Letrozole/timed intercourse -4 follicles- should we try?!

[CarpeDiem75]

Hi
We had a scan today and I have 4 mature follicles after being stimulated with some Letrozole.
The clinic didn't recommend for us to try but did say it was our choice.
Has anybody by in this position and decided to proceed?
I an 40 so losing a cycle is a big waste of time for me...

Hi,

A few years ago I was prescribed Letrozole and had 4 mature follicles on the scan. Like you I was advised to avoid intercourse.

As I had already been trying for about 3 years I thought screw that and went full steam ahead those next few days. Unfortunately for me, nothing happen that time. I had to go with it as I would always have wondered ‘what if’ hadn’t I tried.

Good luck :)

Hi OP,

I recently did 3 cycles back to back on Letrozole, each time I had respectively 2 and 3 follicles in the mature range, did textbook timed intercourse and just didn’t fall pregnant at all.
the reality is even if you have multiple follicles, even in the mature range, it’s unlikely they’ll all be mature and that more than one’ll fertilise.
I absolutely would try if I was you.
Mind me asking what sort of size were they? Were they evenly sized or quite different from one-another? And were you given a trigger injection per chance?x

@SH998 thank you so much for your testimonial, it really makes me feel better... that's how i feel, I am thinking I am going to regret. I am like over 40 hardly get pregnant and when I do it ends in miscarriages so i an a bit like you I am like screw this advice!
@clhiu so their sizes were 16.1, 16.8, 14.7 and 15.2 and I think 3 of them are in the same side. They didn't even offer the trigger shot which annoys me now because I hate not knowing when ovulation happens!! What were the size of yours when you had this scenario? Thanks!

@CarpeDiem75 only you know what’s best for you just make sure you don’t regret whatever decision you make. I would have taken all 4 babies had it actually happened lol 😂
My sizes were all around the 16/18mm mark I think. It was so long ago I can’t really remember but they were all ready to blow within the next few days. I was given the trigger as they said I would then know when NOT to have sex.
Good luck and have fun trying x

@SH998 I got the trigger shot today so let's see how it goes! So exhausting! Did end up having as child via iui or did you have to have ivf?

@CarpeDiem75 good luck to you, I hope you get lucky :)

I'm currently 5 months pregnant via my 4th transfer of IVF, its been a long, emotional journey but I honestly wouldn't change anything to be in the position I am now.

Have they found the issue? We were 'unexplained', on paper both myself and partner were as we should be but it just wasn't happening for us naturally.

@CarpeDiem75 personally I wouldn't. I have a friend who did oi. Clomid not letrzole tho and she was nesrly same age as you she was 41
She had 3 follicles and assumed the likeihood of all taking and being genetically normal is low as told only 1 in 4 or 5 would be genetically normal.
I think egg quality is really dependant on individual. Some women's quality declines quickly In their early 30s and others are still producing top quality aa's even in their early 40s.
What I'm saying is unless you know have had them tested and graded you don't know your liklihood. My friend eneded up with triplets. 2 of the follicles had taken. 2 are identical from same egg and one not. 3 sounds delightful but when they are all the same age it's hell. She dosent sleep. As soon as one sleeps another starts and so on. Childcare is insane she had to give up work as childcare was too expensive and she was too exhausted to work and unwell from birth anyway. She dosent have time to even cook dinner nothing. Life is very complex with multiple babies same age not to mention is a very risky birth. She had complications and even 6 months after the birth still hasn't recovered and is unable to walk unaided. If they go out to appointments shes in a wheelchair.i dont want that to scare you but I would be very careful and listen to your doctors especially at 40

@SH998 congrats!! We are unexplained too! In 3.5yr of trying only managed to get pregnant 3 times and all ended in miscarriages!

@XStardustX thanks for you recommendation. I really appreciate and I am really aware of the odds unfortunately 😞 Having been trying for 8 years just to have 2 babies you will probably understand more why I am ready to take the risk. I am mentally exhausted and I think this is pretty much our last chance unfortunately. 😞 was your friend advised to carry out a selective reduction when she found out she had triplets? The clinic seems to think it will be a no go for me to carry 3 or 4 . You can't imagine how stressed I am this week with the whole process!!!

@CarpeDiem75 thank you, it still seems unreal 🥰. We tried for 7 years with no natural pregnancies, 1 miscarriage from the first IVF attempt then this one from the 4th.

Have they looked into into issues carrying? I had some bloods carried out to see if there was any sort of issues with implantation/carrying they all came back negative. Might be worth an ask as you seem to get pregnant ok x

@CarpeDiem75 hi there, I completely get how frustrated you are. I've struggled with fertility issues myself for the good part of 13 years. I've had multiple failed ivf attempts and will be embarking on yet another one after Christmas .
I do however agree with other posters that you should proceed with caution with 4 follicles. I don't think you'd find any clinic that would encourage you to attempt it with 4 follicles.
My sister also had ivf ( took her 3 attempts) on her last attempt she transferred 2 embryos. Odds were low at 40 but both took. They were genetically untested. 5 months after birth she fell pregnant naturally and now has 3 toddlers. I think its entirely your decision but births especially multiples and in your 40s can be more riskier. Even fertility clinics in uk refuse to transfer more than 2 embryos for women over 40 which is why you see many going abroad and ending up with multiples.
I think you should ask yourself a few things. How will you feel if you eheded up with multiple babies? Would you be able to handle them all at once?
If one or more of your babies had a disability ( which is significantly higher risk above 40) would you be able to cope?
I say that because my sister was blessed with 3 beautiful babies. Her youngest has down syndrome and the middle ( twin) has autism . She now has 3 children toddlers 2 of which have special needs and as much as I love my nephews it's bloody mentally and physically exhausting. I think you should think about all those possibilities before embarking on trying with the 4. There's every chance all 4 might get released and fertilised and then again 1 or none might take. Unless your having ivf ect you've no idea of the quality of your eggs so you've no embryologist to give you a heads up how successful or unsuccessful you might be with your eggs. Ultimately its your choice but like I said I would really think hard and think about every scenario before going ahead. Have you had previous testing to know what is causing your fertility issues?

I would definitely try, after many rounds of IVF (and Clomid etc before) the risk of multiples would not put me off. This is only my personal opinion. As it happens my UK clinic were happy to do double transfers but the clinic in Spain where I eventually had successful treatment would only do single transfers. They really emphasised the risk of multiples.
What I have paid out in fertility treatments would cover my childcare for several years and in the event of multiples we would have paid for help. Obviously can’t know in advance about disabilities such as autism and the challenges of that are huge. Years of infertility treatments mean I’m a much older mum than I wanted to be and when my baby is old enough will be going back for more IVF so I will be an even older mum if I am lucky enough to have another child, which also brings risks.
Over the years I’ve connected with many people doing IVF and don’t know anyone who had triplets (I know it happens just saying I don’t know anyone who had IVF triplets, I do know of natural triplets). A good friend did have some initial complications with an IVF twin pregnancy but all is well.

If against all odds 4 embryos were made then there is time to consult with the medical team and discuss options.

@StillPrayingForAMiracle thank you for letting me know. I am still weighting the pros and cons!! I am not having ivf or iui otherwise I would have not even considered it and the clinic would have not let me anyway. But yes I do get there is a risk..😞
@XStardustX did your friend conceive via iui?
@SH998 yes all the tests came back clear the only thing they found is that I might have an issue with blood clotting which could prevent a pregnancy to survive... so they can treat me for this if I get pregnant. Congrats for your baby that's awesome ☺️

@LongerthanMrTicklesarms thank you!! Sorry to hear about your infertility journey. I totally get the age thing I became obsessed with my age and then the age gap between my kids. I am trying to relax a bit more now.
I won't be doing ivf or iui and like you said I will be doing a genetic test probably for downs and all the others but things like autism 4 eggs or not it can happen even with a natural pregnancy with one egg nothing we can change about it unfortunately. I am really aware that being old plays against me and carries more risks but like you I am sure it is not like we have chosen to have babies at our age! It has been 8 years we are trying pretty much every month! We got a baby and I am feeling so blessed so I am trying to give him the little sibling he is desperately asking for 😞 despite the clinic not recommending it they said that it is my choice as long as I am aware of what a pregnancy reduction implies. So tough... 😩

So in the end I had 4 mature follicule and had a trigger shot plus timed intercourse and nothing happened! At least no regrets! Onto the next cycle ...😴

@CarpeDiem75 I am really sorry to hear about your struggles.

I never responded to a previous question, but in my 3 back-to back cycles of SO, my follicle sizes were the following:

1. 20, 15, 11 - I was told to trigger the following day, potential for 2 mature eggs, ovulation confirmed by LH surge and BBT variations, BFN
2. 16.7, 25.7, 21.1 - I was made to trigger there and then at the clinic, potential for 3 mature eggs, ovulation confirmed by LH surge and BBT variations, BFN
3. 23.5, 17, 25.8 - I was made to trigger there and then at the clinic, potential for 3 mature eggs, ovulation confirmed by LH surge and BBT variations, BFN. This time I also had Hyfosy at he same time, which confirmed my tubes were perfectly clear and it's supposed to help boost fertility, yet still BFN

Came off the Letrozole to try completely naturally the following month and got pregnant although unfortunately it was a chemical

@clhiu i am really sorry to hear your journey. How do you cope emotionally?
I broke down yesterday each period reminds me that I can't conceive and it makes me feel a bit useless! I am like if I can't conceive with 4 eggs then it will never happen! So tough...

Are you still trying?
I might try iui. This is my last hope.

Hi guys ! I am under Dr Shehatas care at CRP. I did a round of letrazole (super ovulation) with the aim to take a trigger shot: however when he scanned me today at cycle day 10 I had too many follicles for him to allow me to trigger so he said just go home and try naturally without the trigger. Basically what I want to know is will all the mature follicles still rupture without the trigger or will only one rupture ? The follicle sizes are
left
17.6mm
8.7mm
12.4mm
right
13.7mm
16.1mm
13.5mm
14.6mm
I just feel like it’s such a waist of a cycle if I don’t trigger :(

@Meg310532 Hi
Im in the same boat. CD 10 today and a few follicles with letrozole. If you don't mind me asking did you get your BFP? and did you end up doing the trigger

@sc1995 hey course I don’t mind you asking. So we decided against the trigger as I knew my anxiety would be sky high. We still had sex but didn’t get pregnant that month. The following month my dose was reduced and I had three follicles triggered and fell pregnant. I have my 12 week scan Monday. How many follicles have you got ? Will they give u the trigger or will you source it privately ? Xx

Ahh congratulations. That's amazing news!
They said so far they can see 4 dominant follicles. Ive got a scan on Wednesday cd15 to see what's happening. They've not mentioned anything about a trigger. Not sure if I should ask 🤔

@sc1995 thank you :)) definitely ask because if you don’t trigger then only one follicle will be released which is just a waist of the other 4 and your chances won’t be increased !!! Xxx