 at 10:30 am. BFN
    2.) IUI Cycle 2 May 2015-50mg clomid days 5-9, U/S cycle day 12 at 3:30pm showed three follicles!!! (17mm, 20mm and 22mm), Ovidrel trigger shot cycle day 13 at 9:30pm, IUI cycle day 15 at 10:30 am. BFN
    3.) IUI Cycle 3 June 2015-50mg clomid days 5-9, U/S cycle day 12 showed one follicle, Ovidrel trigger shot cycle day 13 at 9:30pm, IUI cycle day 15 at 10:30 am. BFN
    Month break and switched RE's.
    4.) IUI Cycle 4 July 2015-5mg letrozole/femara days 3-7, U/S day 12 showed one follicle (18mm), Ovidrel trigger shot cycle day 12 10:00pm, IUI cycle day 14 10:30 am. BFN
    5.) IUI Cycle 5 August 2015-100mg clomid days 3-7, U/S day 12 showed 2 follicles (18mm each), Ovidrel trigger shot cycle day 12 10:00pm, IUI cycle day 14 10:30 am. BFN
    Taking a break and trying acupuncture before continuing another 3 IUI/clomid cycles. I also went back to my original RE; because of my age and normal tests, RE wants to try another 3 IUI and Clomid cycles before considering injectables or IVF. 
    6.) IUI Cycle 6 October 2015-100mg clomid days 3-7, U/S day 12 showed 3 follicles!!!( 18mm, 19mm, and 20mm), Ovidrel trigger shot cycle day 13 at 9:30pm, IUI cycle day 15 at 9:30 am. Did acupuncture with this cycle too. BFN
    Took a break and ttc naturally
    7.) IUI Cycle 7 February 2016-100mg clomid days 3-7, U/S day 12 showed 2 follicles (22mm and 24mm), Ovidrel trigger shot day 12 at 9:00pm, IUI cycle day 14 at 10:00am. BFN
    Meeting scheduled for 2/29/2016 to discuss iui with injectables vs. IVF
    8.) IUI Cycle 8 March 2016-Injectables (Gonal F), U/S showed 2 mature follicles, Ovidrel Trigger BFN
    April-May I lost my mind.
    IVF#1 July 2016-Transferred 2 fair blasts. 9dp5dt BFP 129 BETA, 13dp5dt 944 BETA, 20dp5dpt 8776 BETA, 8/19/2016-1 beautiful heartbeat  of 100 BPM at 6 weeks 1 day! Growing baby grow!! 8/25/2016-another ultrasound at 7 weeks and baby has a heart beat of 129 BPM and is 10mm/1cm! Grow baby grow some more!! Graduated from RE at 10 weeks and had ObGyn appointment at 13 weeks. It's a girl (found out via panorama test)  EDD 4/13/2017


    Lilypie Maternity tickers
  • jdl330jdl330 member
    I know it can be so frustrating when you start to compare cycles.  I did that when I was on clomid and my doctor probably thought I was another "google-crazy" woman in his office!  My doctor said that it's not only the size that make follicles mature. The doctors will look at your blood work and see what your hormone levels are to determine if you have mature follicles.  Just remember that they are the experts and we only THINK we are the experts because we've googled all about this info and have seen what others say on the message boards. I know that I need to probably take my own advice too, lol!

    I'm on my first cycle of letrozole (just started the pills yesterday) and then will be starting FSH injections on Sunday.  I'm interested to see how everything turns out for you. Good luck and fingers crossed!
  • My RE seems to be a lot like your new one. We did 3 cycles of Letrozole, Ovidrel and Prometrium with TI, and that's when he decided it was time for a hysteroscopy/transvaginal endoscopy, all of which ended in a laparoscopy because of how much endometriosis they found. They also corrected the shape of my uterus (slight t-shape, essentially with a band of muscle/tissue inside which prevented my lining from ever getting thick enough). So even though all the BW was fine and I got a good number of follies each time, there was no way it was going to work. Also waiting for AF (any minute now....the one time I'm excited for AF to come, it seems to be taking its sweet time), and then we start Letrozole and Follistim/puregon and IUI. He told us we'd have good chances on our own now, but we want to be more aggressive and he got that. So if our two cycles fail, we move on to IVF in September/October.
    Good luck everyone! And do trust yourself if you know something is wrong! I had an OB perform a 15 second exam and tell me there's no way I had endo. If he had done the lap then, that would have saved us a whole year and a half of waiting...
  • @KidShrink forgive me if I didn't catch it. Why are you excited for AF to come this cycle? Did you have to take a break because of the surgery? Thanks :)
    Me 30 Hubby 32
    TTC#1
    1.) IUI Cycle 1 April 2015- 50mg clomid days 5-9, U/S cycle day 12 at 9:30am showed two follicles (17mm and 19mm), Ovidrel trigger shot cycle day 13 at 9:30pm, IUI cycle day 15 at 10:30 am. BFN
    2.) IUI Cycle 2 May 2015-50mg clomid days 5-9, U/S cycle day 12 at 3:30pm showed three follicles!!! (17mm, 20mm and 22mm), Ovidrel trigger shot cycle day 13 at 9:30pm, IUI cycle day 15 at 10:30 am. BFN
    3.) IUI Cycle 3 June 2015-50mg clomid days 5-9, U/S cycle day 12 showed one follicle, Ovidrel trigger shot cycle day 13 at 9:30pm, IUI cycle day 15 at 10:30 am. BFN
    Month break and switched RE's.
    4.) IUI Cycle 4 July 2015-5mg letrozole/femara days 3-7, U/S day 12 showed one follicle (18mm), Ovidrel trigger shot cycle day 12 10:00pm, IUI cycle day 14 10:30 am. BFN
    5.) IUI Cycle 5 August 2015-100mg clomid days 3-7, U/S day 12 showed 2 follicles (18mm each), Ovidrel trigger shot cycle day 12 10:00pm, IUI cycle day 14 10:30 am. BFN
    Taking a break and trying acupuncture before continuing another 3 IUI/clomid cycles. I also went back to my original RE; because of my age and normal tests, RE wants to try another 3 IUI and Clomid cycles before considering injectables or IVF. 
    6.) IUI Cycle 6 October 2015-100mg clomid days 3-7, U/S day 12 showed 3 follicles!!!( 18mm, 19mm, and 20mm), Ovidrel trigger shot cycle day 13 at 9:30pm, IUI cycle day 15 at 9:30 am. Did acupuncture with this cycle too. BFN
    Took a break and ttc naturally
    7.) IUI Cycle 7 February 2016-100mg clomid days 3-7, U/S day 12 showed 2 follicles (22mm and 24mm), Ovidrel trigger shot day 12 at 9:00pm, IUI cycle day 14 at 10:00am. BFN
    Meeting scheduled for 2/29/2016 to discuss iui with injectables vs. IVF
    8.) IUI Cycle 8 March 2016-Injectables (Gonal F), U/S showed 2 mature follicles, Ovidrel Trigger BFN
    April-May I lost my mind.
    IVF#1 July 2016-Transferred 2 fair blasts. 9dp5dt BFP 129 BETA, 13dp5dt 944 BETA, 20dp5dpt 8776 BETA, 8/19/2016-1 beautiful heartbeat  of 100 BPM at 6 weeks 1 day! Growing baby grow!! 8/25/2016-another ultrasound at 7 weeks and baby has a heart beat of 129 BPM and is 10mm/1cm! Grow baby grow some more!! Graduated from RE at 10 weeks and had ObGyn appointment at 13 weeks. It's a girl (found out via panorama test)  EDD 4/13/2017


    Lilypie Maternity tickers
  • I had the surgery Sunday last week (a little under 2 weeks ago) and I was then mid-cycle. They told me we were fine to start trying again as soon as the bleeding stopped (From fixing the uterus). I just don't know whether that bleeding is having any impact on AF though. Not supposed too, but because of my thin lining history, this was more bleeding than I remember having in a long time. AF should be here today, and then we start our first IUI cycle. I was expecting we might have to wait longer to start, but my RE said we were fine and the sooner the better (given how much endo I had, it's not unlikely it'd come back). So yes, actually excited for AF, but that'll be the first and last time ;)
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