Letrozole and higher BMI

[Journey2022]

Hoping for some advice or success stories with letrozole with a higher bmi (of 33+ BMI).

NHS had told me to get my BMI down to 35 or under to take letrozole. Has anyone had success being just over this BMI or around this BMI?

I had two failed clomid cycles a year ago and the last 8 months I've really made an effort to be more active and healthy, and lose some weight to be allowed further fertility treatment.

Hi I am in the same boat as you. High bmi 35, been giving letrozole to start next month. Have you been prescribed letrozole.

@Pcosttc did they ask you to get your bmi down at all? It seems any dr I've spoken too has said my bmi is the issue or may as well have but I've spoken to others who have been able to concieve with clomid or Letrozole with a high bmi.

Yes I've been given 3 cycles to do unmonitored through the NHS after getting my bmi down as my initial meet with them in June my bmi was around 39.

I did 2 rounds of clomid privately in Jan and Feb this year that even though I produced mature eggs and ovulate.

Have you tried clomid or is this your first ovulation induction medication?

@Journey2022 wish I saw this post before replying to the other one! This is my first round of any fertility medication.

I already have a 3 year old dd so won’t be entitled to ivf on nhs so they’re not to bothered about my bmi. They’ve given me 6 months letrozole with follicular scan and blood test on first cycle. If all fails will have have to go down private route for ivf which I can’t afford.

I wouldn’t worry to much about the failed clomid cycles as after a lot of research it looks like letrozole works a lot better especially with higher bmi. Are you ttc for dc1?

@Pcosttc yes I've read that letrozole is better for a higher BMI (frantically researching the last couple of weeks while I try and shed a few more lbs 😆) I hope that is the case! I've also heard a lot of people are prescribed metaformin with it particularly with actually diagnosed pcos, but I didn't get that (I was with clomid).

Yes I'm ttc dc1 it'd been nearly 3 years ttc.

Ivf rules are very unfair I also don't get it on the NHS due to my postcode I have friends an hour away that are however in a postcode that accepts it. Apparently this isn't unusual. We have been saving for ivf privately if needed, and also considered ivf abroad as its cheaper also potentially better statistics and clinics abroad (but weighed up with flights and extra time off work we came to the conclusion it may not be worth it).

I have a good feeling about the letrozole though I have 3 months worth I think if that fails they will do it with scans and tests also, they said they may also want me to do another hycosy i had one a year ago and it was awful.

@Journey2022 thats all I’ve been doing in my spare time too, reading all the stories on letrozole! Hmm I haven’t been prescribed it either. Are you taking anything else with the letrozole when you start? I’ve heard good things about vitex, maca root and nac but not sure what to do. I’ll be taking my prenatal proceive atm but will probably change to pregnacare (due to costs) and maybe take vitex. I’m also planning to take a uk mucinex version as it may help with cm (sorry tmi).

No way that is so unfair! Hopefully fingers crossed it won’t come to you needing to self fund the ivf and the letrozole will do it’s magic 😃I looked into ivf as an alternative and the abc ivf looked reasonably well priced.

What we’re your HyCoSy results? I had it 2 weeks ago and didn’t find it bad at all but both tubes were open, it can be painful if there are blockages.

@Pcosttc I'm taking a load of vitamins (started back up about 2 weeks ago in prep for the letrozole cycle) I was taking lots of vitamins (i think i took the pregnacare ones plus others) and metaformin with clomid.

Vitamins I've split up rather than a mixed one as I read you get a higher dose that way not sure though?! I've got -
Agnus cactus
Inositol
B6
Vit d
Zinc
Cq10
Folic acid
Vit c
Omega 3
Wild yam root
ccII
think thats them all! I can't keep up these daily for too long due to costs! 😬

I have a clinic nearby me in Essex that offers unlimited IVF for 1 year for £7995 which after weighing up may be our best option. There are some conditions on that one being BMI needs to be 35 or under.

My hycosy was also clear, but the pain was so horrendous I was actually near screaming and I felt like I was going to pass out, it was over quickly but in them few minutes it was 10/10 pain. I was made to feel like I made a fuss over nothing but I am not joking when I say I reconsidered childbirth for a few weeks. I do wonder if my hycosy flushed something due to the pain I had as I haven't heard many people have as bad reaction as I did!

That sounds like a valid point. I guess it’s trial and error, the first month I’ll try pregnacare, vitex (Angus cactus), mucinex uk version and I might get some inositol. What brand are you using? The next month I’ll try single vitamins but like you said the cost is my only worry (especially with crisis of cost of living and everything going up!).

8k is a decent amount for unlimited ivf, I’m guessing it includes all medication etc.

Oh wow yes doesn’t sound pleasant at all, mine was over in a second and I couldn’t believe how easy it was. I had period like cramps after but nothing during the procedure. Are your cycles regular? What date will you be starting the letrozole?

Honestly I gave heard good things about the pre made pregnancy vitamins I think for pcos there are some to add though which is why I just ended up doing it all separately. But then didn't know if I had pcos so wasn't sure if I should take them anyway! Inositol is what is mainly recommended for pcos I use earth's nature 1000mg Inositol from amazon (I only use it once a day as I can never remember to do them twice!). I actually make dh take the preconceive vitamins (he has been told no issues with him but thought it all helps!).

That's a good point if Meds are included for 8k I should probably ask them. I know initial consultation and tests are on top if they haven't been done within the last year (which I now fall outside of a year since having them done) I haven't had a consultation with that clinic. I initially went privately with another but didn't feel the service was great.

My cycles last year were irregular and were between 32 to 40ish days. But after my clomid cycles in Jan and Feb (plus I started regular exercise) they have been regular at 32 days until last month - but I started keto to get some weight off and that can throw the first cycle off. I'm due on by the end of the week and pretty sure I'm back to my 32 days now as I've started spotting so atleast I know it was just that month. It should mean I start my letrozole next week, honestly I'm a mix of nerves and excitement. I would love it to work first time and find out for Xmas 🙈 wishful thinking I know!!

When is your cycle due to start/starting letrozole?

When are you due to take the provera This is to get your period is that right? Which may be why I wasn't prescribed as they weren't significantly long cycles aparently.

Yes I just ordered some more for dh, he said he doesn’t need them as everything was normal for his results but it can’t do any harm to take them. I’ve just ordered the conceive plus ovulation support as they have the 40:1 ratio for the inositol which I need for my pcos.

Fingers crossed you won’t need to go down that route but good to do your research. Did they only give you 3 months letrozole because you’ve had 2 months clomid privately? Will the nhs not give you a further 3 months if it does not work?

That would be the best Xmas present ever!! I really hope it works for you will keep you in my prayers ❤️ I found out I was pregnant with dd on Xmas eve 3 years ago 🥰 She was born in September 2019 so hoping for another September baby as the weather is still nice (I’m a November baby my birthday is on Friday and it’s always so miserable!)

My cycles are irregular they can be 33-35 days but on the months I don’t ovulate (which I haven’t this month) it can be anything up to 50 days which is crazy. According to my tracker I should start my period on 29th November but I doubt it’ll come on time. I might take a pregnancy test midweek and then start the provera so I shouldn’t be too many days behind you with the letrozole 🤞🏼

Im thinking of starting a shake diet tomorrow but don’t know wether it is a good idea.

They just gave me a 3 months prescription to do on my own without scans and trigger injections, just a progrsterone blood test one cycle 1. I asked if I wouldn't have these and I was told if after 3 months then I'd have another consultation and likely further cycles with scans he wad a bit vague though. But to be honest I was so relieved to finally get the letrozole I just took the prescription!! 😆 I waited 6 months since my first consultation with nhs to get that prescription!!

It's funny I also wanted to avoid due dates nov-feb 😆 my birthday is 1st week of december and its always been so frustrating being so close to Xmas - it's often hard to plan due to Xmas work parties or people have no funds due to Xmas, oh and i end up with xmas presents for birthday presents, so definitely feel your pain there 😆

What shake diet are you considering? - be aware that any immediate diet distress can play with hormones and actually be worse for you. I was told to cut back but not go crazy and be more active by 2 nurses and a dr . I was also advised to intermittent fast. I did these things (maybe not well enough) but didn't loose much in months, so that's why I did keto as I did it years ago and know it worked for me and was something I could feasible stick to secondly i wanted to loose weight quickly as a tick box to be allowed my letrozole. I am having a weekend off of the diet for my birthday and Xmas day but otherwise il be sticking to no carbs or sugar ideally. I am very close to my nhs goal weight (of 35 bmi) now though. I wouldn't personally have started keto only a couple of weeks before letrozole though as I would wait and let my hormones re balance from the shock if that makes sense?

6 months is not bad it’s an 18 month wait where I am 😭 I think I am only having a scan on my first cycle and the blood test on day 21. I have read a lot on trigger shots but I haven’t been given those.

Haha oh dear yes I feel for you. I really don’t want a winter baby! Fingers crossed for September babies for both of us.

Yes I agree with what you are saying. It’s slim and save diet. I’m desperate to loose the weight. What Keto diet did you follow? I would like to bring my bmi down to 29 it’s currently 35. I think I’ll try it for 2 weeks until I start my letrzole even if I shift half a stone I’ll be happy!

I’m currently day 29 of my cycle, I had a lot of cm so thought I’d do an OPK. They say I am ovulating but I’m very confused as I’ve never ovulated this late in my cycle. Maybe the HyCoSy delayed my ovulation?

@Pcosttc oh wow you must have ovulate late! At least you know you have ovulated!

I had heavier spotting than usual and mild cramps the last 2 days wasn't sure if I should class this as first day of my cycle. But this morning I was woken with bad cramps which is usual for my day 1 so I've gone with today as day 1 which keeps to my 32 day cycle too. So I start the let on Friday! I'm excited!

Keto is just removing any food with carbs and sugar so anything that has over 5g of carbs per 100g I don't eat including starchy veggies I limit or don't eat like carrots and butternut squash, i swap out carbs for green veg or good fats like avocado, nuts or cream/cheese. It helps also with anyone who struggles with insulin levels (typical with pcos) which I always have high blood sugar. I'm also intermittent fasting, but not by trying I just have less appetite on keto. I really want a cheat meal though but you can't just dip in and out weekly as you come out of ketosis and it messes it up. I am gonna have a weekend off for my birthday (as we're going away for the weekend) just not go mad, but by then if have been doing it for 2 months so should have lost a good amount to warrant it (hopefully!)

Oh wow I’m excited for you! Please keep me updated on your journey and any symptoms with the letrozole. I hope it all goes well for you.

Ahh I don’t know if I can do that it all sounds too confusing for me. I’ve always struggled with my weight and I’ve always been an overweight child. I do need to consider loosing weight as it will help with my fertility journey also.

@Pcosttc hi how is it going your end?! Sorry its been a hectic week for me. I'm currently on CD7 and take my last 7.5mg of letrozole tonight. I've so far felt no side effects but to be fair I didn't when I was on clomid until I ovulated - I had the worst ovulation pains that went down one side/down my legs.

I will start testing for ovulation in a few days - do you use the clear blue 4 days or more ovulation kit ? This one was recommended to me when I went private for clomid and is the only one I've had any success getting a reading from! I'm thinking I may ovulate sooner this month due to the letrozole- I'm usually around CD17-20.

I'm now thinking I need to prep for ovulation as my dh gets stage fright when under pressure which is so frustrating. We have tried so many different methods but because he knows he must dtd it makes it harder for him 🙈

We are luckily away this weekend so hoping he's more relaxed!

I'm feeling positive for this month but also really trying to not get my hopes up...

I've also lost a few more lbs so hoping that helps too, but I'm taking a small diet break for a few days while I'm away.

Hi, nothing new in my tww as I ovulated last week so due on my period on 7th December.

Yes I always use clear blue and the pre mom easy@home strips (cheapies off Amazon) so I can confirm my LH surge.

Any news have you ovulated? Have you been testing and oh dear about dh maybe don’t don’t tell him so he doesn’t feel under pressure 😂 good luck I’m excited to see how it all goes. What cycle day are you on now? Im
glad to hear you haven’t had any side effects with 7.5mg as I’ll be on 5mg so hoping I don’t either!

@Journey2022 hey how are you doing? any update? I’m currently on day 1 of my cycle

@Pcosttc I'm so sorry for my delayed replies!! It's been a hectic week as we was away last weekend then had my birthday this week!

I'm on CD17 and been testing as flashing smiley since Sunday/Monday! Then full smiley flashing smile today. We have managed to BD daily since CD11, thinking we should probably try tomorrow (although have a house full and friends staying tomorrow which may mean we can't!!)

Ive not had any noticeable symptoms, but have had an ache in my ovaries/or full feeling the last 2 days so could tell I was ovulating - on clomid this ache was more of a pain and the pain went down one leg! So it's a lot less severe! I've had some headaches too but I do get headaches anyway so not sure I cab put that down to the letrozole.

I had a few days off my diet and went carb mad - but am back on the diet now hoping I have only put on water weight in them few days!

I've got my TWW now I guess which will kill me I'm trying to be positive and somehow 'manifest' good news 😆 I've done everything I can now though I lost as much weight as I could, I've bd daily, I've maintained exercise, tried to reduce stress and taken vitamins daily other than odd one or 2 says I've forgotten.

Anyway!! How is it going with you? I'm assuming you started the LET today or yesterday?! How are you feeling with it?

Sending you lots of positivity for this month 🥰

Yes that’s great news! I hope you got plenty of BD in before ovulation 🥰 I’m very excited for you and have everything crossed this one sticks 🤞🏼

Those symptoms are not bad at all! I’m glad to hear that! Ahh hopefully it will just be water weight but it was your birthday so you deserved a treat!

How is your tww going? Any symptoms? When will you test on Xmas eve? That would be the perfect Xmas present ever🥺

I didn’t start the let 🥲 as my cycle was so late the dates of when I would have ovulated didn’t work out for us as DH is going up to Scotland for Xmas with his family. I’m hoping to start next month now ❤️

@Pcosttc so I think I actually ovulated on the 9th Dec rather than 10th - my app says when you get a full smiley/pos ovulation then you ovulate the following day. But I actually felt it the late evening of the 9th on my right side it started with an ache then it was a pain - no where near as bad as with clomid though. But that would mean I can test on 23rd (if I can wait that long!) I do have a clear blue few days early test I could do on the 19th if not. If I really can't hold out 😆 it literally would be the best news to get my first BFP on 23rd/24th though! 🤞🏼 I'm actually going mad thinking anything is a symptom right now which isn't possible as I know implantation is around 7-10dpo. But I've felt twinges in both left and right lower stomach quite deep and pelvic like aches, also had what's known as lightening crotch and had that same lightening pain in my right groin this morning (could be from the gym though!). These can in theory be possible symptoms but also can just be elevated hormones which of course letrozole would potentially do. On the other hand I may just have gas 🙄😆. Trying to tell myself it's way too early to tell so I don't get myself too excited.

I had my progesterone blood test this morning for cd21 (but had it on cd23 as I do ovulate late!) I should get results for that tomorrow.

Oh and I loat the weight I gained in Dublin already I'm now 1lb lighter than when I went so that's a relief! But I'm prepared for a few treats over Christmas then January I'll be keeping strict to get my weight down further for the next 2 rounds of letrozole!

Makes sense not taking the letrozole this month for you! When your around lots of people or staying elsewhere it makes it difficult. Christmas in Scotland sounds lovely though! And a nice break and relax before you start letrozole hopefully!

Hi so sorry for the late reply! Merry Christmas ❤️ no update for me as I’m not on the let this month but I do have a lot of cm and I’m day 21 of my cycle so possibly ovulation soon.

Any news yet? What did the blood work show? Do we have a Christmas miracle on the way? 🤞🏼🤞🏼🤞🏼

@Pcosttc merry Christmas I hope you had a lovely time away! Sorry I've had a hectic few says mainly driving between family.

I unfortunately started spotting from 7dpo so took that as it hadn't worked, then I got my period 2 days before Xmas. I was quite teary and upset, and been up and down for a few days tbh! I feel like I don't have anything to look forward to and my life is on hold while TTC.

Anyway I'm CD5 now so on my second cycle of letrozole I can't say I'm feeling positive at the moment as I'm currently in the frame of mind that if it was going to work it would have 1st round, but I know plenty of success stories are 2nd 3rd or 4th round of letrozole so it's a silly thing to think. But just a bit disheartened I guess!

@Journey2022 Oh no I’m so sorry to hear that but don't be disheartened. Most people it works best on the 3rd cycle so I wouldn’t worry at all! I can’t wait to start taking mine but I’m not getting my hopes up!

Are you planning on trying anything different next month?

@Pcosttc do you think there's more chance of it working in later cycles than earlier cycles? I really don't know what I could do extra this month, I have had over a week off my diet over Christmas I will be back on it 1st week of January. I can't see I can add any vitamins I take so many just incase they may work!

@Journey2022 yes most people said they got pregnant on their second/thirst cycle. You are on 7.5mg too which is quite a high dose so I wouldn’t worry too much. Let’s keep our fingers crossed for our winter babies 🥺