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.

@Pcosttc &@Journey2022 wishing you all the best I’m on third cycle of letrezole I have pcos I’ve never ovulated on own. I’ve tried clomid years ago which never worked for me I’ve had ivf which worked I’ve got LO but I’ve no embryos left I’m nearly 40 :-(

@Journey2022 what day of the cycle are you now? I’ll be starting in a week I’m so nervous don’t know what to expect I really just want my BFP now 😪

@Sweet211 welcome, what my are you on and are you ovulating with the let? Send you baby dust 🥰

@Sweet211 what's LO (sorry! 🙈) what dose of letrozole are you on this cycle? If your not ovulating they should be upping the dose? Also have you tried the clear blue 4 days or more ovulating sticks it measures it so much clearer than the cheepies and gives you a bigger window to BD.

@Pcosttc I'm CD10 today I'm going to start tracking ovulation from tomorrow. I've been really stressed this cycle as I'm a planner and feel like I need a plan ready in place incase cycle 2 and 3 fail (I can't see nhs will give me anymore as that will be my plan b is hope they do!) So I've been putting together IVF research on a spreadsheet - ones that are local how much they cost, their ratings etc. And the costs are 7 to 8k per cycle and I can't exactly afford it, that money would be my safety blanket for maternity leave and getting what I need for a baby if that makes sense and it's giving me such anxiety! I'm then worried that the anxiety is going to be no good for helping me concieve 🙈😆 bloody vicious cycle!

@Journey2022 LO is my child little one. I spent loads of money on clear blue kids but didn’t think it was ideal with pcos. I’m cycle day 15 today but my cycles are from 32-42 day so hit and miss. I’m on 3rd round of letrezole I had a months break and my periods took so long to come like over 60 days.

I tested today I’ve only bedded on last Wednesday and Friday :-( hoping to bed tonight hope I’ve not missed it.

@Sweet211 those levels still look quite low so don’t worry. Are your cycles still long on letrozole?

@Pcosttc its made it shorter I use to be on 42 day cycle now its made it 32 day it varies shortest I’ve had is 22 day cycle so it’s hit and miss. The test seems very light nothing came up straight away waited 2 mins

@Sweet211 carry on testing your levels may go higher so bd as much as you can!

@Sweet211 what was your LH test today? Did it seem darker? I only ever got low readings on those it was a pain!
I've not got a reading on mine yet but only CD12.

@Journey2022 it wer lighter i bedded last wed and Friday nothing on weekend till last night

@Sweet211 maybe ask the fc for a higher dose?

@Pcosttc hi have you started your Letrozole now?

I'm CD15 ans had a flashing smiley (high fertility) since CD13, managed to BD yesterday going to try again tonight or tomorrow up until my Peak smiley.

I've also been researching IVF as my back up plan if the letrozole doesn't work for me (I'm a big planner!). So feel a bit more motivated to get my BMI down if I need to do IVF in a few months. I'm back on diet and gym this week I'm going to be strict it and not giving myself a weekend off until March.

@Journey2022 🤞 my clinic tells me to bed from day 11 so I try every other day so I’m covered. Is this your 1st cycle of letrozole? It can take a few cycles so don’t give up hope x

@Journey2022 i should be starting in next few days I’m due on my period tomorrow. I’m really excited to finally start. This month I’ll be using let and my normal vitamins only but I’m hoping they push my dose up to 7.5 next month and then I’m gonna try baby aspirin with it.

Im currently doing intermittent fasting which is working well.

@Sweet211 I usually ovulate late to be fair but thr clear blue usually gives me about 4 or 5 days notice now I'm using that. I've managed to BD CD14, CD16 (this morning) and il do tomorrow and hopefully Monday. I managed 7 days in a row last month all the way up to ovulation day but not the day after ovulation day after ovulation is ideal too really.

I have 3 rounds of letrozole currently on cycle 2, so 1 left after. This is via NHS and unmonitored. If 3 cycles of let fail I'm hoping they will give me another 3 more but they won't do IVF in my area/ccg it's private only. It has taken me a year and half to get 3 rounds of letrozole from them!

Are you in yout TWW now?

@Pcosttc good luck for the next few days. I've had no side affects that I'm aware of other than more headaches than usual (but I do get headaches) also I do feel ovulation pains, ive not yet obulated and they have started to ache very odd. I also intermittent fast but that's mainly as on keto I'm less hungry, and I don't generally eat breakfast so I usually don't eat between 7/8pm and then until 12/1ish the next day.

@Pcosttc im a little worried about the side affects of the letrozole but I’m hoping if I take it at night it shouldn’t affect me too much.

Are you trying anything different this month? Bd every other day is meant to be good for sperm quality so not sure wether to bd everyday from cd11 or very other day?

@Pcosttc to be honest I have read it doesn't make a difference to sperm quality it its every day. Even if there is less sperm it doesn't mean its less quality or going to do the same job. But they say it lives inside you up to 6 days which is why really every other day isn't exactly a necessity. Last cycle was the only month I've managed every day its usually every other but every day on day of ovulation and day after usually. So it means in a week it may work out more than every other day.

I'm not using the conieve plus lube this time round I used it most times last cycle but then I read it can slow the motility of sperm but yet loads of research says it helps it so I really don't know there.

I've also added algae dha supplement about 3 weeks ago to my endless list of vitamins just because I read that can help too but honestly I'm taking so many and it's never made a difference in 3 years so not sure if all vitamins are necessary. My Dr had only told me to take folic acid and vitamin d. But if I've read it helps elsewhere I've got it. Do you take inositol as that is meant to he good for pcos I also take it even though I only have occasional policing ovaries. I believe it helps with blood sugars and hormones.

@Journey2022 hope it works for you, I only take pregnacare conception, vitamin d and folic acid. I’ve got 2 cycles left of letrozole unmonitored I just want to know what size follicle it is I wish I had more letrezole so I can increase dose my self, I was currently on 2 tablets a day I had sharp pains from day 11 so it is working but it’s all about the eggs dunno what size they should be. I’ve been through ivf good few years back only had one successful treatment had so many eggs it was so exciting and worth it but it’s going to cost me now. What area are you from?

@Pcosttc wishing you well with letrezole you might get hot flushes and headaches just keep hydrated you’ll be starting on a low dose so your body will get use to it.

Hi @Sweet211 and @Pcosttc hope your both doing okay with letrozole?

@Sweet211 I totally agree I'm struggling this month with it being unmonitored - last month it actually didn't bother me as my ovulation sticks were guiding me and it was clear when I got ovulation pains.

I'm now on CD21 -
So my update I had a bit of an issue this cycle... from CD13 to CD20 ive had a flashing smiley on the clear blue ovulation sticks. Flashing means it's high fertility but not peak once you get to peak which is a static smiley you can no longer use the test stick as it follows your cycles.
I normally get a static peak smiley around CD16/17 and ovulate CD17 on clomid and the letrozole last cycle I feel the ovulation so I know its happening.
So as I've not had a peak test I don't really know when or if I ovulated as such. But CD18 I had quite a bit of pain on my left side then CD19 I was woken in severe pain on my left side and middle of my abdomen and what felt like when I was walking going down my cervix into my vagina. I also felt bloated and tender to touch. I was in bed all day in pain like I often am with periods. I tried to get through to my consultants office with no luck then went to 111 and my GP and actually got a GP appointment on the phone - they wernt too worried but said if it worsened or hadn't got better the next day to come in for an examination but luckily by the evening it was better and CD20 (yesterday) I woke up and the pain had gone.

Anyway.... it may be I had a cyst or mild OHSS but of course with no monitoring I have no clue.

I BD up to CD18 nighttime but my husband was then away for work CD19 and CD20 he got back late last night do we didnt but did this morning. I do expect though I likely obulated CD19 when I was getting the severe pain.... honestly no clue though! If that's the case I'm wondering if I'm not going to have a short luteal phase and that will mean I'm out this month.

I have a few cyclogest progesterone pessaries from when I did clomid privately I'm wondering if it's worth me starting them in a few days.

Anyway that's my longwinded update! I hope your both doing better than me!

@Journey2022 so sorry I thought I had replied! Oh no doesn’t sound like you’ve had much fun this month but don’t worry it definitely sounds like you’ve ovulated!

I always seem to get the pains you just mentioned when I ovulate and that’s without the let! I spend the day in agony bloated and gassy and it’s not normal I’m guessing it’s linked to my pcos.

Do you only use the clear blue opk? I would have used the Premom ones as they show it in a line version so much easier to read and pinpoint ovulation.

Sadly I didn’t get to start my let this month, I called the secretary on cd1 and she couldn’t fit me in for a scan on cd11-14 due to annual leave and sickness so she told me to cancel this cycle and not start the tablets until my next cycle 😪😪😪

@Journey2022 its cycle day 26 for me today I’ve got no symptoms at all it’s all disappeared your symptoms sound promising hope it all works out for you they say you shouldn’t symptom spot.

@Pcosttc aww so sorry to hear atleast you can prep for before you start like on top of your vitamins hope it works for you too it’s just the waiting game so annoying.

@Pcosttc is that via nhs or private? I think it's bad they have cancelled the cycle due to staff shortages!!

@Sweet211 I'm not sure my symptoms around ovulation are actually a good sign. I think it may have been OHSS even if I ovulate you often are not successful if you get OHSS also I don't think I BD enough around it as I was doubled over in pain. So I've classed myself as out this cycle il just try again next cycle.

I have my follow up appointment with the NHS through for 10th March which is only 2 weeks after my last letrozole cycle finishes. I need to have got my weight down by that cycle as I expect they will weigh me and want my bmi lower. Atleast I can hope they will give me more letrozole and I will ask to be monitored this time if its possible.

I am just thinking I may go and do IVF as I'm worried about egg reserve/age, particularly if I want to then concieve a sibling.

I also understand my CCG is looking into IVF rules in my area (currently only certain postcodes are offered ivf mine being one that is not) I believe this should be discussed in April so it's worth me holding out to find out if they will offer it on the NHS even if I hold out for 1 or 2 months.

@Journey2022 its nhs, I suppose I’m glad it’s given me a month to loose weight and keep on top of my vitamins but I’m starting to get really desperate. I really want to start them now 😭

I would defintley wait a month or two if you’re likely get the funding for ivf on the nhs! It’ll save you a lot of money. How are you feeling at the moment are you in the tww?

@Sweet211 how’s everything at your end? Hope you’re doing well ❤️

@Pcosttc you know when you have just waited so long already waiting another 2 or 3 months feels like forever to probably still get the answer no anyway! I'm always very impatient.

I'm CD24, I had spotting with a clot yesterday and severe cramps again today as if I am on my period no spotting today though but expecting it now but its really early 8/9 days early!

I just knew when I was in such pain CD19 that it hadn't worked this month and was likely a cyst or ohss or something wrong but I'm so frustrated not knowing what the issue is and not having scans particularly as I'm in so much pain today and just want to know why!

I've had a bit of a cry today as its one thing it not working but another being in pain aswell!

I've managed to get down to past my pre Xmas weight I had 2 weeks off my diet across Xmas I've still got 5 or 6 lb to loose for my gp appointment in march, and another few lb to go ahead with the ivf clinic I want to use.