6 months of letrozole or straight to IVF?

[Linalou12]

Hi Ladies,

I’m 32 and my DH and I have been ttc #1 for almost 2 years without any luck. At about the 18 month mark, we went to see a consultant privately, who took a look at all our blood/SA results and suggested that a Hycosy and then IVF would be the next step and he wouldn’t recommend letrozole because I do ovulate regularly (albeit that my cycles range between 28 and 35 days)

I then got referred in to the same clinic as I’m eligible for NHS funding (which has taken ages) but just saw a different consultant who recommended doing 6 months of letrozole before moving to IVF. He thinks although it is more successful for anovulatory women, it could still help improve my chances.

im feeling quite confused by the apparently conflicting opinions. Has anyone had any success with letrozole if they do already ovulate fairly regularly by themselves? If you were me, would you give the letrozole a go or push for IVF?

We were advised straight for IVF because basically what's the point when I was already ovulating.

I understand there's a lot of if's but 6 months added on to your already trying time is alot.

We were in very similar situation to you and were advised IVF. But I personally asked for letrozole first mostly because I was shocked that the only other option was IVF (think I’d assumed we would be able to find the issue before doing that, which we couldn’t). And i saw letrozole as more natural/ less extreme and wanted to see if that could work first.

Spoiler alert - Letrozole didn’t help and we went to IVF and I’m now 36wks pregnant from our second IVF transfer. I think after trying for so long and knowing I ovulate normally, letrozole really was never going to help me.

The letrozole process was very time consuming and emotionally draining (moreso than the IVF!). Regular appointments for scans (several a week during follicular phase - but appts not always available so think I had to skip at least one cycle), clinic always running late, queueing for hours for one dose of medication at a time, then timing intercourse for ovulation. Add the fact we’d been doing that last part for years, that pressure was really taking a toll on both of us. And 6 more months of negative tests.

IVF was then long too as I developed OHSS so couldn’t fresh transfer. First frozen then failed, second one worked.

Will share my timeline as I think if I could have seen this it may have influenced our decision…

Sept 2023 - started letrozole process (agreed to 3m)
Dec 2023 - no success so started IVF referral (kept on with 3 more months of letrozole while waiting)
Jan 2024 - first IVF consult (funding approval was quick and waiting list short!). But lots of appts followed and they wanted full natural cycle for running baseline tests without letrozole in my system, so keep that in mind as it delayed as further!
April - started IVF stims. egg collection late that month, got OHSS so froze all embryos, had to wait for full natural cycle (which was a long one, always is after egg collection).
June - medicated frozen transfer cycle (lots of appts to monitor lining).
July - negative test. Followed by a natural cycle.
Sept - second frozen medicated transfer. Positive test end of Sept.
May 2025 - due date soon!!

They suggested letrozole to me
Even tho i I ovulate without it

They said it would make me super ovulate

When it hadnt worked 3 montha in -,

Nhs consultant recommended
I got private hyfosy
As faster than nhs wait

I did
Blocked tubes

We got nhs funding approved
And are doing ivf now

Have u had the hyfosy ?

Hows your amh/ ovarian reserve ?

Thanks everyone for your replies and a massive congrats @Sierra26 !

my Hycosy is this week and I just had my AMH blood draw so I’m hoping to get the results of that soon.

thanks ladies for your advice. I think at my next consultation I’m definitely going to probe more into why they think letrozole could help as I know it’s not as long as a lot of people but honestly 2 years feels like forever already!