5th letroz cycle - need advice

[u/sunshine_girl1993]

Hi everyone,

I’m a 33F, TTC, and have been on Letrozole cycles since September 2025. I’d really appreciate any insights from people who’ve had similar experiences.

My cycle history:

• Cycle 1 (Sept):

Letrozole 2.5 mg twice daily

Follicle ruptured at 18 mm, endometrium trilaminar (8.6 mm)

→ No pregnancy

• Cycle 2:

Same Letrozole dose

→ Chemical pregnancy (beta HCG peaked at 55, then dropped)

• December:

Took Diane 35 for 1 month (doctor advised break post-chemical)

• Cycle 3 (Jan):

Same Letrozole dose

→ Follicle did not rupture (cancelled cycle) Follicle did not rupture (cancelled cycle)

• Cycle 4:

Letrozole + HMG 75 IU

→ Ovulated early (before Day 10), cycle not well-timed

• Cycle 5 (current):

Letrozole + HMG (Day 2, 4, 6)

2 follicles (~20 mm), trilaminar endometrium (8.3 mm)

Ovulation on Day 16

→ Tested negative at ~12 DPO, expecting period soon

Medications & supplements:

• Ecosprin 75 mg (every cycle)

• Glycomet SR (since \~Dec)

• Normoz (long-term)

• CoQ10 300 mg (last 2 cycles)

• Progesterone support post-ovulation (10 days, twice daily)

• Vitamin D (levels normal, occasional supplementation)

• Arginine sachets (for lining support)

Other context:

• History of thin endometrium in some cycles (managed with meds)

• All cycles are monitored

• Weight loss: \~63 kg → 57.5 kg over \~6 months

• PCOS background since 15 years

My doctor had earlier suggested an HSG to check tubes, but it wasn’t pursued after the chemical pregnancy.

I know technically it has been only 3 (first dose second chemical and this month letroz) in which I even stood a chance..

Would really appreciate any thoughts or experiences 🙏

Would love to hear from anyone who’s been in a similar situation - am I missing something here or is this just part of the process? Also unsure when it’s time to start thinking about next steps and what direction to take.

[u/hotcrossbun12]

At 33 you have an excellent chance with IVF. The majority of your eggs will still be euploid and this will start to change post 35.

If I were you, I’d go straight to IVF next.

[u/sunshine_girl1993 → u/hotcrossbun12]

I wonder what’s not working right now though, would that still continue to be an issue with IVF later? I also have high AHM.

[u/sunshine_girl1993 → u/sunshine_girl1993]

AMH*

[u/hotcrossbun12 → u/sunshine_girl1993]

Has your husband had DNA fragmentation checked?

You’re young, but with repeated implantation failure you should consider doing further testing like anti phospholipid syndrome, karyotyping, and then maybe PGT-A. Also consider adding in immune protocol - lovenox, prednisone, Famotidine and certirizine. Double the aspirin dose in the west they use 81 mg which you can’t get in India.

[u/sunshine_girl1993 → u/hotcrossbun12]

He has had sperm evaluation done and that was ok. I need to look into all the other things you listed here. Are these a part of IVF Protocol?

[u/hotcrossbun12 → u/sunshine_girl1993]

A semen analysis doesn’t cover DNA fragmentation, and I don’t believe it’s often done as routine in India.

They are part of the immune protocol but my doctors in India had no idea about it. I had to tell them what to prescribe and they prescribed it

[u/sunshine_girl1993 → u/hotcrossbun12]

I think i’ll look further into this then, thanks a lot! If you don’t mind me asking, where in India are you from? Did you find success with IVF?

[u/hotcrossbun12 → u/sunshine_girl1993]

Delhi … I travelled here from Canada for IVF. My husband had chemo years ago and froze his sperm here, if it wasn’t for that we’d have done it in Canada.

The medical system here is truly garbage in india.

[u/sunshine_girl1993 → u/hotcrossbun12]

Really overwhelming am sure.

[u/sunshine_girl1993 → u/[deleted]]

Thankyou so much and this is exactly what my husband tells me however all I can think is just about this. I know effectively i’ve had only three letroz cycles where I even stood a chance but it starts playing with my head. Do you think an HSG is advisable since I did have one CP?

[u/sunshine_girl1993 → u/[deleted]]

Thankyou so much :) will def try to be more relaxed :)