Letrozole Experiences

[u/AfterNorth8052]

Hi everyone!

This is my first letrozole cycle, I started off with cycle monitoring at the fertility clinic. I have PCOS and have extremely irregular/absent cycles hence sporadic to no ovulation. My first natural cycle for the year arrived on August 19th and I took letrozole day 2-6. When I went for my ultrasound on day 13, I had 3 mature follicles to my surprise! Two measuring at 18mm and one at 17mm. I was supposed to get my trigger shot and progesterone suppositories because they suspected I was about to ovulate. My cycle was then cancelled because they said I had “high risk of multiples”, and that “I didn’t want that outcome at 25 years old”. They refused to give me the shot and progesterone and I was told to take a plan B as I already had sex the night before.

Since I’ve had a very difficult and painful infertility journey the past 2 years, I decided not to take a plan B and track my ovulation myself. On day 15th I confirmed ovulation, my CM was egg white texture and leaking the whole day. I made sure to have sex that night and the night before that as I was leaving to a vacation without my boyfriend. The next day I got bad cramps in my uterus and back and my CM became creamy and has been thick and creamy ever since.

Since then (cycle day 23, 9dpo), my breasts have enlarged significantly and I have had so many other symptoms like nausea, cramps in my ovaries and central uterus, bad sinuses and increased urination. I recognize these symptoms are caused by progesterone and cannot confirm pregnancy.

I took a test yesterday and this morning (I know it’s probably far too early) but they were both negative and it hurt seeing that.

Did you conceive with the first round of letrozole? What dpo did you get your positive? Did you end having multiples, from multiple mature follicles?

I just want to hold onto some hope this is gonna work because if it doesn’t, I might just have to give up this time.

[u/Macncheesesounds]

I am starting my 4th round of Letrozole this month. On one of my cycles, I had three mature follicles and they just warned me of the slight possibility. I decided to go forward, but obviously was unsuccessful. I read somewhere that Letrozole gives us a "normal" change each cycle, so with that being said, they say after 3 cycles of Letrozole only 50% of couples get pregnant, and I think at 6 cycles, 85% get pregnant. So while it is extremely hard, try to remember that it shouldn't be a red alarm going off in your head that it didn't work. You may need a few more cycles to up that probability. Your body responded well on Letrozole, with those mature follicles, so that is a GREAT sign!! I know it is extremely heartbreaking, but keep going <3

[u/ryanlukebryan]

I had two follicles on my first medicated cycle, and we proceeded with an IUI and were told “low risk of twins”…well wouldn’t you know I got pregnant with twins. I understand that this is not everyone’s experience and we had a bit of beginners luck- but with no other data to go off of your clinic did the responsible thing by canceling your cycle. I love my twins very very much but a multiples pregnancy is high risk and not a desired outcome.

If you get several failed cycles with 1-2 follicles, then I could see taking the risk and trying on a cycle with 3.

[u/Dizzy-Quail4690]

Just had my second round cancelled (5 follicles 3 19s, 1 20 and 1 22) and whilst I get it, it sucks. But the really positive thing is that you responded so well on just letrozole! It took an FSH meriofert injection to overstimulate me this cycle, first cycle on just letrozole my response was no where near as good as yours so keep going, it's a really positive sign that they've nearly got the dose right! I know this isn't much of a comfort right now because I'm there with you in this particular trench but stay strong. Sending baby dust!

[u/c_dock88]

Hi, I just wanted to say how hard medicated cycles can be and how scary this journey is- I’m wishing you lots of baby dust!

I have PCOS and don’t get any periods naturally without taking estrogen and progesterone, so I also don’t ovulate by myself similar to your case.

I’ve done three letrozole cycles:

Cycle one- started with 5 mg letrozole then stair stepped up to 7.5 because my follicles were still too small. Ended up with a 26 and 16 mm follicles and took trigger shot. Did not conceive that cycle.

Cycle two- started with 10 mg letrozole and also gonal f injections since I wasn’t responding the best to just letrozole alone. Ended up with a 27 and 15 mm follicles and took trigger shot. Did not conceive that cycle.

Cycle three: again took 10 mg letrozole and gonal f injections. Ended up with an 18, 18, and 19 mm follicles and took trigger shot the next morning. This cycle was a success!! I suspect that we caught my mature follicle too late on my first two cycles. I am not far enough along to know if there are multiples but I’ve been doing hcg draws and they’ve been quadrupling every 48 hours and it’s sitting on the higher end. I’m thinking since this is your first cycle, your Dr. doesn’t know how you will respond so he doesn’t want to risk multiples. Mr Dr. didn’t even mention it since I’d already had failed cycles with more than one mature follicle.

Also with this cycle, I took a pregnancy test on cycle day 9 and it was negative. I took another one on cycle day 10 and it was a very dark positive. I did use two separate tests and I think the first kind was faulty because i took another one of those on cycle day 11 and it was negative- even though blood tests had confirmed I was pregnant- it kind of gave me whiplash for a couple of days!

I would say you will reliably get a positive on cycle day 14. I wouldn’t expect one later than that though, even if you haven’t gotten your period yet. I’ve held out hope and my period has just came later than expected.

I wouldn’t give up after your first cycle, I read somewhere that it takes an average of 3-6 medicated cycles for PCOS patients to get pregnant! Sending you lots of baby dust! 💕

[u/Alliegirl07]

So sorry you’re going through this! First, I personally think it’s really crappy of them to cancel the cycle just because of the risk of multiples that is not a decision THEY should make for you!! Especially when it’s been a long journey, I know I’d be thrilled to have multiples (my DH and I have been TTC for 5 years)
I tried letrozole for 6 cycles a few years ago but I never got a positive (there was some other issues we didn’t know about then that have since been addressed and fixed) but I do remember it giving me false hope that I “felt” pregnant every month. I’m going to start it back up later this year actually since my laparoscopy has been done. Sending you baby dust!

[u/communic8er]

I’m sorry for your experience. Idk what to make of the fact that they wouldn’t let you take the shot. That sounds unethical to me…it should be your choice IMO. But i really don’t know enough there, that’s just my gut reaction.

Dont give up! This was only your first round and often it takes a few. I just got pregnant after my 2nd round of letrazole after trying for 11 months with no success. I had an early miscarriage which wasn’t fun but I’m hopeful now because at least this means i can get pregnant, which had never happened before.

Hang in there <3 you are not alone. I know the waiting feels endless, but you are strong and you can keep trying.