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Elizabeth
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Joined: 04/24/2009

Share your experiences with taking Letrazole and support each other along the way to your BFP!

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shan13
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Joined: 02/13/2010

Thanks Elizabeth!! If there are any ladies out there who are using Letrazole please share your symptoms cause I am starting it this cycle..and how it affects u v Clomid...

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gujomia
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Joined: 05/20/2010

GL Shan with the letrazole, I will keep checking in here to see what new info people post.

The main difference I have heard is that letrazole doesn't carry the same risk of twins/multiples as clomid does. So it only produces one egg, but there are fewer side effects and it doesn't thin out the uterine lining like either. Hope it triggers ovulation for you this month Smile

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Gia
 

JJS RITA
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Joined: 06/09/2010

Can anyone tell me approximately how much Letrozole costs? My insurance doesn't cover any of this fun stuff - just wondering... Thanks!

shan13
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Joined: 02/13/2010

With my insurance my I paid $20 for my Letrazole script...this is my first month using it and I am on Day 4 of using it...I have to take 2 pills daily for 5 days...so far no big side effects to note like Clomid..in fact I wonder is it working?..lol

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shan13
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Joined: 02/13/2010

Here is info I found on Letrazole....the 3 side effects they named I haven't had....I do know I didn't ovulate on Clomid so I am hoping the Letrazole works...they also started me on the 2.5mg dosage.....got to fertility doctor on Thursday I guess to see if follicles are forming...I guess to monitor me....
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Letrozole (Femara) for Infertility Treatment
Letrozole for Infertility Treatment: Background information
Letrozole is being used commonly as an infertility treatment. Letrozole is the most recent addition to the drugs being used for fertility treatment. Fertility drugs are used often in infertility treatments. There are two situations in which fertility drugs may be useful. First, these drugs can be used to induce an egg to develop and be released in women who are not ovulating on their own. This is known as ovulation induction. Fertility drugs can also be used to increase the chances of pregnancy in women who are already ovulating. This is known as superovulation . In many fertility centers, clomiphene citrate (Clomid, Serophene) has been the drug of first choice for either ovulation induction or superovulation for many years. In general, it has been a relatively effective medication. However, clomiphene citrate lasts for a long time in the body and may therefore have an adverse effect on the cervical mucus and uterine lining. Some groups of patients, such as women with PCOS – polycystic ovary syndrome, do not respond well to clomiphene citrate. Another group of fertility drugs which are administered as injections are called gonadotropins (Gonal F, Follistim). The gonadotropins are very efficient at inducing ovulation and have higher pregnancy rates than clomiphene citrate. However, gonadotropins are much more expensive than clomiphene citrate and the injectable route is uncomfortable for patients to administer and inconvenient. The risk for multiple pregnancies is also much higher with gonadotropins.

Letrozole is a medication that has been widely used in women with breast cancer. It is sold under the trade name Femara. Letrozole belongs to a class of medications known as aromatase inhibitors.

Recently, the manufacturer of Letrozole sent a notice to doctors warning that there are reported cases of birth defects that arose in the children of women who received Letrozole while pregnant. Novartis, the manufacturer of letrozole, reviewed their safety database and found 13 reports of pregnant women receiving the drug worldwide. Of those 13 women, two had children with birth defects. In the United States, the labeling of letrozole already warns that it has been associated with birth defects. Novartis has never sought FDA approval to market letrozole as a fertility medication and is clearly concerned about their liability if given in pregnancy.

However, there are no reports of letrozole being associated with birth defects when given prior to pregnancy. It is important to make the distinction that when used as a fertility medication, letrozole is given before the establishment of pregnancy. Letrozole is a medication that is metabolized rapidly in the body. It is not thought to have significant levels in the blood or tissues for a prolonged period of time.

At least one major pharmaceutical company, Serono, is conducting studies with a similar medication called anastrozole in the hopes of obtaining FDA approval to market it specifically as a fertility medication.

Aromatase is an enzyme that is responsible for the production of estrogen in the body. Letrozole works by inhibiting aromatase thereby suppressing estrogen production. Clomiphene citrate, on the other hand, blocks estrogen receptors. In both cases, the result is that the pituitary gland produces more of the hormones needed to stimulate the ovaries. These hormones, FSH and LH, can cause the development of ovulation in women who are anovulatory or increase the number of eggs developing in the ovaries of women who already ovulate. As a result, several studies have now been published using letrozole as a fertility drug.

One of the earliest studies using letrozole as a fertility drug looked at 12 women with inadequate response to clomiphene citrate. Ovulation on letrozole occurred in 9 of 12 cycles and 3 patients conceived. A later study by the same investigators compared the effects of letrozole to those of clomiphene citrate. This time 19 women were studied. Ten women received clomiphene citrate and nine women received letrozole. This study was unable to demonstrate any difference in the number of women who ovulated, the number of eggs that developed in each woman, or the thickness of the uterine lining during treatment. However, a more recent study by a different group of investigators found that compared with clomiphene citrate, letrozole is associated with a thicker uterine lining and a lower miscarriage rate.

Nobody has yet identified the optimal dose for letrozole. Three dose regimens have been tested: 2.5 mg, 5 mg and 7.5 mg. Different studies comparing these dose regimens have occasionally found favor with one dose or another but there is no conclusive data that one dose is better than another. The usual length of treatment is for five days.

Some early studies suggested that the pregnancy rates with letrozole far exceeded those with clomiphene citrate and were possibly even higher than gonadotropins. Further data has determined that this is not the case. Pregnancy rates with letrozole are similar to those seen with clomiphene citrate and are lower than the pregnancy rates seen with gonadotropins. Older patients have a lower chance of success than younger patients.

Treatment with letrozole may still be successful even if other treatments have failed. For example, some data shows that in women who did not ovulate with clomiphene citrate, they still may ovulate with letrozole.
Letrozole side effects
Letrozole works based on its ability reduce estrogen levels. Low estrogen levels of any cause can cause a woman to have symptoms. The data on side effects comes from women who have been using letrozole for an extended period of time in order to treat breast cancer. The treatment duration for letrozole is only five days. In our experience, we have seen side effects that are similar to those seen with clomiphene citrate:

Hot flashes
Headaches
Breast tenderness
Letrozole and pregnancy
Studies conducted so far have shown either no increased risk of miscarriage or a decrease in miscarriage risk. Letrozole is considered pregnancy Category D. Letrozole should not be given to women who are already pregnant. Studies in rats and mice have shown that letrozole increases the risk of fetal death and malformations. Since there are no studies in human beings, it should be assumed that a similar effect is possible.
Letrozole Fertility Treatment Protocols
Monitoring with ovulation predictor kits and having intercourse only.

1. Call the office on Day 1 of your period.
2. Day 2 or 3 - Office visit- Blood test and ultrasound.
3. Take the letrozole 2.5 mg tablet on days 5,6,7,8, and 9.
4. Start testing urine on the morning of day 10 or 11.
5. Look for the first definite color change. Do not continue to test after the color change.
6. Have intercourse the same day you see the color change and the next day.
7. Call the office when you see the color change. Schedule an appointment approximately one week later for a blood test to verify ovulation.

Monitoring with ovulation predictor kits and having an IUI - intrauterine insemination

1. Call the office on Day 1 of your period.
2. Day 2 or 3 - Office visit- Blood test and ultrasound.
3. Take the letrozole 2.5 mg on days 5,6,7,8, and 9.
4. Start testing urine on the morning of day 10 or 11.
5. Look for the first definite color change. Do not continue to test after the color change.
6. Call the office the same morning you see the color change. Have intercourse that night.
7. Schedule the intrauterine insemination for the next day (The day after the color change)
8. Schedule an appointment approximately one week later for a blood test to verify ovulation
9. Schedule an appointment approximately two weeks later for a pregnancy test

Monitoring in the office with intrauterine insemination or intercourse

1. Call the office on Day 1 of your period.
2. Day 2 or 3 - Office visit- Blood test and ultrasound.
3. Take the letrozole on days 5,6,7,8, and 9.
4. Day 10 or 11 - Office visit - Blood test and ultrasound. You will receive instructions that afternoon when to return for the next visit.
5. Only when instructed – Take the hCG trigger injection in the evening. Have intercourse that evening also.
6. Schedule the insemination for 2 (two) days after the hCG trigger . If you are not doing intrauterine insemination, have intercourse again on this day
7. 1 week after hCG trigger - Office visit - Blood test only (Progesterone level)
8. 2 weeks after hCG trigger - Office visit - Blood test only (Pregnancy test)

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shan13
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Joined: 02/13/2010

Found this article as well.....what is weird is that they say 2.5mg for 1 day and my fert doc gave me 2.5mg 2x daily...wonder if that is gonna increase my chances???

What It Is:
Letrozole is a drug that is commonly used to treat estrogen-dependent tumors, particularly breast cancer in older, post-menopausal women. While not approved by the FDA for this use, it has been shown to induce ovulation in women who do not ovulate. For this reason, some infertility specialists are using the drug in women who cannot tolerate or who do not respond well to Clomid.

Dosing:
Letrozole comes in 2.5mg tablets and is taken once a day for 5 days, usually beginning on day three or day five of your menstrual cycle. You may need monitoring through blood tests and/or ultrasounds to determine when you are approaching ovulation.
Side Effects:
Side effects include:
fatigue
weight gain
headache
bone or muscle pain
hot flashes
Risks of Birth Defects:
It is important to note that this medication is incompatible with pregnancy and breastfeeding. However, please understand that you are taking this drug before you become pregnant, so it does not increase your risk for having a child with birth defects. You should not take this drug while already pregnant, so make sure to mention a suspected pregnancy to your doctor beforehand.

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shan13
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Joined: 02/13/2010

Well I am happy to report that I had no major symptoms from taking the Letrazole and when I went to doc on Thur..he saw a good looking egg measuring 13.9mm and he is sure it will keep growing..if I don't get a surge this weekend I go Monday to get a trigger shot.

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mrssheppard
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Joined: 08/10/2010

Shan, I do not take letrazole, but I am very interested in how it works for you..

DH and I just did the home male fertility test, even though it was expired (posted this in another thread).. and his count is less than the 20 million cut off point. He had his reversal in June, so we weren't really sure what the test would measure anyway.

I am 40 and he is 45. I do ovulate on my own, but with us being older, I don't want to waste any time. When we know his count is up, I am going to do anything I can to make sure I ovulate. From what I was reading, the best option for me is the superovulation. I visited the ob/gyn who delivered my last child and he was all like "you can't just take clomid - you have to have many tests done, blah blah blah..". I understand why many women need various tests when trying to conceive, but my point was that I don't have time to waste and need to "make sure" I am ovulating.. even if that means taking clomid or letrazole to help it. I did get a + on my last cycles OPK, but that doesn't necessarily mean an egg was released. I read somewhere that just because you have a surge, doesn't always mean an egg has matured and was released.

Anyway, keep posting... I wish you the best of luck!!
FX and babydust!!

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