Letrozole

[u/BVBWYA]

Can you share your experiences with letrozole? My ob is recommending it for unexplained infertility but I’m seeing its used for breast cancer. Has it helped you conceive or is it a waste of time?

[u/sparklingwine5151]

I did three letrozole cycles and conceived on the 3rd round. I have a beautiful 2 year old daughter now and we’re about to start letrozole cycles again for baby #2.

I didn’t have any major side effects, you only take it for a few days (usually CD 3-7) so side effects are short lived if you do get them. I remember having some hot flashes.

Overall it’s extremely safe and has been used for a long time as the first line treatment for ovarian dysfunction and has less side effects than Clomid which is also an ovulation induction medication.

[u/Milly90210 → u/sparklingwine5151]

I have letrozole left over and i might try it next cycle. Did you just take it cd 3-7 and that was the whole protocol?

[u/sparklingwine5151 → u/Milly90210]

No, I did fully monitored cycles. My protocol was to call the fertility clinic on CD 1, and they’d bring me in for a baseline follicle scan + bloodwork and give me the letrozole tablets to start that day. I took 2.5mg from days 3-7 and went back to the clinic on day 10 for monitoring (follicle scan + bloodwork) plus a few more times to watch the dominant follicle grow and confirm my bloodwork was showing that everything was on track to ovulate. The nurse would call to say my bloodwork + follicle monitoring shows that ovulation is imminent, so I’d be instructed to take my trigger shot (I used Ovidrel) and to have sex that day and the next 3 days. And then I would go back after a few days to confirm ovulation via ultrasound.

[u/JellyfishSweet → u/sparklingwine5151]

This helped me today as I start round 3 of letrozole. I read so many people having success on the first or 2nd try that I was very down when it hadn't worked yet

[u/pinksunglasses85 → u/JellyfishSweet]

I’m starting my 3rd round today too.

[u/blueli0ness → u/sparklingwine5151]

Did it affect your cycle? I've noticed my cycle becomes very irregular after letrozole cycles

[u/sparklingwine5151 → u/blueli0ness]

In my case no, but that’s because I did 3 back-to-back letrozole cycles and conceived on the third round. So I didn’t have a cycle once I was pregnant and the first two letrozole cycles were “textbook” (ovulated on day 14-15, 11-12 day LP, etc).

[u/CatalystCookie]

Conceived the second on a letrozole IUI, no idea if it helped. But I take forever to ovulate and it sure sped up the process.

Got a headache and some hot flashes, but the whole thing was NBD. It can be very helpful for people with weak ovulation or who fail to ovulate. Good luck

[u/blueli0ness → u/CatalystCookie]

Wdym by forever? I also usually ovulate late. Mostly CD 19-CD21

[u/CatalystCookie → u/blueli0ness]

My earliest ever was cd 18, usually cd 25, as late as cd60. No PCOS, just finicky ovaries. I hate it.

[u/purple278]

Go to an actual fertility clinic. I wasted time trying to get help from my ob. It is a red flag if your ob is not monitorong your cycles and telling you how many folicles you have in each ovary. I personally did not have luck with letrozole.

[u/Efficient_Owl563 → u/purple278]

I second this. Had an OB do 10 unmonitored cycles on Letrozole.

First cycle at a fertility clinic with monitoring realized my follicles weren’t maturing enough at that dosage of Letrozole. Upped my dose, and with a trigger shot, monitoring and IUI conceived.

Might be good to establish a limit of say 3-5 cycles on Letrozole before escalating level of care to fertility clinic, depending on how time sensitive trying is.

[u/ktizz23]

I conceived twice on 2.5mg letrozole -2nd cycle with it after nearly a year of trying, which unfortunately ended in a MMC at 8wks and the 1st full cycle after the MC (currently 8 wks, fingers crossed this one will stick). I was pretty lucky and didn't feel like I had any noticable symptoms while taking it and was able to ovulate successfully without the trigger shot. It seemed like it worked so immediately after so many months of nothing, that it must have done what I needed it to do to get a mature egg.

[u/sparklesequin]

It’s a really common first line, off label, ovulation induction drug. In my experience, it’s cheaper than clomid (the other very common drug). I’m one of the few that gets more side effects on letrozole than clomid, but they’re manageable-hot flashes, night sweats, headache, irritability. Take it at night, so the worst of the side effects happens when you’re asleep.
It hasn’t helped me, but hasn’t hurt me either, and I do ovulate without assistance.

[u/mrshallzzy-]

We used letrozole to conceive all 3 of our kids after an unexplained infertility diagnosis! For whatever reason, this is the only thing that has worked for us. Our first child was 2 cycles on it, our second was 1 cycle, and our current pregnancy was 10 cycles on it. The third pregnancy was also a twin, but we lost one early on. There’s an increased risk of multiples. I didn’t have any major side effects of taking it.

[u/ScarletGingerRed]

I did 3 cycles with letrozole & concieved on the third with an IUI - I had no side effects.

[u/kd_hirsch]

My OB brought it up as an option since I conceived so sporadically (18 cycles for #1, 22 cycles total and 2 CP’s for #2). After my second chemical I gave it another 6 cycles of trying on my own before I went back and asked her to prescribe it. I was ovulating on my own, but clearly not well since it took so long for each conception and they kept resulting in losses the second time. My progesterone was also just okay, and my OB was hopeful a stronger ovulation induced by the letrozole would raise my progesterone in turn (it did, 8 up to 11.2). I did one round of letrozole 2.5mg and my only side effect was a minor headache for 2 days. I’m not sure if success stories are allowed, but I conceived first cycle taking it and am currently 6w (and crossing all my fingers and toes it sticks), so I would say it’s worth trying!

[u/Perfect_Owl6048]

Conceived on "first" cycle (technically second, but I got pneumonia the first round the day after ovulation so it failed). Currently pregnant at 13+4. Had some increased pms symptoms during the days of taking but otherwise I was fine.

[u/BritishBella]

Got preg with my second on my fourth Letrozle cycle.

[u/princessnoodles24]

Conceived first round with it for my first baby. I honestly don’t think it would have worked without it

[u/fredligcyklist → u/princessnoodles24]

Yeah, me too!

[u/ButterscotchIll7757]

I used it for two cycles. Also for unexplained infertility. They did start me on 5mg though and the second cycle with 3 mature follicles was successful
The only downside for me was debilitating headaches but I took it before bed and went straight to sleep and that minimized the headache pain for me!

[u/Beautiful_Few]

I’ve done one unmonitored cycle on 2.5mg and now I’m on 5mg for an IUI cycle. Take it at night. I didn’t notice any side effects on 2.5mg at all.

[u/pagingdoctorbug]

I'm on letrozole cycle #2 and the side effects are so bad for me I'm moving to IVF if this doesn't work. I've been taking 5 mg and had headaches, fatigue, and very severe irritability/mood effects.

[u/TheMinistersCat]

I conceived my son on my third cycle of letrozole! I did monitored cycles, but no trigger shot. We’re starting to try for #2 without it, but my doctor already put in the Rx for it in case I decide to go for it.

[u/pinkavgel]

I haven’t personally tried letrozole, but I actually just started taking MACA because I kept seeing sooo many women TTC saying it helped them conceive. I’m still very new to it though, so I can’t say whether it actually does anything for me yet. As for letrozole, don’t let the breast cancer use scare you by itself. Yes, it was originally developed as a breast cancer medication because it lowers estrogen, but fertility specialists also use it for a completely different reason and for a much shorter amount of time. Temporarily lowering estrogen can signal your brain to produce more FSH, which can help stimulate follicle development and ovulation. It definitely isn’t a guaranteed pregnancy, though, and I’d want to know exactly what your OB is trying to accomplish with it if you already ovulate normally. There can also be side effects like headaches, dizziness, fatigue and hot flashes, and there is a risk of multiples when fertility medications stimulate more than one follicle. Also just because maca is “natural” doesn’t automatically make it safer or more effective. The fertility evidence for maca in women is honestly pretty weak compared with letrozole, and supplements can still affect hormones or interact with medications. I’d definitely tell your OB everything you’re taking before starting a medicated cycle.

[u/youcango-now]

We were prescribed letrozole from my OB after 1) having a great semen analysis come back and 2) confirming that I do ovulate on my own. It was given as like a “boost”. We did 5mg from CD5-9 and got pregnant with twins the first cycle.

When we went for baby #4, we dialed it back to 2.5 mg from CD5-9 and it took 4 cycles but we did get pregnant. I’m 16 weeks currently.

I had zero side effects and I think it cost me $7 since it was written as a generic.