#2

RE emailed me back....I'm still confused. What would you do???

My RE emailed me back and all he said was this below in blue. WHAT WOULD YOU DO?

"This cycle is obviously not going well, so I don’t recommend we try to salvage this one.


"If you would like to move on to the next step, you can start the provera right away. I recommend you try a higher dose of Femara next month (7.5 mg). If that doesn’t work, we need to meet for a follow up to come up with a new plan.
(starting provera ends this cycle and moves us on to the next. I take it for 10days and then AF usually comes 2-5 days later for me.) I have no idea if I'll O this month and if I don't, I may not get AF, since I'm PCOS and very irregular and then would have to take provera days and days from now which could make this into a 50day cycle.....try and see or move on...what to do?. too bad he didn't answer my questions.)

Feel so lost and confused. I remember feeling like this in November 2008 on my 2nd dose of Clomid when I didn't respond. I then went on to take one more dose of clomid, where I also didn't respond and then the next month we tried femara and got pregnant with V. I wish I didn't have this feeling again. It's hard to know if I should scrap this cycle or not. It's also hard to think that femara may not work for us again. Why would it stop working??? Hopefully my body just needs more time. I really need my body to work and let femara work for me. I'm really afraid of injections with my PCOS. I'm so afraid of multiples.....Why is this so hard and so easy for so many people??!!! I'm tried of this, so tired of it. I just want to be pregnant with another baby.

I think we are going to get a provera prescription and scrap this cycle.....but then on to 7.5mg of femara makes me worry about multiples but I'm going to work hard not to worry and simply move on, pray, eat well, and think + for next month!

Kitty
Posted by Kitty at 3/25/2012 08:29:00 PM

1 comment:

Lauren said...

If your RE won't work with you to salvage the cycle, then there is no sense in not taking the provera.

As for the rest of it, I definitely understand your concern about multiples. Femara has a lower rate of multiples because it usually only produces one egg (but the rate of success is still the same as Clomid, which usually produces multiple eggs). However, on the higher doses of Femara there is a pretty high pregnancy rate. Because cycle conditions are more favourable with a Femara cycle than with a Clomid cycle, the eggs are more like to be fertilized and implanted.

My RE studied their first 100 Femara pregnancies to look at this. I'm going to go try and find it for you.

Okay, I can't send you directly to the article because it's a PDF document, but go to this page:

http://www.soft-infertility.com/cycles.php?scID=3

Click on 'Letrolzole (Femara)'

And scroll down to page 9 where it says Side Effects. It talks about the twin rate on higher doses of letrozole.

Unfortunately. 7.5mg for 5 days wasn't looked at in the study. I think that's a really high dose.

I have read somewhere else in my clinic information that if you're having trouble with endometrial thinning that taking more femara earlier in the cycle (and finishing it sooner) can help with this.

Also, you COULD try 5mg of Femara CD3-7, and add just a few injections. Like, 75IU on days 6, 8, and 10. That's not much, but it could be just enough to give the follicle sustained stimulation and to help with your lining. Taking that few injections probably won't increase the risk of multiples much, because the follicles that are going to mature will already be induced earlier in the cycle. Do you understand what I mean? If you don't take the injections until day 6, and just take a low dose every other day, it won't cause more follicles to be induced, it will just help the one or two that WERE induced to grow.

My very first cycle I took 7.5mg Femara on Day 3, 50mg of Clomid on CD 3-7, and 75IU Bravelle CD 6, 8, 10 (and then 11 and 12). When I went for my CD 11 u/s I only have ONE 13mm follicle. Just one small one, with all those drugs. I took more injections to help it grow (and it did), but I still only had the one.

Sorry, this is long. I don't want to confuse you more, I just want to give you another option. I think staying with 5mg of Femara and adding just a few injections (day 6, 8, and 10, or maybe even just 2 days) would probably have a lower chance of multiples than taking 7.5 mg of Femara for 5 days.

March 25, 2012 at 9:52 PM

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