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.

@Journey2022 oh no what day are you on now? Hopefully you haven’t had a period? Was this your last cycle.

Hey how’s everyone getting on ?

@Sweet211 hey this post went a bit quite, I’m starting my let this week hopefully as long as I start my period!! Can’t wait to finally start taking it. How are you getting on?

@Sweet211 @Pcosttc Hi! I am so sorry for my radio silence. I was really unwell with Letrozole last cycle as you know, I ended up being taken in for a scan and they found I had a small cyst on one ovary that could have been given me the pain/additional bleeds. I then had a consultant appointment and was told I had to have 2-3 cycles off of letrozole so that my hormones calmed down and hopefully the cyst would then pass.

Honestly, it was gutting to hear I had to wait 3 cycles, particularly when we have been TTC for 3 years, 3 cycles then seems a life time to wait. I was very down about it for a couple of weeks. I am now waiting for a scan appointment to come through which wont be until end of march time likely.

I have just passed ovulation in my current cycle with no letrozole - and my ovulation pain was minor I felt it a couple of times when going to the toilet yesterday and been fine. So I know that the let was causing this severe pain.

If I am honest I think my next steps are to just go for IVF now, I am fed up of waiting, via the NHS and I have weighed up the wait/my age/timescale vs financially paying privately.

There is a clinic I want to use for my IVF however they ideally need my BMI down to 34 or lower, I am 10lbs off this. So I am giving myself some time to try and get to this if not I think May time I will go with my second choice clinic who will accept me with a BMI of 35 however they are considerably more expensive.

I do still have one cycle of letrozole left, I am considering taking it outside of my drs request next cycle but on a lower dose, but at the same time I really cant be dealing with the pain I had last month!

Sorry for the essay - hope that explains my radio silence and where my head has been at!

How have you both been doing? Good luck with your next cycles!!

@Journey2022 oh dear I’m so so sorry to hear that lovely. I hope you’re doing and recovering well? Not the news you want to hear 😪 did the letrozole cause the cyst, your on 7.5? Maybe if your symptoms are better this month try 5mg next month and add in a iui as ivf is very invasive. I have been looking into my option too incase the letrozole doesn’t work, we will be adding in iui in the 4/5th cycle and then move on to ivf at the end of the year. We have been ttc 2 years so dh doesn’t want to waste anymore time.

I hope you’re feeling better, gutted it’s not good news but we are all in this together and I’m here to support you even if you go down the IVF route ❤️

Currently on CD1 so hoping to start my letrozole on Friday finally! I have emailed my consultants secretary asking to book the follicular scan (I really hope they can get me in this month) :)

@Pcosttc hi have you asked to be scanned this month/throughout cycle? My understanding is NHS doesn't do monitoring unless there's a need to. Maybe that's just my area!

I hope this month goes okay for you!

In regards to IUI my last round of letrozole is leftover from NHS they haven't offered me IUI it could take me months or a year to get offered it (if they even do!). If going privately I would have to use their medication etc and my consultant when I went private said the results were a lot lower with IUI and recommended going to ivf if clomid and letrozole didn't work.

Also I just don't want to wait any longer I've waited 3 years 2 years of that via various appointments private and NHS. I'm 34 this year and inpatient.

I would only be using the letrozole I have left while I'm waiting for ivf/to get my bmi I down for ivf, I'm considering using just 2.5g so using 1/3 of the dose maybe as I do ovulate anyway without it the idea of having it was to mature the eggs.

If I'm honest I don't think it's going to happen for me on letrozole anyway.

@Journey2022 hi no I haven’t asked to be scanned my consultant just wants to scan me for the first cycle to make sure she’s got the correct dose so she can adjust the dose if I don’t grow enough mature follicles. I’ll only have this one scan after this the cycles will be unmonitored maybe just say 21 bloods.

Oh I wasn’t aware of that, I thought since I am already on the the letrzole the private side to IUI would be easier as I wouldn’t have to get medication etc but I suppose what you are saying is also correct.

I wouldn’t give up, maybe try 5mg this cycle but a lot of people get lucky on their last cycle so don’t worry!

Hi @Pcosttc &@Journey2022 hope you both doing well I’m on day 56 of my cycle I don’t know what’s going on my cycles have gone longer my last period was on the 19th December I’ve got 2 cycles of letrezole left. I feel like giving up I’ve had enough of my cycles being messed up.

@Sweet211 oh no did your doctor not give you provera to help induce your bleed?

I am on day 4 of letrozole today, I had very bad symptoms day 2 headteacher ovary pain etc but not as bad yesterday but I do have a constant headache!

Hi ladies how are we doing? I’m due for follicle scan today, really hoping the letrozole worked it’s magic!

@Pcosttc How did your follicle scan go?! How many mg of letrozole was you on this cycle?

I had a scan for my cyst on Sunday - I still have a cyst but it has reduced in size, so I got the all clear to start letrozole today again at 7.5mg, I am on CD3 today so I have taken that this afternoon.

If the letrozole fails this month we are giving until April to see if I can get my BMI to below 34 to do an egg share cycle and start the process to do that in April/May, or if my BMI is still not below 34 I will then do an IVF cycle local to me privately. So either way I know I am going to start my IVF consultations in April/May if this fails, Ive waited 3 years, I feel its long enough ive been quite emotional and upset the last couple of months and feel ive given everything else enough time and now IVF is my next shot.

Have you been watching Alex Jones - Making Babies about IVF? I really recommend it!!

Hey ladies @Pcosttc @Sweet211

I haven't updated for a while. I have just done my last round of letrozole taking cyclogest only once a day from 3dpo. My cd21 bloods were at 150 (previously had been around 30 then 68 so it was a lot higher).

in this time I've only just got my bmi down to 34 (needed bmi 35 for private ivd and bmi 34 for egg sharing ivf which was my preferred)

Had a faint positive test 11dpo (Top photo) then with fmu 12dpo it got slightly darker. Today 13dpo fmu it was quite clear. Hoping my lines get darker the next couple of days and it's a viable pregnancy.

In 3 years of ttc I've never even had a shadow of a positive test! I've been an anxious mess, I really wasn't sure my body was capable of conceiving.

Sorry not sure why photo won't upload.

@Journey2022 Wow congratulations hun that’s absolutely amazing!!!! I’m so so so happy for you ❤️ carry on testing everyday just until you get a strong positive but that’s 100% positive 🥹 ahhh I’m actually so happy.

Did you do anything different this month? How many mg of letrozole were you on and what days did you take them? I’m currently on my second cycle of 5mg letrozole CD6 and day 3 of the let, was told to take it day 3-7 but I’ve been reading day 2-6 is apparently better! Cycle one was a fail but my progesterone was 35 which is the highest I’ve ever had! Hoping for a Christmas miracle now 🥺

@Pcosttc oh thank you! 🤞🏼🤞🏼

Yes I did days 3-7 on 7.5mg a day. This was my third cycle.

So I've been low carb/keto basically since October so my blood sugar will be really low, then the last 6 weeks I've calorie counted on top of that keeping to 1600 calories and lost weight quicker - I've lost just over 2 stone in total since October. The last 2 months I've been walking but not been as active at the gym due to having a cyst and being in pain. I've been consistent with vitamins either a concoction of things or pregnacare with omega 3. Dc also on well man. I've also been having a tsp of sea moss jelly every day since early/mid feb in my morning green tea.

Nothing particular different just this cycle but major thing is maybe the weight loss and no carbs and sugar.

I hope that helps!

I'll keep you updated 🤞🏼

Wishing you all the luck please keep me posted.

@Pcosttc sorry this round the other thing I did was take the cyclogest pessaries from 3dpo (I had a box left from last year) it states to use 2 a say but I was only using at night. From 11dpo when I got my faint I started using 2 a day though!

@Journey2022 hey how are you getting on today? Did you test this morning to confirm the line is getting darker? Today will be last day of 5mg of the let. I haven’t been given any pessaries or anything else to use.

I really need to control my blood sugars too and you have really given me the motivation! I hope I get my positive soon too.

@Pcosttc maybe speak to your Dr about getting metaformin (for blood sugar) and progesterone alongside your letrozole - I was prescribed both when I went privately but also after 3 rounds of letrozole they offered me another 3 rounds with progesterone and metaformin - which I took as I didn't know we had/would concieve this cycle.

My tests all came up darker and digital also came.up pregnant 1-2 weeks. My first day of my last period wad 19th Feb which makes me 4 weeks 1 day (as I understand its taken from period date rather than conception!).

I also went to hospital for bloods this morning my hcg came back at 251 and I go back Wednesday for second bloods to see if it's doubled/gone up. They said they will book me in for an early scan once my hcg is high enough but that it would be too early to see anything at the moment.

@Journey2022 hey any update? Did you have any more bloods?

Currently CD9 haven’t started TTC yet as I didn’t ovulate until CD18 last month so will try in a few days. Did you use a fertility lubricant to help? What day did you ovulate o feel CD18 is quite late!

@Pcosttc I'm going for my second bloods today, then will find out when they can give me a scab hopefully.

Cd18 does seem late I found I ovulated earlier on letrozole (than without it) I would ovulate cd15 or 16 each time.

Do you use these - Clearblue Advanced Digital Ovulation Test Kit (OPK) Double Your Chances Of Getting Pregnant, 1 Digital Holder And 20 Ovulation Tests amzn.eu/d/1PE01Ez

If not order them as they have been the best thing for me working out my ovulation compared to the cheapy sticks they just never worked for me. But the clear blue ones was spot on every time (and I know as on stims I feel myself ovulate). They measure 2 hormones rather than 1. They give me usually 6 days pre ovulation then me and dh will bd daily from then to a day or 2 after ovulation.

I used fertility lube months ago but gave up as I read positive and negative things on it.

Good luck!! Try and get them clear blue tests - I'd not BD every day from tomorrow or Friday!

@Journey2022 keep me updated fingers cross the hcg levels have doubled. What’s the earliest they can do the scan? I had a scan at 5 weeks but it was a tv scan when I was pregnant with my dd. They can’t see much at 5 weeks just a sack no heartbeat etc.

Yes I swear by these as they pick up ovulation up to 2 days before! I got my peak fertility on CD17 last month and definitely O CD18 as I had pain all day. This month I’ve got cramps and twinges in both ovaries. I think I will start bd from Friday which is cd12 but I definitely can’t do everyday so will have to be every other day. I might start testing tomorrow to see if I get high fertility on them. I might scrap the lube too! Such a faff.

@Pcosttc ive just checked my app and this month we BD CD11, 12, 13, 14, 15 - and I ovulated on CD 14 this month. My clearblue usually picks up high fertility 4-6 days before then gives me a peak the day before. so I usually try to BD every day from the day after it gives me a high fertility (as in flashing one).

To be fair ive had some months where we have BD 7 or 8 days in a row! so this was a light month for us 😂

@Journey2022 I think I’m just so sick of BD atm it’s so draining and feeling so forced 🥲 I will start ovulation testing tomorrow. Did you temp? I don’t know I can be bothered with temping!

How are you feeling do you have any signs of nausea etc? What cycle of let was this for you? Apparently cycle 3/4 is the most common one to fall.

@Pcosttc I know the feeling scheduled BD isn't the most fun! It's just a 'get on with it' situation 😆

Yes this was 3rd round of letrozole but across 4 cycles as i had a cycle off due to a cyst. I had done 2 rounds of clomid early last year so not sure if it would be classed as 5th round.

I've had cramping and my boobs ache/feel heavy but no difference to what I would feel if I was coming on my period. I spoke to a nurse and they seemed to think they are the normal first signs.