TTC with Letrozole/Clomid

[acaciabluebell]

Anyone else here on Letrozole or Clomid for ovulation induction?

I'm on my 2nd cycle of Letrozole and looking for others in a similar situation.

Info about me:
26 y.o
Been TTC for just over 2 years.
Dosage: 5mg of Letrozole on days 3-7.
Diagnoses: Male factor (0% morphology), low AMH, low progesterone

I'm currently on CD10 and using OPKs to track for ovulation. I'll be taking a blood test on 7dpo to check if I ovulated.

@Loz365 Thanks, I didn't think it had worked but there's always a part of you that hopes! I'm going to go straight into cycle 3.

@Hopeislost sorry to hear about AF arriving. Hope it wasn't too upsetting for you.

Has letrozole altered anyones cycle length? I was due AF yesterday and no signs of it. I'm too scared to test. I'm thinking maybe it's giving me the full 14 day luteal phase, whereas I usually have 10/11 day luteal phase? I don't have any PMS/pregnancy symptoms except for sore boobs. I keep getting the odd cramps and I think 'this is it' then they stop after 5 minutes and I still haven't got AF. Just trying not to get my hopes up!

Okay so cycle length not altered... just a BFP 😭😭😭 I cannot believe it!!! First cycle of letrozole! I am bloody terrified this is a cruel lie 😭

@BritInNZ Congratulations!!! That is a nice strong line! How many dpo are you?

@Hopeislost only 12 or 13 I think! Thank you, in total disbelief!

@BritInNZ oh my gosh!!! Yay!!!! Congratulations, that's such a strong line!!
That might explain why your progesterone was so high!

Congratulations @BritInNZ ☺️. All my best wishes to you . Am I right remembering you were an unexplained lack of conceiving, not someone who isn't ovulating?

@TheDaydreamBelievers yep I was unexplained infertility, so definitely wasn't expecting it to work 😊

Wow @BritInNZ super excited for you!! Congratulations! Sending lots of luck and prayers your way xx

Hi everyone 😊 @TheDaydreamBelievers told me about this thread and I'd love to join if okay? I'm at the start of the TWW for my first cycle of letrozole now 🤞

I came off the pill last August after 15 years of contraception and turns out (surprise!) it's been masking PCOS. I had a 45, 44, 64 day then 100+ and counting cycle before my husband and I started to get some private treatment while we wait to be eligible for NHS support. In the meantime I'd been diagnosed with PCOS through the NHS with raised testosterone (2.4, top of rage 1.8) and bilateral polycystic ovaries, each with 20-25+ follicles. I'd taken metformin for 3 months (most of that at 1500mg per day, and I've gone up to 1750mg since) as well as myoinositol 2mg twice daily with no change to my cycle. I've been working on improving my diet and exercise routine but I have a normal BMI (23-24) and a slightly complicated history with food so don't feel able to go too hard and fast, iykwim. We have no family history I know of, my mum always got pregnant in the first cycle she wanted to! DH's tests all came back normal as well, only morphology borderline at bang on 4.

I know we've been really lucky to be able to access letrozole so quickly, I'm so grateful we have the option. Still I flip between having really high hopes and being cynical to protect my feelings, or just feeling sad at not having the "normal" experience.

This cycle I was prescribed 5mg letrozole on days 2-6. I had scans on days 10, 12, 15 and CD18 when I took the trigger shot (this Thursday morning). At that time I had a 22mm follicle and a nearly-there 17mm follicle. Bloody lucky as at the end of CD19 DH was leaving on a 2 week business trip 😱😅 hopefully we got the big day, or close enough. My BBT hasn't jumped yet and I've started cyclogest today so now it will be misleading, but those times I have ovulated I always got a slow rise.

From today I'm on 4mg oestrogen daily to support my lining (on day 101 of my last long cycle it was 4.9mm. This CD18 it was 6.2-6.4mm) and 400mg pessaries of cyclogest twice daily. I can test on 8th July, just before DH gets home 🤞🤞🤞

Would love to hear about your experiences and to support others in the same boat.

@BritInNZ, congratulations on your BFP that is so amazing! What a fabulous good news story and from your first letrozole cycle, gives me hope 💕 truly happy for you x

Hi Ladies I hope you don’t mind me joining the thread. I’ve seen a few of the names around before. :)

we’ve been TTC 15 months now since a miscarriage. Got pregnant easily twice before but doesn’t seem to be happening now. Since last July I’ve been getting 5-7 days of spotting before actual AF arrives. I’ve had tons of blood tests and even paid private for a hyterscopy to check my lining for infections and polyps etc which could be causing the spotting. I never thought it was low progesterone as my BBT temps were always super high post ovulation and my blood tests at 7 dpo always high.

The next step was clomid. I did 50mg days 2-6 last month and got a really slow rise on BBT and my 7/8 prog read was only 21 n mol. I just didn’t have a great chart where it shoots up and stays high like in my natural cycle. Dr said I’ve likely just released one egg and the idea was to try and have a “super ovulation”. Anyway this month I’m on 100mg clomid 2-6. Estrogen 7-11 and then I’ve got progesterone to take 48 hours after ovulation.

i just can’t help but think maybe clomid isn’t doing me any favours because of the slow rise bbt and low prog result.

I charted all last year and was all good numbers but no BFP.

just loosing hope and wondering what to do next month. Maybe just the estrogen and progesterone without the clomid and see how that goes?

Also any views of clomid is unsuccessful for me should I try letrozole before moving to IVF?

@Loz2467 if you already ovulate without drugs, my understanding is letrozole isn't evidence based to help

Hi @Loz2467, nice to meet another thread newbie 😊 I'm afraid I don't know much about treatment options for people who are ovulating naturally, but it definitely sounds like it's worth a conversation with your doctor about what role the clomid is playing for you vs the other hormonal support. Do your 2-5 day bloods provide any extra clues?

I don't think scientifically it's shown to help - but I was put on letrozole as someone who ovulates naturally and fell pregnant the first month, after 17 months of trying.

@AprilMayAnne fingers crossed for your TWW. I’ve had day 3 bloods done twice. Last august was okay LH and FSH however in December my FSH was 11 which is a little high! Well it was only around 6 or less in august so it shot up! My AMH is 8.4 and a follicle count of 21 so I’d be a difficult one with the IVF meds if it comes to that. After getting pregnant naturally twice I just can’t get my head around it. The spotting for a whole week before my period is really getting me down and this progesterone next month is the last thing to try to try and stop the spotting. My BBT was much better on a natural cycle and not the clomid so I’m wondering if it’s not really helping. The drs idea was to give 2 eggs and Higher progesterone and better chances but that didn’t happen. 1 egg released and low progesterone. I’m not sure if a slow rise BBT isn’t a good indication or not. There’s just so much to think about!

thanks @BritInNZ it’s something to try before potentially moving onto IVF and that’s amazing for you!! I know I’ve already said congrats but congrats again :)

@AprilMayAnne I’ve just read your post. I had the clomid without scanning - I’m private so I haven’t paid for the additional scans as I ovulate anyway.

i was intrigued about you taking oestrogen after ovulation as well with the progesterone. I’ve got 400mg cycolgest to take each evening 48 hrs after O to see if it stops the brown spotting I keep getting each month. I’m on oestrogen before O which I believe will help my lining too. Is this correct? Xx

@Loz2467 I'm not sure of the rationale for taking oestrogen before vs after ovulation. I assumed that as the mechanism of action of letrozole and clomid is to block oestrogen receptors, they either didn't think it was worthwhile to put me on oestrogen beforehand or didn't want supplementing it to undermine the effect of the Letrozole. I emphasise that I have not heard that from a doctor! I'll discuss it with my clinician actually, as if it is okay to take oestrogen before ovulation it seems logical that would better optimise my lining, and also maybe CM, as mine never got past creamy this cycle (sorry if TMI!). Would welcome advice from anyone else too!

Also yes, I hope to reduce the number of scans I have in future cycles if it appears that I ovulate reliably on letrozole! I don't think they'd let me have no scans at all on a first cycle in case I showed a tendency for multiple (3+) follicles or OHSS. It's charged as a package with however many scans you need anyway, but there is a reduced price if you only have 1 or 2 scans which is the aim in future. It was too much probing for one week, that's for sure 😂

@AprilMayAnne nothing is TMI when we are talking about this. Haha. Yeah that’s kind of what I thought because I started the estrogen the day after the last clomid which I was hoping would help to build my lining. It’s all so much to think about isn’t it. My first clomid cycle which was last month I ovulated day 15. Had 2 days EWCM and O day was watery. (Sorry) !!! Then this cycle I’m on day 12 and no fertile CM yet. I started my opks late so I got the blank smiley this morning because it was first test this cycle so we will just see. I thought I’d really feel my ovulation last month on clomid but I didn’t but on my natural cycles I get really obvious twinges and the sides change each month. Then I had the slow rise bbt and low prog results so not sure if to take next month off clomid xx

@AprilMayAnne 4 scans in a cycle is mad! I am trying to limit to one scan a cycle as it's such a pain!

Cycle 3 of 2.5mg letrozole days 2-6 for me. CD11 today, scan showed an 18mm follicle but only 5mm thickness so they want to give it a couple more days. If I don't get a smiley face by Friday, I have to give myself the trigger shot!

@Hopeislost im not having scans with my clomid and I’ve just changed to 100mg days 2-6. On my last cycle I had 50mg 2-6 and ovulated on day 15. I’m day 13 today and still got a blank smiley :( literally loosing hope! I’ve had estrogen this cycle too so wondering if it’s affected my CM and ovulation date.

I hope your lining thickens up. This was an issue for me too but without the scans I’ve no idea what it’s doing. Before I move to IVF I might do a couple of medicated cycles with scans just to see

xx

@Loz2467 I never get a smiley face! Last cycle I had a huge follicle and still had to be triggered. Gave myself the shot this morning, it wasn't that bad actually.

Everything crossed for you! @Hopeislost

I got my peak and solid smiley this morning so likely to ovulate today or latest tomorrow.

My progesterone pessaries say 48 hours after ovulation. Would I do the first One tomorrow evening or Sunday evening. Worried to start them too early and also worried to start them too late.

i can feel ovulation twinges today.

Hello ladies, hope everything is going well for you 🤞@Hopeislost yes anything less than 4 in future will be a plus 😅 but it's been good to get an idea of how and when my ovaries and lining respond during this first go. I also had a big 22cm follicle this cycle and had to trigger, no LH surge in sight. Hope those extra days before trigger gave your lining a good head start 😊

I'm 10DPO today (though if I ovulated 36 hours after the trigger that would have been at 9.30-10pm at night... So maybe I'm more like 9.5 days? ). I tested on a cheapie today to see if the trigger shot had left my system and BFN so looks like it has. I know its generally too early to get a BFP and going to wait until Thursday and Friday to test next if no AF by then, and will use FRERs.

Feeling a bit generally discouraged anyway. Boobs are flipping sore now but that's not unusual and no implantation symptoms. Wondering if you do get a gut feeling if you've picked up, or if that's all woo. No cramps yet but also no real idea when to expect AF. In my first 2 cycles off the pill I had a luteal phase of 12 days. My next/last cycle (the only one we were actively TTC for before my periods stopped) it was 16 days, but never got a BFP.

@Loz2467 definitely sounds like it was ovulation station for you on the 1st! Hope its all been going well since then, I've found the pessaries a real nuisance 😅