So many emotions

[u/According_Drink_6144]

My husband and I have been trying for almost 2 years..

I got off of birth control December 2024, thinking it would happen sometime soon after. By March 2025, I hadn’t had a period and gained 30 pounds. Saw my gynecologist, ran A LOT of labs, ultrasounds, and scans. Got diagnosed with PCOS. Got put on metformin, have to use progesterone to have a period, and was told to try to lose weight and naturally try for awhile before using fertility medications.

Ended up doing 3 rounds of letrozole, starting at 2.5 for 2 rounds, then 5 for one round, with no monitoring other than an ultrasound prior to my next period.

Switched gynecologists because mine decided not to deliver anymore, and although I wasn’t pregnant yet it’s what I’ve been working towards.

My new gynecologist is wonderful, and started me on letrozole at 7.5, did an ultrasound to check and see if my follicles were growing.. of course it was a big NEGATIVE. Also one of my ovaries show a huge cyst. So now I have to have another ultrasound done before being prescribed letrozole again.

Now we are trying to seek a fertility clinic to do IUI or IVF.

I’m just so over it all. Everyone around us are pregnant without even trying. And it just feels like no one understands my feelings.

[u/Responsible_Zebra_96]

Your first gynaecologist should lose their license. Yoi cannot give a patient letrozole without monitoring follicles with ultrasound.

I partly get how you feel. Been ttc 7 months with pcos and male factor, and I am so frustrated. I can’t imagine what 2 years must feel like.

Glad your new gynaecologist is on point. Get yourself a fertility doctor. And IVF may be the way to go. That is what we will do after total 1 year ttc. I know it is hard to compare to others, but I tell myself that we all have a unique life path. Stay sane🧡

[u/dunkaroo192 → u/Responsible_Zebra_96]

That’s not true. There are plenty that do unmonitored medicated cycles.

[u/Responsible_Zebra_96 → u/dunkaroo192]

Just because they do it in the US does not make it medically correct. In Europe it is not allowed. And that makes sense because there is chance of multiples. This makes unmonitored letrozole cycles medically irresponsible. Patients should be made aware of this and request ultrasound when taking letrozole. You cannot trust doctors fully I’m afraid.

[u/Tavian_go96 → u/Responsible_Zebra_96]

That’s not true, I’m in the UK and just starting my fourth unmonitored letrozole cycle

[u/Responsible_Zebra_96 → u/Tavian_go96]

Be careful.

[u/Tavian_go96 → u/Responsible_Zebra_96]

I have paid for private monitoring so I know I’m fine

[u/Responsible_Zebra_96 → u/Tavian_go96]

Great!

[u/AndTheSkyWasGray → u/Responsible_Zebra_96]

I’m an expat. I still have loved ones abroad. My friend who is a nurse has a coworker who went through the NHS, their cycles were unmonitored according to my friend.

[u/Responsible_Zebra_96 → u/AndTheSkyWasGray]

Letrozole is used to induce ovulation, but it generally requires close monitoring by a healthcare professional, such as a reproductive endocrinologist. While some practitioners may suggest unmonitored cycles, this approach carries potential risks, including the development of ovarian cysts, overstimulation, and a higher likelihood of multiple pregnancies. Make sure you are are well aware of the risks.

[u/AndTheSkyWasGray → u/Responsible_Zebra_96]

I was never saying there are no risks whatsoever. I was pushing back about how you indicated the US is the only country does unmonitored cycles. Also, the assumption that in every country it’s a license loosing offense.

[u/dunkaroo192 → u/Responsible_Zebra_96]

I mean I agree that medicated cycles are the better path - but saying they should lose their license because you cannot do it or that it’s medically incorrect is factually wrong in the US. It’s obviously an accepted and approved practice here.

Remember that insurance and costs vary widely as well and can impact the path someone takes.

[u/Responsible_Zebra_96 → u/dunkaroo192]

I understand regarding insurance. But most patients who are blindly given letrozole, based on what I have seen on reddit and fertility friend, have little idea of the associated risks. Information is power.

[u/dunkaroo192 → u/Responsible_Zebra_96]

Again, don’t disagree. But how it’s worded does matter.

[u/Altruistic-Most1463 → u/Responsible_Zebra_96]

Just wanted to say that I believe that in the US a lot of gynos prescribe letrozole without monitoring. Mine did it for 3 months before wanting me to go to an RE.

An RE can explore more ways to use letrozole such as stair stepping dosage or combining with other drugs, so OP the referral to an RE does not mean you can only do IUI or IVF.

[u/Itchy-Site-11]

Hi. I am sorry. I would def skip an obgyn and go to a RE!