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Letrozole
Letrozole is a medicine that adjusts the hormone cycle that makes the egg to ovulate and get pregnant.
Letrozole is not the actual hormone to stimulate making an egg, it is a medicine which makes your body
MAKE MORE of the hormone responsible for making an egg. There is a 10 % of conceiving TWINS
while taking clomiphene. Otherwise, the side effects of Letrozole are the “feelings” of a crampy menstrual
cycle. There is a RARE but serious complication of swollen ovaries called ovarian hyperstimulation
syndrome (OHSS).
All women trying to get pregnant should take 400 micrograms of Folic Acid, daily.
Directions:
1. Each cycle begins with a period. The period can come “naturally” or it can be “made” by taking
medroxyprogesterone acetate, 10 mg each day for 10 days. The period-like bleeding after MPA
usually starts between 3-7 days after finishing all 10 days of pills.
2. DAY ONE is the first day of bleeding… and you should take a home urine test on DAY ONE. If
the urine test is negative then CALL Becky (265-7745) or contact me through email OR phone
(575-4519). We will then call your pharmacy to give a prescription for Letrozole.
3. Take the Letrozole pills each day: Days 3, 4, 5, 6 and 7. The starting dose is 2.5 mg (one pill).
4. Have SEX – days 9 to 19. Every other day intercourse OR every day intercourse.
5. Wait until day 35… based on DAY ONE, which is the first day of bleeding.
THREE THINGS MAY HAPPEN between day 21 and day 35:
1. NO PERIOD by DAY 35…. Take a urine pregnancy test on day 35…. If the pregnancy test is
negative AND you did not get a period THEN we will increase the Letrozole dose by on pill, 2.5
mg. The maximum dose is 12.5 mg a day, or FIVE PILLS.
2. You get a period…. This means the dose of Letrozole is most likely working, but you did not get
pregnant this cycle. You can “count” the first day of the period as Day ONE, and begin another
cycle at the same dose. We may schedule a “day 21” progesterone level blood test. A
progesterone level over 15 confirms ovulation.
3. No period and a POSITIVE URINE PREGNANCY TEST… Yeah!!! We can schedule an
ultrasound on day 49, to make sure the pregnancy is developing correctly.
 PROGESTERONE SUPPLEMENTATION – OPTIONAL – you may choose to use
vaginal progesterone, Crinone 8 percent, 90 mg, into the vagina, until 12 weeks of
pregnancy.
When is the NEXT APPOINTMENT:
You need to have a brief examination of your ovaries BEFORE starting another cycle. This exam can be
done any time after Day 26. The examination is intended to detect enlarged ovaries, and prevent OHSS. If
one of the ovaries is larger than 5 centimeters I will recommend delaying the next cycle for one month, to
allow the ovary to shrink back to normal size.
How long does it take to get pregnant?
FIRST you have to ovulate while taking the Letrozole: this means you will get a period between days 25
and 35. We begin at 2.5 mg each day, and increase by 2.5 mg each cycle until you ovulate. It may take 2
or 3 cycles before you ovulate. Most couples will get pregnant within 3-6 ovulatory cycles on Letrozole.
Once you are ovulating on Letrozole we can then discuss your progress AND what more we may need to
do to help you get pregnant.
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