Letrozole, did it work for you? If not, what did?

[thislittlebird]

I woke up to test today and had a BFN yet again to mark two years of trying. This was our second failed Letrozole cycle.

If Letrozole worked for you, how many cycles did it take? If it didn’t, what did work for you? Did you have any other fertility problems you were aware of?

I need to decide whether to keep going with it or just stop handing over £770 per month for monitoring etc and try ‘naturally’ (which may be pointless anyway) until IVF.

Morning @thislittlebird. Letrozole did work for me after 18 months of trying (I’m now 17 weeks pregnant). I had secondary infertility due to a short luteal phase and low progesterone. I took Letrozole to strengthen ovulation and then progesterone.
I actually tried clomid first which worked first time but I miscarried. Letrozole took 6 cycles (!!). I would say that I was going through a private clinic and after 2 months they just left me to it so I didn’t pay for scans just did opks and paid for a prescription. We also didn’t have male factors - it was always my issues!
Good luck!

@Kitte321 thanks! glad it worked for you! I also have low progesterone and I’m on cyclogest, normal LP, and I had my progesterone tested this month and it was 108 so really does work, it’s disappointing we got that BFN.

Oh god I wish my clinic would do that but I doubt it. We also have male factor, so it’s a long shot. I think I might try one more time and then take December off as we’ll be moving to IVF in January.

Letrozole worked for me on the third cycle. My issues were due to PCOS (so i was also taking metformin). First cycle - no ovulation, second cycle - upped the dose and i ovulated but not successful at conceiving, third cycle - kept dose the same and was successful. My treatment was on the NHS and after the second cycle, i wasn't scanned for the third cycle - just allowed to get on with it at home. I was told if the third cycle didn't work, i would have to go back for monitoring for cycles 4-6.

Thanks @GuidingSpirit. I may or may not have PCO/S, it’s unclear but I do have a good number of follicles and higher AMH so it’s possible.

Ours is private so I don’t think they’ll let us just get on with it because they’ll be losing money, which is very annoying. I think we might give it one more to, a third cycle.

Hi @thislittlebird. I got pregnant on the first monitoring cycle (private clinic) with Letrozole but ended in miss miscarriage Aug 2021. Private consultant decided doing another monitoring cycle would not be beneficial and now we are on IVF treatment process. Currently, took the first set of injections yesterday.

@EveryMumDay Did they give any reason why they though it didn’t work or wouldn’t work? Fingers crossed the ivf works for you.

@thislittlebird they said it could work and it did but as both my husband and I had fertility issues (me low amh and husband 70% good sperm) the chance it could work was 50/50. So, when I fell pregnant I was shocked but week 5 I had the miss miscarriage. I'm sorry to hear the monitoring cycle with Letrozole is not fully working. Did they say they what was not working in the morning cycle? I hope all goes well for you, it is exhausting but hang in there. Lots of hugs x

Sorry, I should have mentioned what medication I took for the first monitoring cycle:
Letrozole 5mg/OD 5 day course of taking 2 tablets each day.
Ovitrelle injection 250mg 0.5ml.
One cyclogest pessary 400mg tablet evening before bed.

@EveryMumDay thanks. Sounds a little like us. He has motility issues but I have high AMH/PCO(S). No, they seem to think it’s working as it should for me, I got high progesterone tests for the first time ever with my two follicles, I personally suspect it’s my husband’s sperm that’s the issue and they just aren’t getting there, and we’re really, really hoping ICSI will do the trick. You’re right, it’s very exhausting. Definitely doing my best to hang in there!

@EveryMumDay that’s the same meds as me!

@thislittlebird, is your husband seeing a male fertility specialist too? If not, I would highly recommend Jonathan Ramsey. He's very thorough in his work and provides very useful information and guidance too.

Below is the link:
jonathanramsay.co.uk/

Will you be doing icsi only or jointly icsi and imsi? We are going for icsi and imsi. Mine is the same issue that my eggs were ready after the trigger injection but one of the abnormal sperm reached it first. Hence, we took the route of not doing a second monitoring cycle and go straight with IVF icsi imsi.

I hope your partner is ok, it's not easy for anyone the woman or man but there are specialists out there who can lend help. On some level, having the consultants take some of the stress/pressure off us, as we know they are keeping a close watch on our progress.

If you're thinking of stopping your monitoring cycle and going for IVF icsi then take a little break before starting it. It takes a month and half for the while treatment, which can take a toll on health mentally and physically. After I miss miscarriage ended, I waited for my period to return then I started the IVF treatment, which helped give me that breathing time to grieve and get my mind back to normal space. Not sure, if that makes sense but for me I needed a breather.

@EveryMumDay yes, we’ve seen Mr Ramsay a few months ago now! He basically said there’s nothing much wrong he could identify, couldn’t really explain the poor motility, but he said his fragmentation was imperfect but good enough to move to ICSI after we did all the tests. That was July, I think. How did it go with your DH and JR? We planned to start ivf in September with them and then we heard we had received nhs funding and decided to wait for it because it’s was going to be three more months. Turns out that three months is more like five because of Christmas so that’s why we tried a few rounds of Letrozole, since we don’t know if I’ve ever ovulated properly really. We’re probably going to try one more round of Letrozole and then have December off, hoping to start ivf in January.

Interested that you’re doing ICSI + imsi because our private clinic suggested that to us but we’ll be doing our nhs round first where it’s just ICSI.

We are finding Dr Ramsey ok for now. The only down side is that it takes long to get an appointment with him. However, he did provide guidance and said he will monitor my husband before the egg collection.

That's brilliant NHS has given you a round of IVF. Aawww yes having December off will be nice for you before entering IVF. You'll be able to relax and unwind over Christmas break.

Yes, we decided we will go for icsi and imsi, as it's a few hundred pounds more and I don't want to lose out any try especially if my amh is low. My consultant said either go with IVF icsi or IVF icsi and imsi, so we thought very hard about imsi, i.e, any risks to me and/or baby, etc.

Hope all goes well with the next round of monitoring cycle and everything goes to plan for you :)

@EveryMumDay oh god, it took us from late may to mid July or something to get our results appointment. It’s SO slow. At least he’ll monitor your husband, that’s something.

Were you guys entitled to nhs help? We nearly didn’t qualify, a gynaecologist sent us packing saying low motility wasn’t enough of a problem, and the private doctors wrote letters for us which helped us get the funded round.

We’re going to have lots of stuff on over November to January too, my husband’s 40th on November, then Christmas, then i’m arranging a trip to Scotland for early January so I’m hoping there will be lots to distract me from ticking biological clock.

Can I ask who you private clinic is? I’m wondering if it’s the same as mine.

Thanks! It would be great if it worked third time but I don’t think we’ll be that lucky lol

Yes, long wait for appointments. But what we've done is told our consultant of when my husband can get the appointment with Dr Ramsey as it can be too late so she works with him to get the information. This is to ensure all information is lined up and consistent.

NHS will not help us, as I've already have a child and a miss miscarriage last year. This year miss miscarriage they don't not know about it yet. All NHS would provide us is being on clomid for 6 months and I don't feel I'll get anywhere with it. Plus, I've researched about clomid and don't like what I've read of baby could face abnormalities.

I'm at Beaconsfield clinic with Dr Lynne Chapman. She's amazing and very thorough. Without her and her team, I wouldn't be able to get this far. Who are you with?

Keep positive and you'll soon get your baby news. I know it feels like a lifetime these next few months but when things start moving it will fly by. You're doing amazing to have come this far.....hats off to you. All I would say is enjoy the happy celebrations of your husband's 40th birthday, Christmas break and Scotland holiday.....happy hormones :) Easier said then done but definitely you have some nice occasion's lined up that definitely helps mind distraction.