When attempting to become pregnant, your physician may investigate potential causes of infertility. Upon evaluating your exam and medical history, they may advise letrozole as a course of treatment. This guide will provide an overview of the medication and how it may facilitate conception. Letrozole For Fertility & Getting Pregnant Letrozole, similar to Clomid known by its generic name, is a prescription drug commonly used to stimulate ovulation in those wishing to become pregnant. It is typically prescribed by an ObGyn or fertility specialist, though in certain cases a primary care physician may also write the prescription. For best results, dosing and dates of administration should be tailored to an individual's unique cycle, and it is recommended to track ovulation either in the physician's office or with an at-home ovulation predictor kit. What is Letrozole? Letrozole was approved by the Food and Drug Administration for the oral treatment of early stage breast cancer. As an aromatase inhibitor, it suppresses the production of estrogen in the system by preventing the conversion of androgens to estrogen. Due to its effect on estrogen levels, fertility specialists have prescribed it to patients with unexplained infertility or polycystic ovarian syndrome PCOS who did not respond to Clomid or could not take it for other reasons. How does Letrozole help with infertility issues? Letrozole is a medication utilized to induce ovulation in people who do not naturally ovulate or increase egg production in those who do. Though it suppresses estrogen, when timed correctly, the medication supports the body's natural process of ovulation. By dropping estrogen levels, the body responds by producing follicle stimulating hormone (FSH) to maintain hormonal balance, which is further stimulated by letrozole to release more eggs and improve the chances of natural conception or egg freezing. Additionally, letrozole is believed to improve endometrial thickness, which assists in the implantation of an early pregnancy. When taking letrozole, it is important to adhere to a precise schedule, with some doctors recommending use from days three through seven of the cycle, and others from days five through nine. Insemination or sex should begin before ovulation, with most doctors recommending from days 11 to 18 if starting on day three, and days 13 to 21 if starting on day five. Ovulation predictor tests should be used after finishing a round of letrozole to narrow the window. Generally, letrozole is prescribed for three to four cycles before determining the medication failed. Letrozole (Femara®) side effects Common side effects of letrozole include bloating, blurred vision, breast swelling and tenderness, difficulty sleeping, dizziness, fatigue, nausea, headaches, anxiety, mood swings, irritability, hot flashes, night sweats, and spotting. In rare cases, people may develop ovarian hyperstimulation syndrome (OHSS) or ovarian cysts. Prior to beginning letrozole, it is important to consider the effects of the medication on pregnancy and breastfeeding. Your doctor may require a negative pregnancy test before starting letrozole, and given the short duration of treatment, the medication should leave your system and not harm a new pregnancy. Average success rates with Letrozole To determine if one is a candidate for letrozole, a physician will need to assess if their periods are irregular and how often they miss their period for unexplained reasons. Additionally, progesterone levels are tested to see if they are low. Blood tests to check thyroid, prolactin levels, and blood sugar are done, as well as AMH testing to determine egg reserve. Furthermore, sperm count is evaluated if a partner's or known-donor's sperm is being used. Letrozole only addresses fertility problems related to ovulation, and will not affect other issues that may be causing difficulty conceiving. Evidence suggests it is more effective than Clomid; a 2014 study from the New England Journal of Medicine found 27.5% of people with PCOS taking letrozole had successful births, compared to 19.5% taking Clomid. Additionally, a 2012 study found 25% of people taking letrozole had a live birth, whereas 16.8% of people taking Clomid had a live birth. Thus, letrozole may be a viable option for those looking to increase their chances of successful conception. Letrozole vs. Clomid For years, Clomid has been the first-line treatment for ovulation-related infertility. However, recent studies suggest that letrozole is more effective for specific populations, such as those over 35, those prone to excessive weight gain, and those with PCOS. Letrozole has a slightly higher success rate in terms of ovulation and birth rates, and is associated with fewer congenital and chromosomal abnormalities in babies conceived with its use. On the other hand, Clomid is prescribed at a higher dosage, starting at 50mg, compared to 2.5mg of letrozole. Additionally, Clomid can assist male-factor infertility by improving sperm count and motility. Other uses for Letrozole Letrozole is a medication used in combination with surgery, chemotherapy, and radiation for the treatment and prevention of hormone-receptor positive breast cancers. It may also be employed as a first-line treatment for early-stage breast cancer for those who have gone through menopause or have been treated with tamoxifen for a minimum of five years. As fertility specialists continue to explore treatments beyond Clomid, which has been used for over two decades, there is an increased hope for those experiencing infertility. Through understanding the effects of different medications on the body, doctors and researchers can identify the best course of action to help someone conceive and have a healthy pregnancy and birth. If one method of treatment is unsuccessful, individuals can still explore other potential options that may offer similar, or even greater, rates of conception. It is important to discuss any questions or concerns you may have regarding treatment options with your doctor. Every person's journey to fertility is unique and should be approached with an open mind. Should you require any support, please do not hesitate to reach out. We are here to assist in any way possible.
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