Letrozole/Femera 2-3 times in a cycle? (upped doses?) — The Bump
Infertility

Letrozole/Femera 2-3 times in a cycle? (upped doses?)

Not really sure how to word it...but has anyone had multiple 5 days of letrozole prescribed during a cycle? Would be curious to hear your experience/experiences!

First time I got a 2nd dose of Let in a cycle was when I went from 2.5mg (no mature follies) from cd 3-7 to another dose of 5mg for 5 more days in the cycle (and again no mature follies).

From then on I took 5mg of let each cycle cd3-7 (sometimes with mature follies and sometimes without success)

This time I took 5mg of Let from cd 3-7 (no mature follies) and another 5mg of let cd 15-19 (no mature follies) and now 7.5mg of let CD 22-27. 
Me: 37 DH: 32 TTGP Since 2014 INFERTILITY INFO (Medicated, IUI's, IVF/FET) IN SPOILER
October 2014-April 2015: Without Medication or Doctor Guidance No Periods/No O BFN 
Medicated April-December 2015: Clomid (didn't work) and so we tried Femera/Letrozole. Progesterone Met 1000 Not diagnosed PCOS but treating the same. Anovulatory. TI No US No O BFN 

- TW - 
IUI"S 
January 2016-October 2016: Letrozole 2.5mg-7.5 mg, Pregyl or Ovideral Trigger Shot.
9 cycles of IUI
(7 Cancelled due to no mature follicles) (2 attempted IUI's with mature follicles)  

IUI # 2 June 2016 and July 2016:  Met 1000, Estrogen (21 days), Progesterone (5 days) Femera 5m 6/28/16 Ultrasound CD14 = 25 follie. Pregnyl Trigger CD14 IUI 7/13 1stBeta (DPO 15): 7.6 (Surprise BFP...but Low #'s) 2ndBeta (DPO 17): 18 3rdBeta (DPO 19) 52.8 Progesterone Prescribed (spotting) 4thBeta (DPO 26) 6.9 Chemical Pregnancy BFN

IVF and FET (diagnosed with PCOS) 204 pounds at start of IVF
IVF # 1 October and November 2016: CCRM - Minneapolis 10/14 Consult and CD 3 testing, 10/14 started (OCP Antagonist - BCP) BCP, 10/21 1 day work up, Doxycycline 100mg 10 days, 10/24 stop bcp, Bloodwork US 10/29, 10/30-11/8 Stims 2 vials of Menopur, Dexamethasone, 225 of Gonal-F daily (dropped to 120). CCRM Vitamin Cocktail (like 20 of them), Monitoring (11/2, 11/4, 11/5, 11/6, 11/7, 11/8), Retrieval 11/10 (38 eggs, 30 mature, 16 fertilized ICSI), 11/16 8 Blasts 11/30 CCS testing results 3 Normal 5aa's (2 boys and 1 girl) 1 Unknown 4 Abnormal (All girls) 


Fet #1 January 2017: CCRM - Minneapolis bcp/lupron/suppository/p4 in oil QOD AF 12/7, 12/8 start meds. 1/3 lining and blood work check 14/15 mm, BW check 1/6. 1/9 transfer with acupuncture 1 CCS/PGS Normal 5aa hatching Progesterone around 26ish? Lower estrogen level 207 (wanted above 300 but over 200 was acceptable), started 1 estrace, progesterone in oil every other day, vivelle dot patches 4 every other day, 3x estrodiol daily, vitamin cocktail. POAS: - 4dp5dt and 5dp5dt, 6dp5dt frer very very very faint line. 7dp5dt and 8dp5dt + on Accuclear. 8dp5dt pregnant on a clear blue easy digital. 214 pounds at FET
1/18 #1 Beta 91.1
1/20 #2 Beta 215.9
2/3 6 week US 2 sacs? Twins? but only 1 heartbeat/pole good heartbeat Stopped taking baby asprin Added in DHEA Veg Vitamin (also got the report that they transferred a girl 5aa eggo) 
2/10 7 week US 2 sacs (likely vanishing twin) only 1 heartbeat/pole etc good heartbeat 137
2/24 9 week US 1 eggo sac good heart beat 182 1 very small fluid sac (shrinking) 
2/24 9 week 2 days start weening. Graduated from RE (CCRM is now starting weening as soon as 8.5 weeks)
3/7 10 Weeks 5 days  weened completely of FET meds A1C 5.3% (Normal)
3/9 11 Weeks 1 day my progesterone level was 15 and my estrogen level was 881 (I freaked out!)
3/16 12 Weeks 1 day baby heard on doppler 164 HB
4/14 16 week 2 days Ultrasound baby is looking good with all good numbers sized 17 weeks. Also got to hear her on the doppler for a few mins too. 

5/5 19 Weeks 2 days going in for "20" week anatomy ultrasound got measurements but need to come back as wasn't able to get all the measurements
MEASUREMENTS BPD 4.6 cm 19 weeks 6 days* (78%) HC 17.0 cm 19 weeks 4 days* (70%) AC 14.5 cm 19 weeks 4 days* (69%) Femur 3.1 cm 19 weeks 6 days* (63%) Humerus 3.1 cm 20 weeks 2 days (84%) Cerebellum 2.0 cm 19 weeks 5 days
CisternaMagna 6.2 mm Nuchal Fold 4.5 mm
HC/AC 1.17 FL/AC 0.22 FL/BPD 0.68 EFW (Ac/Fl/Hc) 309 grams - 0 lbs 11 oz
THE AVERAGE GESTATIONAL AGE is 19 weeks 5 days +/- 10 days.

6/9 24 Weeks 2 days Glucose Test 1 hour (Failed) 190
6/16 25 Weeks 2 days Ultrasound and 1st Baby Shower 
6/20 25 Weeks 6 days Glucose Test 3 Hours (Failed) 95 (95), 183 (180), 213 (155), 198 (140) etc
6/21 26 Weeks Recommended to a perintologist
6/22 26 Weeks 1 day start monitoring blood sugar levels 
6/30 27 Weeks 2 day A1 (blood sugar test ordered)

7/5 28 Weeks Echo and 3d Ultrasound
AMNIOTIC FLUID Q1: 2.6 Q2: 3.2 Q3: 4.8 Q4: 5.6 AFI Total = 16.3 cm Amniotic Fluid: Normal 
MEASUREMENTS BPD 7.2 cm 28 weeks 5 days* (60%) HC 26.4 cm 28 weeks 4 days* (48%) AC 23.3 cm 27 weeks 4 days* (36%) Femur 5.2 cm 28 weeks 0 days* (36%) Humerus 4.8 cm 28 weeks 0 days (49%)
HC/AC 1.13 FL/AC 0.23 FL/BPD 0.73 Ceph Index 0.77 EFW (Ac/Fl/Hc) 1142 grams - 2 lbs 8 oz (37%)
THE AVERAGE GESTATIONAL AGE is 28 weeks 1 day +/- 14 days.

7/10 28 Weeks 5 days Dietitian Appt and Lactatcian Consultant and A1 blood draw 5.4% (normal) 218.5 pounds
7/20 30 Weeks GD consult. 6 Lantus at 7pm daily. Novolog 1 unit for every 15 gm carbohydrate if consumed more than 30 gm at brkfst or 60 gm at lunch or supper 215.6 pounds
7/20 30 Weeks Transferred care to OB due to high risk. 216 pounds

8/2 32 Weeks Ultrasound (not cooperative and still breech) and then weekly NST's
MEASUREMENTS BPD 8.0 cm 32 weeks 2 days* (44%) HC 29.2 cm 31 weeks 6 days* (22%) AC 26.9 cm 31 weeks 0 days* (24%)  Femur 6.3 cm 32 weeks 2 days* (57%) Humerus 5.7 cm 32 weeks 6 days (71%)
HC/AC 1.08 FL/AC 0.23 FL/BPD 0.78 Ceph Index 0.78 EFW (Ac/Fl/Hc) 1808 grams - 3 lbs 15 oz (29%)
THE AVERAGE GESTATIONAL AGE is 31 weeks 6 days +/- 18 days.
AMNIOTIC FLUID Q1: 3.4 Q2: 2.9 Q3: 2.9 Q4: 4.4 AFI Total = 13.6 cm Amniotic Fluid: Normal

8/8 32w6d upped to 1:10 for dinner 
8/11 Baby Shower
8/13 Baby Shower
8/16 34 weeks NST good reading Upped to 8 at bed for fasting and 1:7 for dinner 
8/18 Dr Appt

8/24 35 weeks 1 day (was suppose to be scheduled for 36 weeks) Weeks Ultrasound/GD Dr Appt/OB Appt 
Frank Breech
MEASUREMENTS BPD 8.9 cm 35 weeks 6 days* (67%) HC 31.7 cm 35 weeks 1 day * (35%) AC 30.2 cm 34 weeks 2 days* (33%) Femur 6.9 cm 34 weeks 6 days* (57%) Humerus 6.0 cm 34 weeks 6 days (64%)
HC/AC 1.05 FL/AC 0.23 FL/BPD 0.78 Ceph Index 0.80 EFW (Ac/Fl/Hc) 2494 grams - 5 lbs 8 oz (39%)
THE AVERAGE GESTATIONAL AGE is 35 weeks 1 day +/- 21 days.
AMNIOTIC FLUID Q1: 3.3 Q2: 3.8 Q3: 2.4 Q4: 3.8 AFI Total = 13.4 cm Amniotic Fluid: Normal

8/31 36 Weeks
9/7 37 Weeks
9/10 Water broke...I got it tested at the emergency room it it showed it was negative. More water breaking and didn't go to the dr.
9/11 37 weeks 4 days Called the Dr and got retested for water breaking...
10:30pmish Baby Girl Born via Emergency C Section (Frank Breech Baby) 6lbs 3oz  -
9/13 Dropped to 5 pounds 10oz and had jaundice 
9/13 38 weeks

9/22 39 Weeks 2 days C Section Scheduled for 10am (arrive at 8am) Equinox/Solstice
EDD 9/27

Re: Letrozole/Femera 2-3 times in a cycle? (upped doses?)

  • Hey there,

    I had that happen once when I didn't respond to the first dosage. I took 2.5 for 5 days CD 3-7, and it looked like I had some follicles growing. But when I went in for my second round of scans, they had actually shrunk! So I got prescribed another round of Femara on CD 12-15 or something like that. This time 5 mg. I ended up growing some follies and triggered and had my IUI (BFN though). 

    That only happened once though. I'd imagine if you were having trouble getting any mature follicles with so much letrozole, they might consider injectables?
    ***TW***
    Married 3 years. TTC #1.
    DH & I both 33.
    DX: Unexplained (+short LP +Hypothyroidism)
    2/16-7/16: IUI and TI with Femara: all BFN
    8/16: IVF, antagonist protocol 
    21 eggs | 9 blasts | 7 normal through PGS
    10/16: FET  = BFN  :(
    12/16: Surprise natural BFP 
    Beta 1: 177 | Beta 2: 483 | Beta 3: 8,755 | Beta 4: 39,007. EDD Sept 8 2017
    Miracle Baby Girl June born September 5, 2017. 6 lb 14 oz.  <3

  • I'm going through that right now, but with Clomid. I had a 12mm follicle on CD11, so the doctor had me go back today (CD14) to check. The follicle was gone but bloodwork showed I hadn't ovulated. So, I just got off the phone with a nurse, and I am going to start a round of Letrozole tonight. It feels weird to be starting meds again mid-cycle!
    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

  • Loading the player...
  • Hi @BecauseLove  You may have seen on our other threads, but I took letrozole for 5 days, had 2 days off, then had 4 more days of letrozole.  This resulted in a u/s showing a follicle ready to go.  Apparently my ovaries really needed the kick of extra medication.  I had three u/s during this time, so they were really checking me closely.  Best of luck!!
  • Thanks Ladies! It is just good to hear from other people that have gone through something similar. So far my follies haven't responded to the 2nd doses any differently then they responded to the first ones...which means no mature follies. FX though that this 3rd upped dose might be magic to get me a mature follie. :)

    As my dr would say...I respond un uniformly to Let..sometimes great and sometimes nothing. Maybe this is just a nothing cycle.... 


    Me: 37 DH: 32 TTGP Since 2014 INFERTILITY INFO (Medicated, IUI's, IVF/FET) IN SPOILER
    October 2014-April 2015: Without Medication or Doctor Guidance No Periods/No O BFN 
    Medicated April-December 2015: Clomid (didn't work) and so we tried Femera/Letrozole. Progesterone Met 1000 Not diagnosed PCOS but treating the same. Anovulatory. TI No US No O BFN 

    - TW - 
    IUI"S 
    January 2016-October 2016: Letrozole 2.5mg-7.5 mg, Pregyl or Ovideral Trigger Shot.
    9 cycles of IUI
    (7 Cancelled due to no mature follicles) (2 attempted IUI's with mature follicles)  

    IUI # 2 June 2016 and July 2016:  Met 1000, Estrogen (21 days), Progesterone (5 days) Femera 5m 6/28/16 Ultrasound CD14 = 25 follie. Pregnyl Trigger CD14 IUI 7/13 1stBeta (DPO 15): 7.6 (Surprise BFP...but Low #'s) 2ndBeta (DPO 17): 18 3rdBeta (DPO 19) 52.8 Progesterone Prescribed (spotting) 4thBeta (DPO 26) 6.9 Chemical Pregnancy BFN

    IVF and FET (diagnosed with PCOS) 204 pounds at start of IVF
    IVF # 1 October and November 2016: CCRM - Minneapolis 10/14 Consult and CD 3 testing, 10/14 started (OCP Antagonist - BCP) BCP, 10/21 1 day work up, Doxycycline 100mg 10 days, 10/24 stop bcp, Bloodwork US 10/29, 10/30-11/8 Stims 2 vials of Menopur, Dexamethasone, 225 of Gonal-F daily (dropped to 120). CCRM Vitamin Cocktail (like 20 of them), Monitoring (11/2, 11/4, 11/5, 11/6, 11/7, 11/8), Retrieval 11/10 (38 eggs, 30 mature, 16 fertilized ICSI), 11/16 8 Blasts 11/30 CCS testing results 3 Normal 5aa's (2 boys and 1 girl) 1 Unknown 4 Abnormal (All girls) 


    Fet #1 January 2017: CCRM - Minneapolis bcp/lupron/suppository/p4 in oil QOD AF 12/7, 12/8 start meds. 1/3 lining and blood work check 14/15 mm, BW check 1/6. 1/9 transfer with acupuncture 1 CCS/PGS Normal 5aa hatching Progesterone around 26ish? Lower estrogen level 207 (wanted above 300 but over 200 was acceptable), started 1 estrace, progesterone in oil every other day, vivelle dot patches 4 every other day, 3x estrodiol daily, vitamin cocktail. POAS: - 4dp5dt and 5dp5dt, 6dp5dt frer very very very faint line. 7dp5dt and 8dp5dt + on Accuclear. 8dp5dt pregnant on a clear blue easy digital. 214 pounds at FET
    1/18 #1 Beta 91.1
    1/20 #2 Beta 215.9
    2/3 6 week US 2 sacs? Twins? but only 1 heartbeat/pole good heartbeat Stopped taking baby asprin Added in DHEA Veg Vitamin (also got the report that they transferred a girl 5aa eggo) 
    2/10 7 week US 2 sacs (likely vanishing twin) only 1 heartbeat/pole etc good heartbeat 137
    2/24 9 week US 1 eggo sac good heart beat 182 1 very small fluid sac (shrinking) 
    2/24 9 week 2 days start weening. Graduated from RE (CCRM is now starting weening as soon as 8.5 weeks)
    3/7 10 Weeks 5 days  weened completely of FET meds A1C 5.3% (Normal)
    3/9 11 Weeks 1 day my progesterone level was 15 and my estrogen level was 881 (I freaked out!)
    3/16 12 Weeks 1 day baby heard on doppler 164 HB
    4/14 16 week 2 days Ultrasound baby is looking good with all good numbers sized 17 weeks. Also got to hear her on the doppler for a few mins too. 

    5/5 19 Weeks 2 days going in for "20" week anatomy ultrasound got measurements but need to come back as wasn't able to get all the measurements
    MEASUREMENTS BPD 4.6 cm 19 weeks 6 days* (78%) HC 17.0 cm 19 weeks 4 days* (70%) AC 14.5 cm 19 weeks 4 days* (69%) Femur 3.1 cm 19 weeks 6 days* (63%) Humerus 3.1 cm 20 weeks 2 days (84%) Cerebellum 2.0 cm 19 weeks 5 days
    CisternaMagna 6.2 mm Nuchal Fold 4.5 mm
    HC/AC 1.17 FL/AC 0.22 FL/BPD 0.68 EFW (Ac/Fl/Hc) 309 grams - 0 lbs 11 oz
    THE AVERAGE GESTATIONAL AGE is 19 weeks 5 days +/- 10 days.

    6/9 24 Weeks 2 days Glucose Test 1 hour (Failed) 190
    6/16 25 Weeks 2 days Ultrasound and 1st Baby Shower 
    6/20 25 Weeks 6 days Glucose Test 3 Hours (Failed) 95 (95), 183 (180), 213 (155), 198 (140) etc
    6/21 26 Weeks Recommended to a perintologist
    6/22 26 Weeks 1 day start monitoring blood sugar levels 
    6/30 27 Weeks 2 day A1 (blood sugar test ordered)

    7/5 28 Weeks Echo and 3d Ultrasound
    AMNIOTIC FLUID Q1: 2.6 Q2: 3.2 Q3: 4.8 Q4: 5.6 AFI Total = 16.3 cm Amniotic Fluid: Normal 
    MEASUREMENTS BPD 7.2 cm 28 weeks 5 days* (60%) HC 26.4 cm 28 weeks 4 days* (48%) AC 23.3 cm 27 weeks 4 days* (36%) Femur 5.2 cm 28 weeks 0 days* (36%) Humerus 4.8 cm 28 weeks 0 days (49%)
    HC/AC 1.13 FL/AC 0.23 FL/BPD 0.73 Ceph Index 0.77 EFW (Ac/Fl/Hc) 1142 grams - 2 lbs 8 oz (37%)
    THE AVERAGE GESTATIONAL AGE is 28 weeks 1 day +/- 14 days.

    7/10 28 Weeks 5 days Dietitian Appt and Lactatcian Consultant and A1 blood draw 5.4% (normal) 218.5 pounds
    7/20 30 Weeks GD consult. 6 Lantus at 7pm daily. Novolog 1 unit for every 15 gm carbohydrate if consumed more than 30 gm at brkfst or 60 gm at lunch or supper 215.6 pounds
    7/20 30 Weeks Transferred care to OB due to high risk. 216 pounds

    8/2 32 Weeks Ultrasound (not cooperative and still breech) and then weekly NST's
    MEASUREMENTS BPD 8.0 cm 32 weeks 2 days* (44%) HC 29.2 cm 31 weeks 6 days* (22%) AC 26.9 cm 31 weeks 0 days* (24%)  Femur 6.3 cm 32 weeks 2 days* (57%) Humerus 5.7 cm 32 weeks 6 days (71%)
    HC/AC 1.08 FL/AC 0.23 FL/BPD 0.78 Ceph Index 0.78 EFW (Ac/Fl/Hc) 1808 grams - 3 lbs 15 oz (29%)
    THE AVERAGE GESTATIONAL AGE is 31 weeks 6 days +/- 18 days.
    AMNIOTIC FLUID Q1: 3.4 Q2: 2.9 Q3: 2.9 Q4: 4.4 AFI Total = 13.6 cm Amniotic Fluid: Normal

    8/8 32w6d upped to 1:10 for dinner 
    8/11 Baby Shower
    8/13 Baby Shower
    8/16 34 weeks NST good reading Upped to 8 at bed for fasting and 1:7 for dinner 
    8/18 Dr Appt

    8/24 35 weeks 1 day (was suppose to be scheduled for 36 weeks) Weeks Ultrasound/GD Dr Appt/OB Appt 
    Frank Breech
    MEASUREMENTS BPD 8.9 cm 35 weeks 6 days* (67%) HC 31.7 cm 35 weeks 1 day * (35%) AC 30.2 cm 34 weeks 2 days* (33%) Femur 6.9 cm 34 weeks 6 days* (57%) Humerus 6.0 cm 34 weeks 6 days (64%)
    HC/AC 1.05 FL/AC 0.23 FL/BPD 0.78 Ceph Index 0.80 EFW (Ac/Fl/Hc) 2494 grams - 5 lbs 8 oz (39%)
    THE AVERAGE GESTATIONAL AGE is 35 weeks 1 day +/- 21 days.
    AMNIOTIC FLUID Q1: 3.3 Q2: 3.8 Q3: 2.4 Q4: 3.8 AFI Total = 13.4 cm Amniotic Fluid: Normal

    8/31 36 Weeks
    9/7 37 Weeks
    9/10 Water broke...I got it tested at the emergency room it it showed it was negative. More water breaking and didn't go to the dr.
    9/11 37 weeks 4 days Called the Dr and got retested for water breaking...
    10:30pmish Baby Girl Born via Emergency C Section (Frank Breech Baby) 6lbs 3oz  -
    9/13 Dropped to 5 pounds 10oz and had jaundice 
    9/13 38 weeks

    9/22 39 Weeks 2 days C Section Scheduled for 10am (arrive at 8am) Equinox/Solstice
    EDD 9/27
  • Sorry @BecauseLove - it's really hard to get that news at an ultrasound. I really hope it works for you this time!
    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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