Letrozole for unexplained infertility, already ovulate?

[wtbpg]

TTC for 8 cycles, confirmed that I do ovulate, DH's sperm is normal although his DNA fragmentation is ever so slightly on the high side. So basically it's unexplained infertility.

My dr prescribed me 2.5mg letrozole but I'm unsure how that would help if I already ovulate? Anyone taken it who already ovulated and it helped?

I conceived my little girl in Oct 2019 with 2.5mg of Letrozole .. I was told I had pcos but not severe. Husbands sperm was also fine. Just was trying for 9 years and nothing. Periods all over the place and some months felt ovulation etc
I took Letrozole 2.5mg and had a monitored cycle and my body reacted like it would do for a normal 26/28 day cycle..
had a day 10 scan and then had a scan a week later to confirm ovulation and like I say lucky enough to fall pregnant - lots of baby dust! Sorry that’s not much use but my experience of using Letrozole

@loubi90 aw congratulations!! Love a success story.

My periods are very regular, no PCOS, all blood tests, hormone levels etc have come back fine every time I've tested. That's why I'm just curious if it can help and how!

Not sure if it will help with the frowing of the follicle?
silly question but hve you asked why they have chosen Letrozole?

@loubi90 sounds really silly but... no I didn't. I kind of assumed to "help me ovulate". Feel a bit like an idiot for not asking though so I'm asking here

I’m 5 weeks pregnant after a monitored cycle using letrozole. They use it because you have a lower chance of multiples than clomid.

I ovulated several days earlier with letrozole and my understanding is that it helps mature the egg.

Don’t feel silly - you are kind of given all this information and then everything comes to you after you have led the appointment

@loubi90 thank you ❤️

@Isitisit ah that kind of makes sense. So it's improving egg quality if jts helping to mature it? Or what would be different vs a situation where I didnt take letrozole?

I tried it for a few cycles. It did nothing for me.

It’s increasing the chance of fertilisation if it’s mature. Egg quality takes longer than one cycle to change. If you haven’t already then I’d really recommend you read ‘It starts with the Egg’.

I was given Letrozole after many miscarriages. I was already ovulating but they gave it to me to increase the number of eggs I was producing. So I’d produce two per cycle essentially doubling my chance of pregnancy per cycle. This was because egg quality was an issue with me and we were literally waiting for a good one.

What is your husband doing to improve his DNA fragmentation?

@Pollywoddles thank you for the super thorough explanation!

He's doing... literally everything! Healthy, plenty of nuts, fruit and veg, has pretty much stopped drinking, given up cycling, we ditched plastic tupperware...

What tests did you do to determine your egg quality was poor?

@wtbpg There are no tests for egg quality per se but I’d had some of my losses tested and one embryo from IVF and they came back as trisomies. That and my age meant that egg quality was most likely our issue.

The consultant tested my testosterone which was too high. That can also lead to poor eggs so I was given medication to bring it down. I was put on CoQ10 (600mg a day) high dose Vitamin D and C and methyl folate rather than folic acid. I also quit all plastic in the kitchen and removed as many parabens and phthalates from my personal care items as I could. Who knows of any of it helped or it was just statistics but either way I eventually managed to have a baby and she’s perfect.

@Pollywoddles aw congratulations - must be such a relief to have your baby in your arms after trying for so long ❤️

With us it's as unexplained as it gets: I'm 27 so relatively young, fit, healthy, we have a 2 year old conceived in the first month of trying, had a hycosy and the tubes are clear. My husband is similar age as me, also fit and healthy, he has lots of sperm (very high count) so as a % of the sperm the "damaged" (ie DNA fragmentation) may be slightly above the threshold but the number more than make up for it. Motility, morphology both fine. Such a mystery

@Pollywoddles when you say 'parabens and phthalates from my personal care items as I could' what did you remove?

@wtbpg Ah so it’s secondary infertility? That’s frustrating but given your age your egg quality is probably not the issue. In your case I’d go back and have a discussion with your doctor about what exactly the course of action they have taken is. If there’s one thing I’ve learned from my experience is that you can’t blindly trust healthcare professionals in this area, you need to understand what’s going on and don’t be afraid to question them as most of them are just trying stuff that has worked for others with no real understanding of why.

Just to answer your question about the parabens etc. I just swopped all my toiletries to ones that were free from and stopped wearing nail varnish, perfume etc. You could go crazy doing this and you’ll never completely get away from them but I just made changes where I could.

I really hope it happens for you soon 🤞🏻

@Pollywoddles thank you! ❤️
Yes I'm planning to go back but the issue is... this doc is private so each consultation is like £250 so I'm trying to not go more than once every couple of months and save any questions up. So far everything she says is along the lines of "this might help" "it'll help you ovulate" but really doesn't give in depth opinions. Maybe I need a new doc...

Interesting about the parabens, thank you. I actually do always have my nails done so that's probably one of the first things to stop... and perfume too!

@wtbpg I remember my first consultant was utterly useless. I got a recommendation for the second one and she was infinitely better and there was a clear plan of action and I could always email her with updates and questions between appointments.

I’m not in the UK unfortunately but perhaps some other Mumsnetters can help if you do decide you want a second opinion.

@Pollywoddles yeah from what I've read sometimes it's a bit of shopping around with consultants.

I just wondered did you do CD2-6 or CD3-7 with Letrozole if you remember? Different people seem to be prescribed it for different days, I wonder what the difference is

I did days 2-6 but I’ve no idea the difference between that and 3-7 I’m afraid.

I was monitored during every cycle with Letrozole, I’d have a scan between days 10-12 and that would tell me when to trigger. Then we dtd 12, 24 and 36 hours after the trigger.

@Pollywoddles oh cool, I'm not getting any trigger. Just taking them and then... hopefully ovulating on my own? Took my first one this morning so fingers crossed!

@wtbpg I’m on the same boat, wondering how you got on? Im starting letrozole next cyle plus cyclogest after ovulation. Will also have monitored cycles. I’m with Lister Clinic. Xx

@Pep1952 how did your letrozole journey turn out? And what does the cyclogest do?

I'm on my second cycle of letrozole and hoping for success stories :)

@JJB92 we tried for 3 cycles but unfortunately it didn’t work for us. It did work for so many others though particularly those with PCOS but just not for us. Our consultant suggested that usually you can try it for 6 cycles but we don’t want to wait any more and decided it is time for us to go down the IVF route which we can hopefully commence this month. Good luck!

@JJB92 cyclogest is progesterone to help the embryo (if there is one) stick I think! Other clinics will check your progesterone level a week after ovulation to see if you need it. Our one just put me on it anyway twice a day until I take the preg test.

@Pep1952 thank you for replying. I'm so sorry to hear that it didn't work! All the best with the IVF. I know that's a very rough journey, but hoping it will pay off for you 🌻