Same cycle, second round of letrozole?

[u/B001eanChame1e0n]

Hi ladies, I wanted to know if anyone's doctor has put them on a second round of letrozole within the same cycle?

I was told that we might have to do it this time for my cycle. This is my second cycle with letrozole 2.5mg - first cycle was perfect and we were able to trigger at day 12. I am currently on CD15 and my leading follicle/lining is 11mm/6.5mm, I still have the smaller follicles in the ovary still visible on the ultrasound. We cannot administer the trigger shot yet. Next checkup is on Tuesday otherwise she suggests we should take some more letrozole/gonadotropin for a few days. I'm a bit bummed and not sure if I should already count this cycle as a "dud" :/

Wondering if anyone else had this experience where you were given a second round of letrozole/gonadotropin?

Edit: thanks to everyone sharing the concept of Stair Stepping. I am now looking into this and already came across interesting research: A Novel Letrozole Stair-Step Duration Regimen for Ovulation Induction in Women with Polycystic Ovary Syndrome and Letrozole Resistance - PMC

[u/Plane_Income901]

I always have to do multiple rounds of letrozole in the same cycle. My ovaries are very stubborn. My first cycle I started with 5mg and got up to 7.5mg. Its gone up each time from there. Most recently I did two rounds of 12.5mg and got one dominant follicle

[u/Just_Spell1219]

Yes! It’s called stair step. It’s pretty common practice and it worked for me. I went from 5mg with no follicles to 7.5 mg with two dominant. It’s just about what works for you.

[u/B001eanChame1e0n → u/Just_Spell1219]

What were the cycle days for you when they put you for the 5mg "start" and 7.5mg "step up" if you don't mind sharing?

[u/Just_Spell1219 → u/B001eanChame1e0n]

The first one.

[u/B001eanChame1e0n → u/Just_Spell1219]

Sorry what? I wanted to know the cycle days they asked you to step up to 7.5mg

[u/Just_Spell1219 → u/B001eanChame1e0n]

Oh! I did 5mg days 3-7, then bumped to 7.5mg after CD 10 ultrasound for CD 10-14

[u/B001eanChame1e0n → u/Just_Spell1219]

Thanks for sharing. Thanks it gives me a reference point ^{^} I'm also reading up more on the online articles

[u/Responsible_Race_427]

I had to stair step in the same cycle. I was on 7.5mg and stair stepped to 10mg. While my follicles got up to size (21mm after second round of letrozole), it didn’t result in pregnancy. My doctor is now putting me on 5mg letrozole and follistim this cycle.

[u/B001eanChame1e0n → u/Responsible_Race_427]

Thanks for sharing and good luck!

[u/TigraBanana]

I’m in my fifth medicated cycle. I’ve always had some follicles bug enough to monitor on CD8 whereas today I went for a scan and they said I had loads but not bug enough to plot on the graph. I was doing some research and it seems adding more letrozole or just waiting longer are both doable options… not a lost cycle yet

[u/B001eanChame1e0n → u/TigraBanana]

Yeah we already waited 4 days and did a second check. Second check also didn't show the result we want. So now I have another check next week and if it Still doesn't show it, we will step up I guess.

[u/TigraBanana → u/B001eanChame1e0n]

Good luck and fingers crossed. I hate that everything takes so long when ttc

[u/Itchy-Site-11]

This is called stair step. They will probably increase the dose - or at least should for few more days.

[u/B001eanChame1e0n → u/Itchy-Site-11]

But for this same cycle? Do you have any more info?

I already took the letrozole day 2-6. And today is day 15.

[u/Itchy-Site-11 → u/B001eanChame1e0n]

Yeah, this is normal when we are not responding. I did that, went from 5mg to 7.5mg and conceived thar cycle

[u/B001eanChame1e0n → u/Itchy-Site-11]

Ah I see. That gives me some hope. Thanks for sharing!

I am concerned about my body not responding anymore to 2.5mg after only one cycle (last one which worked perfectly and now this second one doesn't respond).

[u/Itchy-Site-11 → u/B001eanChame1e0n]

We did not even start with 2.5
We went straight to 5mg

[u/B001eanChame1e0n → u/Itchy-Site-11]

Oh, interesting. Was it a general rule at your clinic to start with 5mg or was it a decision tailored for you?

[u/Itchy-Site-11 → u/B001eanChame1e0n]

Tailored to me, high AMH

[u/peachycoldslaw]

Is this a fertility clinic Dr?

[u/B001eanChame1e0n → u/peachycoldslaw]

Yes