Infertility
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PCOS/Letrozole

>:) HELLO EVERYONE TODAY WAS CD20 FOR ME AND MY FERTILITY SPECIALIST TOLD ME THAT LETROZOLE ISN'T WORKING FOR ME SO WE ARE SCHEDULE FOR AN APPOINTMENT ON NOV 19 , BUT MY QUESTION HERE IS HAVE ANY OF YOU LADIES HAD ANY SUCCESS WITH THIS MED ? WHAT OTHER MED ARE OUT THERE TO HELP ME OVULATE CAUSE SHE COUNTED 9 FOLLICLES IN ONE OVARIE AND 7 IN THE OTHER IN 26 AND HAVE BEEN SUFFERING FROM PCOS ALL MY LIFE IT'S A HEADACHE AND THE WEIGHT IS NERVE RECKING
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Re: PCOS/Letrozole

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    I'm assuming those follicles you mentioned are just immature and not at a level your specialist thinks will ovulate in the near future? If Clomid and Letrozole don't work for you, there are options to increase the dose, which may provide results. Or, you can do a combination of injectables like Gonal-F or Follistim + Letrozole. Or, you can do straight injectables. I've seen plenty of women have success with Letrozole and with Clomid alone. I don't have PCOS, and I ovulate on my own. However, Clomid did nothing for me but decrease my lining. So, I moved from Clomid to injectables only and had several mature follicles. I'm about to start my second cycle of injectables only. My RE doesn't like Femera (Letrozole) for some reason, so I didn't even try that one. Best of luck to you, and please let me know what your doctor recommends next time. This whole process is terrible, but at least you're in treatment now and taking steps to get closer to your goal of a baby! I'm confident your doctor will figure out a way to overcome your PCOS and get you pregnant!
    Married to DH 10/6/12
    TTC since 5/14
    Unexplained with (controlled) hypothyroidism and suspected ovulatory dysfunction (but, I do ovulate on my own)
    Clomid 50 mg 3/15 (unmonitored) - BFN
    Clomid 50 mg + metformin 4/15 (unmonitored) - BFN 
    First RE appt. 5/15; Natural cycle 5/15 monitored with 2 mature follicles and Pregnyl Trigger (full dose) + prometrium - BFN
    6/15 HSG - clear tubes & normal uterus; great PCT test results
    TI - 100 mg Clomid + prometrium (AM & PM) + vaginal estrace (AM & PM) 6-7/15 (monitored) --> no additional response and thinned lining - BFN
    TI - Injectables (follistim + Gonal-F, Ganirelix, & 1/2 dose Pregnyl) + prometrium (AM & PM) 9/15 --> 3-7 mature follicles (3 definites and 4+ that could have matured due to trigger) @ O -->BFN + 5 large cysts
    BC for 2 weeks due to cysts
    TI - Injectables (Gonal-F, Ganirelix & full dose Pregnyl) + prometrium (AM & PM) 10/15 --> 1 mature follicle --> BFN 
    TI - Last attempt at injectables (Gonal-F, Ganirelix & 1/2 dose Pregnyl) + crinone (AM only) + vaginal estrace (AM & PM) 11/15 --> 3-4 mature follicles --> BFP!! 11/27/15 @ 13dpo (shockingly, actually waited until then to test)

    Beta #1 @ 16dpo (11/30/15) = 1,075
    Beta #2 @ 19dpo (12/3/15) = 3,150
    One baby: Saw heartbeat @ 5w5d (114 bpm; baby measuring 2.3mm)

    "Great Things are Happening"
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    I also have PCOS. I didn't not respond to clomid (like at all) and my RE was not confident that letrozol alone would be effective so we are doing a mixed cycle with letrozole and gonal-f. Just waiting for cycle day 1 to get this treatment cycle started. Fingers crossed.
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    I have a mild case of pcos and endometriosis and the letrozole plus ovidrel trigger shot worked for me the first cycle. I was on 5mg on cycle days 4-8. Good luck!!!
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    Thanks you guys
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    I have PCOS and was successful on my first round of Clomid 3 years ago.  Now, I'm going to be doing IVF (but I'm also 40).  It CAN work!
    *** Child & current pregnancy mentioned ***
    Me - 41 (PCOS), Hubby - 43 (healthy)
    7/2013 - Sweet baby girl born (Clomid + TI)
    3/2014 - TTC #2, return to RE 7/2014
    12/2015: IVF #1 transferred two great looking embryos - BFP!
    First ultrasound: TWO beautiful little heartbeats!!
    Harmony: negative; level 2: babies look great and are boy/girl! :) 
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    I too have PCOS and did not respond to femara (letrozole) or clomid. We are now moving onto a mixed cycle of injectables with letrozole and dexamethasone and hoping that will make me O. Best of luck.
    NTNP since 2012
    Officially TTC #1 since January 2015
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    @kaitlink33 when will you be starting your mixed cycle? Bam doing my first mixed cycle with letrozole and gonal-f this month. Hoping to start any day now just waiting on AF...
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    @PCOSat25 I just started my cycle with femara and gonal-f. Currently on cycle day 4!
    Married to DH since 8/15
    TTC since 5/15
    PCOS, 35+, diagnosed with pre-diabetes
    TI for 4 cycles: 1 round of femara; 2 rounds femara/ injectables: all ended in BFN. 
    3 IUI Cycles: letrozole/Follistim with HCG Trigger,all resulted in BFN.
    FET #1: Baseline appt 4/28/16, Gonal-F/Menopur stims, Centrotide 5/4/16, ER 5/11/16; 6/8/16 ET, BFN
    FET #2: Baseline appt 6/22/16, Estrace/PIO shots: 7/12/16 ET, 1st beta 7/21/16: 83 BFP, 2nd beta 7/23/16: 315. 1st U/S: 8/4/16 empty sac.  2nd U/S: 8/10/16 yolk sac appeared, everything stopped growing. Office D&C: 8/11/16, MC.
    FET #3: Baseline appt 12/28/16, Estrace/PIO shots: 1/17/17 ET, 1st beta 1/27/17: 146 BFP, 2nd beta 1/29/17: 336, 1st U/S: 2/16/17, 2 healthy twin babies measuring 7w0d.  EDD: 10/5/17
    Pregnancy Ticker
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    @emgem819 woo hoo!!! Hopefully i will just be a few days behind you! I started provera last Tuesday becaus AF has been no where to be found...hoping to see her any day now so we can get this party started. I haven't been able to do a cycle since APRIL because of a change in doctors and multiple tests (HSG, water sonogram, genetics, the works). DH and I are so ready to get this party started. All i want for Christmas is a pregnancy lol
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    @PCOSat25 awesome!!! I hope she comes soon (don't usually hope that though lol!) for you! I had to use provera a few months ago to induce AF also so I know how that works! We are ready to get that BFP as well...the TWW is going to be hell! Will do my best to not test too soon! Keep me posted on what's happening with you:)
    Married to DH since 8/15
    TTC since 5/15
    PCOS, 35+, diagnosed with pre-diabetes
    TI for 4 cycles: 1 round of femara; 2 rounds femara/ injectables: all ended in BFN. 
    3 IUI Cycles: letrozole/Follistim with HCG Trigger,all resulted in BFN.
    FET #1: Baseline appt 4/28/16, Gonal-F/Menopur stims, Centrotide 5/4/16, ER 5/11/16; 6/8/16 ET, BFN
    FET #2: Baseline appt 6/22/16, Estrace/PIO shots: 7/12/16 ET, 1st beta 7/21/16: 83 BFP, 2nd beta 7/23/16: 315. 1st U/S: 8/4/16 empty sac.  2nd U/S: 8/10/16 yolk sac appeared, everything stopped growing. Office D&C: 8/11/16, MC.
    FET #3: Baseline appt 12/28/16, Estrace/PIO shots: 1/17/17 ET, 1st beta 1/27/17: 146 BFP, 2nd beta 1/29/17: 336, 1st U/S: 2/16/17, 2 healthy twin babies measuring 7w0d.  EDD: 10/5/17
    Pregnancy Ticker
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    @PCOSat25, I am starting as soon as AF shows up. I am currently on provera to jumpstart my period so I should be getting AF in the next week or so. 
    NTNP since 2012
    Officially TTC #1 since January 2015
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    @emgem819 and @kaitlink33 looks like we are in this one together!!!
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    @emgem819 and @PCOSat25 what dose of tonal-f did they start you on? I just went yesterday for my teaching appointment and they are starting me on 75iu, I feel like this is a real small dose?
    NTNP since 2012
    Officially TTC #1 since January 2015
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    Hi @kaitlink33--I'm on 75iu of gonal-f but I use 6 vials each cycle (this is my second cycle) on cycle days 3, 5, 7, 8, 9, and 10.  So each time I inject 75iu's.  I don't think you want to inject a large dose at one time because they don't want your follies to grow too much too fast.  It worked for me the first cycle to increase the size of my follicles so I don't think you need to ask to up it.  Are you taking it more than once?
    Married to DH since 8/15
    TTC since 5/15
    PCOS, 35+, diagnosed with pre-diabetes
    TI for 4 cycles: 1 round of femara; 2 rounds femara/ injectables: all ended in BFN. 
    3 IUI Cycles: letrozole/Follistim with HCG Trigger,all resulted in BFN.
    FET #1: Baseline appt 4/28/16, Gonal-F/Menopur stims, Centrotide 5/4/16, ER 5/11/16; 6/8/16 ET, BFN
    FET #2: Baseline appt 6/22/16, Estrace/PIO shots: 7/12/16 ET, 1st beta 7/21/16: 83 BFP, 2nd beta 7/23/16: 315. 1st U/S: 8/4/16 empty sac.  2nd U/S: 8/10/16 yolk sac appeared, everything stopped growing. Office D&C: 8/11/16, MC.
    FET #3: Baseline appt 12/28/16, Estrace/PIO shots: 1/17/17 ET, 1st beta 1/27/17: 146 BFP, 2nd beta 1/29/17: 336, 1st U/S: 2/16/17, 2 healthy twin babies measuring 7w0d.  EDD: 10/5/17
    Pregnancy Ticker
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    I do two days of 50 then drop down to 25 for 2-3 more days . And last time I had three mature follicles . I think everyone is just different with their doses !

    **BFP and loss warning**

    Me: 29
    DH: 29
    Us: Married Valentine's Day, 2015
    DH: No issues.
    Me: PCOS, unexplained infertility (whatever that means!!)
    June 2015 Medicated TI cycle: BFN
    July 2015:  Medicated TI cycle: BFN
    August 2015: IUI: BFP. Chemical pregnancy :(
    October 2015: IUI: BFN
    January 2016: Egg retrieval: 10 frozen embryos!
    March 2016: FET Cycle- 2 embryos transferred!: BFP !
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    I guess I was just not sure what the norm was. I am going to be taking it more than once but I am not sure on which days yet. I go for a U/S on day 8 and start taking it then and go back for another U/S day 10 and thats when they will let me know how many more days to take it. 
    NTNP since 2012
    Officially TTC #1 since January 2015
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    @kaitlink33 Yeah they'll probably want to see how you take to it and how many follicles of a bigger size you can grow. I know I always just have one large follicle (<20 mm) after injects but it only takes one! Your re will likely not want you to "over" stimulate so too many follicles can mean multiples and that's not ideal. good luck to you...I hope it works to help you!
    Married to DH since 8/15
    TTC since 5/15
    PCOS, 35+, diagnosed with pre-diabetes
    TI for 4 cycles: 1 round of femara; 2 rounds femara/ injectables: all ended in BFN. 
    3 IUI Cycles: letrozole/Follistim with HCG Trigger,all resulted in BFN.
    FET #1: Baseline appt 4/28/16, Gonal-F/Menopur stims, Centrotide 5/4/16, ER 5/11/16; 6/8/16 ET, BFN
    FET #2: Baseline appt 6/22/16, Estrace/PIO shots: 7/12/16 ET, 1st beta 7/21/16: 83 BFP, 2nd beta 7/23/16: 315. 1st U/S: 8/4/16 empty sac.  2nd U/S: 8/10/16 yolk sac appeared, everything stopped growing. Office D&C: 8/11/16, MC.
    FET #3: Baseline appt 12/28/16, Estrace/PIO shots: 1/17/17 ET, 1st beta 1/27/17: 146 BFP, 2nd beta 1/29/17: 336, 1st U/S: 2/16/17, 2 healthy twin babies measuring 7w0d.  EDD: 10/5/17
    Pregnancy Ticker
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    i doing 50mg global-f. But still waiting on day one over here. Ugh...
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    kaitlink33kaitlink33 member
    edited October 2015
    I'm still waiting on day one as well. Today is day 3 after my provera so I am hoping it is today or tomorrow. 
    ETA: @emgem819, thanks! I never have any follicles bigger than like 9mm :( so I am hoping this is the trick!
    NTNP since 2012
    Officially TTC #1 since January 2015
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    @kaitlink33 any luck waiting on day one? I started cycle on 10/21. Went in for baseline ultrasound on 10/22. Began letrozole of 10/23. The plan is letrozole 10/23-10/27. Begin glonal-f on 10/27-10/31. Add in estrace starting 10/28. Ultrasound and blood draw on 10/31 (happy Halloween). Then ultrasounds everyday until they determine I am good to trigger. We will do two IUIs on consecutive days after the trigger. Getting excited!!!

    TIP: I have been taking the letrozole at night as it seems to make me PASS OUT
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    Day one started yesterday, finally! Go in for U/S day 8, but it will probably be day 7 since day 8 will be a saturday. I started taking my dexamethasone yesterday when AF came, and will start the letrozole tomorrow (i take mine in the morning because they told me to and it doesn't seem to make me sleep) and I will start the gonal-f on day 8 (or day 7? whevever I get the U/S)  and return for another U/S day 10 which is when they will tell me how long to continue the injects. I am not doing a trigger though so hopefully that takes care of itself. 
    NTNP since 2012
    Officially TTC #1 since January 2015
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    Woo hoo!!Glad you were able to get started! I am just hoping to have really good progress at my US on 10/31. My husband has to leave on a business trip 11/6-11/8 so we will either need to get the IUIs in before then or do a frozen sperm cycle. My RE said they should be able to tell at that US when I should expect to do the IUIs. I am hoping for days 13 and 14 as then we would be able to do fresh. Fingers crossed! Wish he didn't travel so much...really messes with my treatments lol. I am thinking it should be fine though. He leaves on cycle day 17 (so the latest day we could do a fresh IUI would be day 16) and that seems late to me. What cycle day do they expect to do your IUI?
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    I would think they would do your IUI before cd17, that does seem a little late. I am not doing IUI, just TI. 
    NTNP since 2012
    Officially TTC #1 since January 2015
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    It's so hard to say unless u have predictable cycles. Personally, I didn't have my IUI until CD21 because my follicles and hormones stalled on CD16 thereby requiring meds for a few days to get things jump started.

    Can you cancel the cycle if needed?
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    @RMM1204 I can cancel the cycle however what we will probably do if it looks like the IUI may be later in the cycle is just bank sperm and do a frozen cycle. Not the ideal option but better than a cancelation with how much we spend on MEDS!!! Just did my first gonal-f injection. Not gonna lie I was a bit of a wimp about it lol
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    I am totally freaking out about giving myself injections. I HATE needles and look away when they do bloodworm. lol my nurse said I shouldn't even feel it because of the needles being so thin. How bad was it?
    NTNP since 2012
    Officially TTC #1 since January 2015
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    @kaitlink33 I honestly could never give the shot to myself so forced DH to do it. I'm also squeamish in blood tests and cannot give blood because I've fainted before. The shots actually aren't awful (if I look away) and DH has gotten the hang of them now. They sting and it's a little sore after but def the needle is small and you get used to it after awhile. you'll do fine!
    Married to DH since 8/15
    TTC since 5/15
    PCOS, 35+, diagnosed with pre-diabetes
    TI for 4 cycles: 1 round of femara; 2 rounds femara/ injectables: all ended in BFN. 
    3 IUI Cycles: letrozole/Follistim with HCG Trigger,all resulted in BFN.
    FET #1: Baseline appt 4/28/16, Gonal-F/Menopur stims, Centrotide 5/4/16, ER 5/11/16; 6/8/16 ET, BFN
    FET #2: Baseline appt 6/22/16, Estrace/PIO shots: 7/12/16 ET, 1st beta 7/21/16: 83 BFP, 2nd beta 7/23/16: 315. 1st U/S: 8/4/16 empty sac.  2nd U/S: 8/10/16 yolk sac appeared, everything stopped growing. Office D&C: 8/11/16, MC.
    FET #3: Baseline appt 12/28/16, Estrace/PIO shots: 1/17/17 ET, 1st beta 1/27/17: 146 BFP, 2nd beta 1/29/17: 336, 1st U/S: 2/16/17, 2 healthy twin babies measuring 7w0d.  EDD: 10/5/17
    Pregnancy Ticker
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    @kaitlink33 here's the deal... You will feel the needle puncturing your skin. It pinched more than anything but it was enough to surprise me. If you hesitate before pushing the needle the rest of the way in, it is worse. Just try to do one confident motion and you hardly feel anything after the initial pinch of the skin. I did my second injection tonight and it was WAY better. I knew what to expect and didn't hesitate.
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    thanks ladies! I start mine on saturday and am zoo nervous. I have tried to talk DH into doing it for me, but he doesn't want to because he is afraid he'll hurt me and I can't do anything to convince him to do it so I guess I'm gonna have to suck it up and just do it. 
    NTNP since 2012
    Officially TTC #1 since January 2015
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    @vaustin38 what dose of letrozole were you on? 

    I have PCOS and was never successful with clomid, so my RE switched me to letrozole. I did a dose at 700 and had a little growth, but not enough. RE followed it up with a second dose of 750 at CD18 and BAM! 2 perfect follies. We did an IUI that month that was BFN, and then went to do a second round of letrozole at the 750 dose that again produced 2 follies but a BFN with the IUI. So we did a 3rd round of the 750 dose, with no success that time. 

    RE said PCOS makes it so unpredictable that he was wary of combining with injectables for fear of overstim or multiples. We have since moved on to IVF and so far things are progressing the way they should. 

    FX for you!
    *TW* Pregnancy/Loss Mentioned
    Me: 37 /PCOS DH: 37/no issues TTC: 7/13
    Started with RE 12/14; 3 failed rounds of clomid, started letrozole
    IUI #1 & #2- BFN
    IVF #1 - 9/15 Cancelled Day 9
    IVF #2- started stims 10/24  ER- 11/15 6 eggs- 5 fertilized/ 1 frozen
    FET #1 -1 embryo-12/9/15- BFN
    IVF #3- started stims 1/22/16  ER- 2/8 33 eggs(!)- 21 mature, all 21 fertilized - 6 snowflakes!
    FET #2- 2 embryos- April 4th-BFN
    ERA-June 8- results show need 12 addt'l hours of PIO
    FET #3-  2 embryos transferred August 14,2016  BFP! on 8/24! Beta #1-22  Beta #2-83 Beta #3-368 
    Confirmed singleton-Heartbeat on 9/19-160bpm! EDD: May 1, 2017, It's a girl!!
    Pre-term labor/loss-stillborn at 18w. 
    FET #4- 1 embryo-Aug 12th-BFP on 8/23 Beta #1-112 Beta #2-298 Beta #3-1010
    Confirmed Identicals!- Heartbeats seen on 9/8  Miscarriage on 9/18
    FET #5- 1 embryo- 1/12/18-BFN
    Lots of testing and finally determined I have elevated natural killer cells. Will begin prednisone and IVL treatment before next round.
    IVF#4- April 2018 8 eggs, 7 fertilized/3 frozen
    FET #6- 1 embryo- 6/11/18- BFP on 6/21 Beta #1-446, Beta #2-1841 
    Confirmed singleton- 6/29/18 HB-157 EDD: February 22, 2019. It's a Boy!



    BabyFruit Ticker 
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    Hi there.... Basically we have exact same story. Just last week re said letrozole won't work for me any more. So we are going to injectibles. Menopur. I'm just waiting for my period to start and I'll start it. I. Will then do an iui. Hope that helps. There are a lot of alternatives, and metformin and clomid were one, but she said menopur was good for my type (pcos long time and don't ovulate on my own). Good luck to you!
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    @kaitlink33 I did my third injection last night and seriously could hardly even feel it! It definetly gets easier every time. Don't worry you are going to rock it!
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    Woah @halips what unit of measurement for the letrozole? 700-750 seems like a crazy high number!!! This cycle I did 5 mg of letrozole per day CD 3-7. That was two letrozole pills as they come in 2.5 mg dosage. Were you maybe on 7.5 mg (3 pills)? Or am I just on a crazy low dose???
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    I agree that 700 and 750 are crazy high because I did 5 rounds with letrozole and the highest I was on was on was 10mg. Maybe you were on 7 and 7.5 like pp suggested??? And @PCOSat25 I am on almost a week of taking the gonal f now. I have found the one spot that doesn't hurt so I've been doing it there but the first time was definitely hard I almost completely backed out because I was so worked up over it then forced myself to because its worth it. How are you progressing in your cycle??
    NTNP since 2012
    Officially TTC #1 since January 2015
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    Ha! Yes, sorry it was actually supposed to say 5.0 and 7.5
    *TW* Pregnancy/Loss Mentioned
    Me: 37 /PCOS DH: 37/no issues TTC: 7/13
    Started with RE 12/14; 3 failed rounds of clomid, started letrozole
    IUI #1 & #2- BFN
    IVF #1 - 9/15 Cancelled Day 9
    IVF #2- started stims 10/24  ER- 11/15 6 eggs- 5 fertilized/ 1 frozen
    FET #1 -1 embryo-12/9/15- BFN
    IVF #3- started stims 1/22/16  ER- 2/8 33 eggs(!)- 21 mature, all 21 fertilized - 6 snowflakes!
    FET #2- 2 embryos- April 4th-BFN
    ERA-June 8- results show need 12 addt'l hours of PIO
    FET #3-  2 embryos transferred August 14,2016  BFP! on 8/24! Beta #1-22  Beta #2-83 Beta #3-368 
    Confirmed singleton-Heartbeat on 9/19-160bpm! EDD: May 1, 2017, It's a girl!!
    Pre-term labor/loss-stillborn at 18w. 
    FET #4- 1 embryo-Aug 12th-BFP on 8/23 Beta #1-112 Beta #2-298 Beta #3-1010
    Confirmed Identicals!- Heartbeats seen on 9/8  Miscarriage on 9/18
    FET #5- 1 embryo- 1/12/18-BFN
    Lots of testing and finally determined I have elevated natural killer cells. Will begin prednisone and IVL treatment before next round.
    IVF#4- April 2018 8 eggs, 7 fertilized/3 frozen
    FET #6- 1 embryo- 6/11/18- BFP on 6/21 Beta #1-446, Beta #2-1841 
    Confirmed singleton- 6/29/18 HB-157 EDD: February 22, 2019. It's a Boy!



    BabyFruit Ticker 
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    @Vaustin38
    I am currently in my 2ww all thanks to Letrozole. I ovulated on day 21,mature follicle at 21. I have done Clomid before with no luck
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    @kaitlink33 I am on the TWW. I went in for a U.S. on CD11 and had one follicle at 19. The doctor triggered and I did IUI on CD 12 and 13 which was Sunday and Monday this week. I felt pretty crappy and run down the day of my 2nd IUI but have been feeling a lot better. Currently on estridiol and progesterone suppositories at night. No symptoms but it is still to early for implantation so we will see how I feel in a few days. Though I only had one follicle my lining looked really good at 9.5 and my DH had high sperm counts both days so we are hopeful. I just would feel so much more confident if I had more than one follicle...
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    I was super ecstatic that I responded after all this time! I am in the 2ww now too. I had my last U/S on monday the 9th and had 5 measurable follicles 11, 16, 17, 22, and 29! I triggered on monday as well even though my estradiol was still low, they were afraid they were gonna lose the follicles. Im pretty sure I ovulated on tuesday and our timing was pretty good so here's hoping! I have never had an actual 2ww cuz I knew i never had mature follicles so this one is gonna kill me. I am testing on the 23rd. 
    NTNP since 2012
    Officially TTC #1 since January 2015
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    @kaitlink33 that is great news . FX
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    LizzieJ13LizzieJ13 member
    edited November 2015
    @kaitlink33 Great news for you! I triggered Monday also - am going to try to hold out to test till the 25th. Good luck!
    Me: 33, PCOS with anovulation
    DH: 36, No known issues
    TTC since 11/2014
    1000mg Metformin daily

    Oct-Dec 2015: Letrozole 5mg, Ovidrel, TI = BFN x 2
    Feb-May 2016: Letrozole 5mg, Ovidrel, TI, Prometrium = BFN x 3
    August 2016: Clomid 100mg no response, Letrozole 5mg, Ovidrel, TI, Prometrium = BFN

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