How many rounds of letrozole?

[quetzal93]

Hello,

I've been TTC for 2.5 years now with no success. Just to give some background, I have PCOS but healthy otherwise. I've never figured out the cause of my PCOS, for a few months I tweaked my diet because it thought it might be due to inflammation but nothing changed. I have no insulin resistance, my thyroid is fine. I don't have a lot of stress but I've actively tried to reduce whatever I do have. My main PCOS symptom is polycystic ovaries and anovulation. I've done two rounds of Letrozole (one at 2.5mg and another one at 5mg) without ovulation. I'm guessing they will give me 7.5mg next but I'm wondering how many rounds of Letrozole do people do before moving on to something else? I'm feeling a little deflated and looking to hear some stories.

Thank you!

So they never upped my dose because the 5mg is making me ovulate so the 7.5mg wouldn’t really do much more for me. A lot of people seem to get trigger shots though and I’ve never been offered those so we’re in the dark every month on exactly when to try. I tried ovulation tests for a few cycles but got many false negatives and false positives before I was on the letrozole so try to avoid them now.
So great that you’ve gone private and it’ll definitely help speed the process up! They told me that the first cycle of letrozole is basically like TTC for the first time so not to expect too much. Same as you, they’ve offered me 6 rounds and then if this final round doesn’t work I’ll be moving onto injections apparently.
In terms of ovulation symptoms, I definitely feel cramps and twinges during ovulation week and I’ve noticed a small jump in my BBT post ovulation too ☺️xx

@TinyTraveller thanks for the reply :) ahh that makes sense. I am like that too the only reason I started ovulation strips was when I started this first cycle on letrozole as prior to this I always got negatives and just gave up on them.

Bless you! I do hope that this cycle may be the one for you though as it just would make things so much easier for you 💕 do you know what types of injections they are offering if you don’t mind me asking? xx

Yes I’ve found them super hit and miss - last cycle I did them everyday over ovulation week and they were all negative and then the blood test confirmed that I had ovulated 😂!

Thank you!! Have read a few lucky stories about people falling pregnant on their last cycle so you never know 🤞! So they’re offering me something called HMG ovulation induction. They’re called Menopur injections that you have to self administer 😬so I’m hoping it doesn’t come to that but good to know the next step xx

@TinyTraveller lol same I find that they are very hit and miss! Especially if you have inconsistent cycles it’s so draining to test everyday knowing it’s a negative.

Never heard of those injections before , might do some research later as I need as many back up plans ready 😂 yes definitely it’s good to know you have a plan laid out because soon or later something will definitely work for you. Best of luck and keep us updated on this cycles results ❤️

Hey @BDismakingmeexhausted .. definitely! I didn’t find the waiting to be seen for treatment by the NHS too long necessarily, but to say we started treatment 6 months ago and we’re “no further along” per se I can definitely see the benefit in going private and skipping the box ticking exercises the NHS have to go through. I have to say though, our experience so far has been positive and I can’t fault them. It’s not their fault the lower doses didn’t work and they’ve been great in keeping us on the right path etc.

The one month I did ovulate on the letrozole, I have to say it was extremely text book and I was almost like “ohhh, this is what it feels like!” Vs all the months I thought I’d been ovulating but clearly hadn’t. I had all of the classic signs in the lead up to ovulation, then the ovulation pain and then lots of signs after due to the high progesterone.

Regarding the ovulation tests.. I’d never had a positive before so like you gave up on them. However, once I was told I would ovulate when they saw a big follicle on my scan I did buy some to test which day it happened. On that ovulatory month the tests worked great for me.. I used strips (easy@home) and the clear blue ones, and they both went positive on the same day so that coupled with the symptoms were a great way for me to confirm ovulation had happened. I have to say though, last month when I didn’t ovulate I got no positives on the strips, but clear blue gave me a positive!!! The only reason I can think is that my LH spiked a bit but not enough to release my egg, but it’s definitely made me wary of the tests and I’ll be doing both alongside each other again next time because the fact one was positive and the other wasn’t also confirmed my suspicions I hadn’t ovulated.

it sounds like you have a great attitude and plan towards everything with regards to already wanting to figure out what your next steps might be etc. I do think that’s the best way to be in this situation because you have to listen to your body and push for what’s right for you I think :) the only thing I’d say from my experience is that sometimes thinking TOO far ahead sent me into a bit of an anxiety spiral, so I’ve found focusing on the month I am in has helped to avoid getting overwhelmed by it all…. Especially because every month could be “the” month.. you never know!

Good luck.. I hope it’s not too much of a long journey for you x

Hi @AnonTTC thank u for the reply 💕 you seem to be lucky, where I live the waiting list takes forever. For instance follow up appointments are around 3-4 months (including cancellations, reschedules) and when I went for scans I would get my consultations a couple months later so it was really dragging the time for me when I could be trying different options. Sorry I don’t want to come across as Ungreatful but for me I found it better to go private for those reasons. I’m happy it’s all working promptly for you though :)

I have had that before too where some ovulation tests are positive and some are negative so it’s very mind boggling :D what cycle number are you on now and what dosage are you taking? Are you also taking triggers ?

Yes definitely I have noticed it’s better to take things one at a time and focus on one month at a time because it can feel very overwhelming otherwise. Especially as this is my first cycle xx

Hey @BDismakingmeexhausted .. oh gosh, yes that does sound frustrating. A couple of us on this thread have said how wild we find it that it differs so much depending on where you live, really not fair is it!? For us, the wait from being referred for fertility treatment to actually being seen was around a year, so that part certainly wasn't 'quick', but once we were 'in the system' everything has been fairly accessible/moved quite quickly. Having said that, we've only had the Letrozole so far so I'm only basing that on monitoring scans etc. and when rounds haven't worked for whatever reason the team have been available to discuss next steps pretty quickly.. if we need to move on to IVF I'm not sure what the wait time will look like.

I'm about to start cycle 5 (waiting for my period to arrive!), and I'm on 7.5mg. I haven't had a trigger so far, but as my last round of Letrozole stopped working (having worked fine the previous cycle), the clinic have said they will monitor me this month and I may potentially need a trigger introducing. Not sure why my body has decided to stop working without one but clearly wanting to test me!! Ha.

You must be waiting to test soon for this cycle!? I was on another thread when I first started this process and a good few people on there got pregnant their first cycle of Letrozole so it definitely does happen! :) x

@AnonTTC sorry for my late reply hope you are well :) yes it’s so unfair because sometimes it can take many treatments to find the one which works for you so the waiting time feels even longer. I’m happy that’s things are going as planned for you though :)

How was cycle 5? Did you end up triggering with that cycle ?🩷 unfortunately cycle 1 did not work for me so I’m on cycle 2 now (still on 7.5mg) on CD 12 so I’ve booked a scan on CD 14. Fingers crossed this might be the one but the good thing is since taking letrozole my period has regulated and I started on time so I guess that was a positive to take from the first cycle.

Hey @BDismakingmeexhausted ,

I'm good thanks, hope you are too? :)

Still in the midst of cycle 5, but the good news was that there was a juicy follicle when I went for my CD12 scan, and after some deliberation the hospital decided to give me a trigger shot that day.. assuming that means I ovulated on either CD 13 or 14, so I am now waiting for my bloods on Thursday to confirm (feeling pretty nervous because I have some post ov signs but not all of them that I got last time). Sorry to hear cycle 1 wasn't successful for you, but it's great that the medication is making you ovulate and you're well on with cycle 2 :) I have read quite a bit that suggests the average is 3 cycles so keep the faith!! x

Hey @BDismakingmeexhausted sorry for the late reply. For my DD I did one round at 5mg and fell pregnant. Im currently on cycle 2 . The one positive thing so far is definitely regular periods.
I hope everyone's getting on well.🥰