New to Site--Unexplained Infertility OB Suggested Femara

lmroz8605 · October 2015

Hi everyone. I am brand new to this site and I was hoping for some insight on the use of taking Femara if the BBT chart is already showing that ovulation is happening by itself. My husband and I have been TTC for 14 months now. My OB suggested that if nothing happens for me after this month, that I should think about taking Femara in hopes that it help with my egg quality. So far I have done the HSG (which came back negative, no blockage), husband completed the Sperm Analysis which was fine, and then my hormone levels were also tested (my thyroid function was a little low, so I was put on a small dosage of Levothyroxine). I was wondering if any of you out there have been in a similar situation with this unexplained infertility and the Femara treatment ended up helping in the long run. Thanks so much for comments and feedback. Baby dust to you all out there.

Laura

bsckgb7 · October 2015

You should be seeing an RE for a full fertility work-up. Don't take fertility meds from your OB. OBs are trained at KEEPING you pregnant. REs are trained at GETTING you pregnant.

HBamama2B · October 2015

Hello, sorry you are struggling. I hope you get your BFP soon. It's great you've been able to confirm O with BBT!

I gently agree with above comment and suggest seeing an RE before taking femara/letrozol. It's efficacy drops significantly after the third cycle so every one counts. It can also cause multiple follicles and occasionally cysts, so the extra monitoring an RE would provide would be beneficial as a reduction of risk. Even if after the consult you stick with your OB and do letrozol, the RE can provide good insight and pointers to make the most of your cycle. GL!

junicek · October 2015

@HBamama2B how do you know the efficacy of letrozole drops after 3 months? I've been on it I think for five cycles and I haven't heard of this...

blessedwtwins · October 2015

I third suggesting you see a RE instead of your OB.
I had many issues with my OB that when I told my RE about, she was furious and said that unfortunately a lot of OBs try to help but more often hinder the process.
One major issue we found was that the OB tested DH's sperm and said everything was fine. Well our RE ran a more in depth analysis and found that even though he had a higher than usual quantity, the quality was half as good as it should be. Something so simple to test and help explain some of our possible reasons for being unable to conceive naturally.

HBamama2B · October 2015

@junicek that is how my RE explained it to me: that success rates on Femara are bell curved so most who do achieve success on it do so in months 2/3. However, I've seen women on it alone for up to 5 cycles so you're in good company! I'm not sure if their dosing was increased or combined with injectibles.

Most REs will move on from a method that hasn't worked 3 times either by adjusting dosage or combining meds/methods. As long as you are responding and getting several mature follicles I could see why your RE might keep you on it. You might just be the other side of the bell curve.

GL!

HBamama2B · October 2015

@lmroz8605 also, I'm sure even your OB would do this, but make sure to have a blood test confirming negative beta before each round of letrozol! Good luck!

junicek · October 2015

@HBamama2B I was ovulating before femara and I have been while on it. Out of the five months I've only been monitored two times...the first month when I had one mature follicle and last month when I had two. I have considered asking for Clomid...

pumaprnc7 · October 2015

I agree that you should see and RE. I will tell you that my RE has me on femare, gonal-f injections and a trigger. Keep in mind each persons treatment is personal and the best person to help you is not your OB, even as nice as they are and RE's focus is on infertility issues.

bsckgb7 · October 2015

junicek - My doctor also believes in the 3 rule. I have had 3 failed IUIs and now I am headed for lap surgery. He said once we come back he will change my meds from Follistim to another injectable, just because. I respond well to Follistim and have no issues. But it didn't work, so he will switch to another injectable, for no other reason than the "rule of 3".

Also, Clomid is MORE likely than Letrozole to cause multiples follicles. My doctor explained that Clomid has a higher rate of twins than Letrozole. Letrozole tends to produce 1-2 lead follies as Clomid tends to produce more. So if you are NOT being regularly monitored, I would not be taking Clomid.

lmroz8605 · October 2015

Thank you all for your feedback. I have a call into my OB about some of my concerns with moving forward with this process. The thought of actually being referred to a RE scares me (not only because I really feel like now I'm never going to get pregnant on my own) but also about treatments/expenses that will be involved in this next step. I've been healthy my entire life and I'm not dealing with the fact that now, of all things, I can't get pregnant when I haven't had any warning signs that there could be issues. I know I'm not the only one going through this, it helps to have the support for people like you all out there. I think the worst part is just feeling so helpless and not knowing what's the main cause...I have my good and my bad days...Today just isn't one of the good :-(

blessedwtwins · October 2015

@lmroz8605, we all know that feeling of dread and disappointment that we may need a little help. This process is nothing to be ashamed of! You and your body did nothing wrong.
It took me a long time to come to terms with that and at first, we were extremely private about our struggles because of the shame I felt. I felt that I wasn't enough woman and felt immense guilt that I couldn't just "relax and it'll happen". Over time, we opened up more to friends and family and they were an amazing support system. None of them looked down on us or blamed us, it was great. Now, I'm not saying to run out and tell everyone you know but we did find it helped our final few struggling months to have that extra support.
As for your fears of seeing an RE, those are completely valid and common. I think the way to look at it is this- a RE may be able to run additional testing to help you find an answer quicker as to why you've been struggling. It could be something very simple and it may be something big. Either way, the sooner you find out, the better.

HBamama2B · October 2015

@lmroz8605 I think talking with your OB and expressing your concerns is a great first step.

@junicek are they prescribing it then to improve egg quality? Make sure either way you are at least having blood work on cd3 before starting a new round each month. This should never be prescribed for a cycle without negative beta confirmation.

greengypsy · October 2015

i took clomid for 6 mo (not monitored) after not conceiving for 2 years from my OB.. ive been seening an RE for the past year & am now 4 yrs into this TTC journey.. my only regret is not dealing with it sooner... i have a friend who took clomid for an entire year & did IUI's with her OB (for same cost as what my RE charges) & she lost her one tube she had left due to an ectopic pregnancy. i dont wana scare you but an RE provides more monitoring than an OB usually.. she wishes she would have seen an RE & not done the IUI's or been on clomid for so long with her OB.. now her only option is IVF. i know that feeling of hopelessness & i hope these boards bring you comfort during your IF journey.. they def have for me! good luck & i wish you all the best with whatever you decide

tbyars07 · October 2015

Though the idea of an RE may make this "real and scary" in the end you will be much happier. I had a friend that told me not to bother with my OB. I gave her 3 cycles with no medication and even that was a head ache - I felt like I was having to tell them what to do. Now that I'm at the RE - my stress levels have gone way down! Yes its scary but I finally feel like I'm in the right hands. Organization and knowledge are huge things to me. Since most insurances don't cover infertility anyway - the price is basically the same with the OB vs. RE. Wish I wouldn't have even given my OB those few cycles. I have no doubts she will be wonderful when I actually do get pregnant. But leaving getting there up to the Pro's now!

lmroz8605 · October 2015

Thank you all again. I was able to speak with my OB and I've decided that it's time to see an RE. I know she has the best intentions for me, but after she confirmed again that there wouldn't be any monitoring, I told her I definitely didn't feel this was the right way to go about taking these drugs and asked that she just refer me over to an RE now. So begins another step in our journey to bring us the baby that we've been dreaming about.

tbyars07 · October 2015

GOOD LUCK!!! FX and baby dust to you!!

HBamama2B · October 2015

@lmroz8605 I'm glad it resolved well! GL on your journey and I hope you have your BFP soon!!

junicek · October 2015

@bsckgb7 I phoned today and they do not have a rule of 3 policy so I guess I'm staying on letrozole until I change it up. My husband doesn't want to try anymore so I have some decisions to make.

@HBamama2B I don't know why he prescribed letrozole since I was ovulating on my own. I'm 37 so if it helps with egg quality that's good. I usually take a hpt before starting on day 3 so I don't harm a potential baby. By this time though, 19 months of trying, it feels useless. I guess that's not that long but it sure feels it

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