Opinion needed

[AshRS]

So I am trying to decide if I should do another month of Clomid (50mg and 100mg didn't work for me) at 150mg, or if I should just jump to Femara. Any thoughts?

[Ferret Mommy]

You know my thoughts.. I think if you are comfortable with Femara, you should give it a try...



From Clinical Pharmacology

For the treatment of infertility† in women due to anovulation, irregular ovulation, or luteal phase defects, including women with polycystic ovary syndrome (PCOS):
NOTE: Ensure that patients are not pregnant prior to initiating letrozole. While the outcomes of pregnancies in one cohort study demonstrate a similar rate of miscarriage and ectopic pregnancy in women who took letrozole versus other drugs for ovarian stimulation [31753], the manufacturer of letrozole urges physicians to ensure that letrozole is not used in women who may become or are pregnant; birth defects have been reported in the children of women who were receiving letrozole during pregnancy.
Oral dosage:
Adult premenopausal females: Limited studies indicate that 2.5 mg, 5 mg, or 7.5 mg PO once daily for 5 days, typically given on days 3—7 of the menstrual cycle, may be effective; in a study comparing 2.5 mg letrozole (n=34) to 5 mg letrozole (n=38) PO daily for 5 days, pregnancy rates per cycle were significantly higher in patients treated with the higher dosage (26% vs. 6%, p<0.05).[32940] Alternatively, a single dose of letrozole 20 mg PO on day 3 of the menstrual cycle has been shown to be as effective as 2.5 mg PO once daily for 5 days in a nonrandomized study [32939], although more data are needed before a single dose can be recommended. In general, ovulation and pregnancy rates are comparable to those with clomiphene (pregnancy rates per cycle of 9—27% for letrozole vs. 5.6—26% for clomiphene).[32937][32938][32941] Efficacy has also been demonstrated in patients with PCOS; ovulation occurred in 66% (65/99) of letrozole cycles vs. 75% (71/95) of clomiphene cycles, with pregnancy rates per cycle of 9% vs. 7%, respectively.[32942] In addition, successful pregnancies have occurred when letrozole is administered to patients who do not respond to clomiphene (lack of ovulation or insufficient endometrial thickness). In 30 patients that were treated with clomiphene 100—150 mg/day for 6—24 cycles, the administration of letrozole 2.5 mg (n=4) or 5 mg PO (n=26) PO once daily during menstrual cycle days 3—7 was associated with an ovulation rate of 90% and a pregnancy rate of 26%; pregnancy occurred during cycles 2—5 of letrozole therapy.[32943]

[BC-LittleaBige]

I vote for Femara too!! I should have stopped taking Clomid so much sooner than I did. Femara was what I needed in order to get pg. Let us know what you decide to do!!

[HolmesHX2]

I'm probably late in this one but I vote for femara. I'm going through the same thing now my doc said he would do 50,100,150 of clomid of nothing then move to injections well after 50 and 100 didnt work I asked to skip 150 and move right to injections and he was fine with it after making sure I knew the extra risks that came along with injectables currently waiting to be able to start this cycle with them.

[AshRS]

I went with Femara...today is my 3rd day on it. I skipped 150 of Clomid too. Just curious...what are the extra risks with injectibles? I'm thinking of doing 2 months of Femara and if it doesn't work, going to injectibles too...but I know nothing about them.

[Ferret Mommy]

My friend, on her first round of injectables.. had triplets.

She did menupure and follitism (sp) and then *maybe* the trigger.. with TIMED INTERCOURSE!! NO IUI!!!

[HolmesHX2]

some of the risks include a higher risk of mulitples which some people are ok with but do know it adds extra complications to pregnancy for both mom and babies. There is also a greater risk of OHSS which is ovarian hypsertimulation which depending on the severity can become really really bad. They have 3 main risk factors for people to kinda of judge if they may get it and 2 are having PCOS and being under 35. My doctor will not let me do regular dosage of injectables he feels it'll be far to risky so hes doing a super low dose over a 2 month span because they feel it's the safest protocol and generally a common one he uses. I'm in Korea right now so they do things differently sometimes and as much as I didn't like the idea of taking shots everyday for 2 months the reduced risk of OHSS works because if you get it it takes awhile to heal from even if you get it mild but it can be so severe it becomes life threatning. Iwould read up on it just so you know what side effects to look for and be aware of. Kind of confused why your 3 days in and don't know risk factors you doctor didn't inform you of them?

[AshRS]

I'm 3 days in on Femara...last time I was in we briefly talked about possibly doing injectibles if oral medication doesn't work...he just mentioned doing it, but didn't give any details. If the Femara doesn't work, he will definitely talk to me about the risks of injectibles I'm sure.