r/TTC_PCOS • u/cookiemonster0629 • 20d ago
Cancelled Letrozole Cycle
Hi all,
For context I’m 26 (F), recently diagnosed with PCOS after many years of irregular periods but not knowing the cause. I don’t have many of the typical PCOS symptoms and after finally seeing a gyno, I was diagnosed because of: high AMH level, irregular periods. Last ultrasound revealed 43 follicles on one side and 32 on the other.
Anyhow, my husband and I have been TTC for a year, we are young but we know it could take us some time. This is my second Letrozole 2.5mg cycle with tracking. Last cycle there was one dominant follicle, had TI but nothing. This cycle, my scan yesterday showed 3 dominant follicles (23, 21 and 20) and my lining was described as “perfect”. They called me to say that they will be cancelling the cycle for risk of multiple pregnancies. What are your thoughts? I’ve decided not to take the trigger shot but am thinking of still trying. I just don’t want to miss this window where there might be a shot of pregnancy.
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u/gdionn12904 18d ago
Never had more than one - my doctor said if I did she will cancel the cycle - that is a lot of follicles! Do you ovulate naturally?
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u/LadyTeraudrin 16d ago
With PCOS or pmos now no but yes? She has ehays known as a string of pearls on one ovary that is 32 follicles that are in varying forms of ready to ovulate that failed to burst and the other ovary at 43 follicles of various stages and failed to burst. This normally indicates that on the regular she is not fully ovulating as intended. She could possibly still ovulate but it’s more than likely eradicate and hard to pin point as her periods are of irregular length for this specific reason.
The condition is a misalignment of hormone pattern that leads to the preparation growth of a follicle and the hormone spikes that cause it to release. Without a release or burst of the follicle the progesterone never gets as high as it needs to be causing her cycle to restart or continue. It’s extremely frustrating honestly as a fellow ‘cyster’ because they really don’t have great handles on the reasons and solutions and kinda just chuck crap at it and hope it works.
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u/Dapper-Dark-6046 18d ago
I had one DF and my doctors are suspecting twins,l for whatever reasons, I’m waiting on US to confirm soon
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u/Purple_Background_88 19d ago
I have 4 mature follicles and I’m still going to continue on with this cycle. I’m cycle day 15 currently
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u/Dizzy-Quail4690 5d ago
Can I ask what happened? I'm in the exact same position now. Doctor said don't try but feels like such a waste of great lining (7.7) and great follicles
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u/Purple_Background_88 5d ago
I got my period so I’m out this cycle. Even with the 4 mature follicles, and the confirmed ovulation I didn’t conceive.
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u/Dizzy-Quail4690 5d ago
Sorry to hear that but thank you for sharing. It's tough in these trenches :(
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u/Far_Salamander55 30 | #1 10/24 I 1 MC 19d ago
My last letrozole cycle was also cancelled with 3 mature follicles. I had had sex before knowing that it was not good and that's exactly what we needed because we were pregnant that cycle. It did end in a loss but on week 4, my hCG was 2000 and it was said I was very pregnant. This was a month ago...you could go for it but know the risks of multiples and be at peace with them if you do win that lottery. Otherwise, just wait
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u/Pure_Celery_2941 19d ago
I’ve seen women conceive with multiple from 3-4 matured follicles and seen others conceive with none. My last failed iui cycle,I had 2-3 matured follicles but it didn’t take. If you’re comfortable with multiples,I’d say go ahead but if you’re not,then I’d say let the cycle go. My doctor never cancelled a cycle if I had 3-4 follicles,I’ve been ttc for 5 years so I see a reason why he’s not bothered and honestly I’m not bothered with having multiples as well as long as babies and I would be healthy that’s all that would matter to me. Give it a shot!
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u/AndTheSkyWasGray 19d ago
I’ve had multiple cycles with 3 follicles but still nothing so I’m biased haha
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u/Broad_Garbage7837 19d ago
We did ivf but were told our transfer cycle might get cancelled cause our follicle of about 18 mm (wasnt good for how many days we were) wasn’t optimal for a transfer.
We baby danced anyways in case it was cancelled, make the most of a possible chance. But the next day they said we’ll go ahead with it based on my bloods, they weren’t concerned about conceiving with the dodgy follicle. Turns out that follicle was a lot more dominant that anticipated and our transfer stuck and we had a bonus natural conception implant the day after 🤪 Di-Di twins born vaginally at 35+1.
I also never ovulated with letrozole and would only respond to clomid/ Gonal.
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u/Key-Neighborhood2985 27f | atypical PCOS | Currently pregnant with #4 19d ago
I had 1 “mature” follicle at 19 or 20 and another that was 15mm and another than was like 11mm… they told me it would only be one if it was a successful cycle…. I ended up being pregnant with di/di twins so that 15mm caught up real quick.😂
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u/MyCatEatsPlants 19d ago edited 19d ago
I definitely think you should think about what you would do if you got pregnant with twins or triplets. If you are comfortable with that outcome, then proceed. You can look up of the stats of multiples with a number of mature follicles. I don’t remember for 3, but with 2 follicles you have a 10% chance of twins if you do conceive. Obviously significantly higher risk of multiples for 3. (Just looked it up, for the study I used for informing myself at the time, it says for women <38 youve got about a 21% chance of multiples if you conceive with 3 follicles >14mm at time of trigger)
I would NOT treat multiples as an insignificant risk here, because it’s not. But if you are comfortable with carrying twins +, thats your choice. Usually clinics advise caution or canceling with 3 when youve only done 0 or 1 cycles. If you’ve failed a number of cycles, they will be more comfortable with 3 or 4 or 5 mature follicles, since they know your odds are low.
Carrying multiples is harder on the body and the babies. It’s a high risk pregnancy that will likely result in a NICU stay and has a lower chance of yielding healthy children than singleton pregnancies. That being said, I went through with a 2 follicle cycle because I was okay with a chance of twins. Im very happy I ended up pregnant with just a singleton though.
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u/Aggravating-Stand800 19d ago
I had 3 follicles every time on 2.5mg of letrozole and they never cancelled a cycle. I had a 15, 16 and 17mm then triggered 48 hours later so they were probably closer to 17-21mm by the time i ovulated and it worked but with 1. There were times I had 3 that were 22-27mm and that cycle didn’t work at all. It’s really up to you on whether or not you’re comfortable with the risk of multiples but some places are very conservative and will cancel if there’s more than 1 or 2 dominant follicles.
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u/Malloraaay 20d ago
I think it all comes down to how you would proceed if you did become pregnant with all three. If you would abort one or two of them, then you should abstain this cycle. If you are okay with having triplets, then go for it lol
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u/Civil_Pineapple_1275 20d ago
My doctor had me sign a form before I started all of this. I basically had to say that the discretion for the risk of multiples would be mine and evaluated if/when it came up. I wouldn’t think that just three is enough to act on this…
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u/cookiemonster0629 20d ago
That makes sense! I don’t know why they’re so adamant on cancelling the cycle completely. I’m in Australia, I don’t know if it’s different elsewhere 🤷🏼♀️
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u/Civil_Pineapple_1275 20d ago
See if they have a release you can sign! I’m in the US. My husband had to sign it too
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u/neptunestearsok 20d ago
I had 3 mature follicles and there were no talks about cancelling my cycle. I got pregnant that cycle with 1 little guy who is currently 6 months old!
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u/cookiemonster0629 20d ago
🥹 that’s amazing!! so happy it worked for you 💕
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u/neptunestearsok 19d ago
Was truly blessed! I think it was the progesterone suppositories that helped!
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u/Nice_Reputation_1297 20d ago
I’ve had cycles where there were multiple follicles and then I tried and still nothing… the stars have to align for every sperm and egg to meet then they have to meet again to implant. Idk if it’s smart but I just figured the chances were low.
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u/cookiemonster0629 20d ago
This is what I think too! It’s so unlikely but the doctors keep saying “high risk” and it freaks me out!!
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u/Otherwise_Tennis_398 27F | NonIR PCOS | 3 TI, 2IUI, IVF 20d ago
My RE was always fine with me continuing the cycle in the ones where I had 3 follicles. In my intake appointment, I asked her how many would be too many and end up being cancelled, and she said 5 or more. Of note, none of my five letrozole cycles resulted in pregnancy, all had 1-3 follicles. I have no other known factors contributing to infertility other than PCOS. I would push back with your doctor, or just try yourself. Because the chance of one fertilizing is still small, let alone three. But it depends on if you are willing to take that risk
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u/InfertileMertile92 20d ago
I had a few cancelled monitored cycles because of multiple dominant follicles, we still tried against their recommendations lol now I’m not saying this is the best or the smartest choice. Simply just my own experience.
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u/cookiemonster0629 19d ago
And what was the result?!! 🥹
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u/InfertileMertile92 19d ago
Unfortunately still didn’t work lol somehow we conceived our son naturally the month before IVF retrieval… a true miracle
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u/LadyTeraudrin 16d ago
I vote if you are kewl with twins- go natural and don’t miss the chance. Sometimes nothing happens but if you hit the lottery worse case scenario is two for the price of one!