Back on the TTC wagon

14 Sep

So this will be our first attempt since April doing  TTC. Today is the first day of my cycle and I am SUPER nervous. I wish I could explain how I am feeling on the inside. The last time we went to the doctor she discussed us using the medication Letrozole (better known as Femara). I am super conflicted about this decision. Should I take it or shouldn’t I take it? 

These are my thoughts…

This is my fourth attempt I don’t think I need medication. 

This is my fourth attempt maybe I do need medication. 

This is going to cost a lot of money. 

I’m going to waste a lot of money if I don’t try it with medication. 

But what about the studies? 

Many physicians will not prescribe letrozole because of concerns from a 2005 report from some Canadian fertility doctors suggesting a possible higher incidence of birth defects in pregnancies from using letrozole.

  • This study was from a small group of pregnancies and the study has been severely criticized for having an improper design
  • Femara is known to have a short half-life in the bloodstream and is given early in the menstrual cycle – several days before a fertilized embryo is present.
  • It is believed that the drug has cleared from the system before the egg is fertilized. Therefore, it is puzzling as to how the drug could cause birth defects.
  • The manufacturer of letrozole sent a warning to doctors saying there are reported birth defects in children born after mothers took Femara. This may have been due to liability concerns (lawyers and financial risks for a drug company) rather than real science.
  • The manufacturer of the drug has apparently not filed for FDA approval to use it for infertility. However, physicians often use medications in an “off label” way. When the off label use is safe and effective it is perfectly legitimate. Taken from:

But what about the women I know who used it and have healthy children. 




7 Responses to “Back on the TTC wagon”

  1. Flying Mermaid September 14, 2012 at 8:42 pm #

    Wow, that’s a hard and scary decision!

    This may not be relevant, as it was nearly 60 years ago, but I was a DES baby, meaning my mother took that drug when trying to conceive me. Later on, all these horrors came out about cancer in those babies, so that I had to have pelvic exams every 6 months starting years before I was sexually active.

    But 20 years or so after that, when all the affected babies had long since grown up, they decided it wasn’t such a big deal, after all.

    But this is not my vote for using the drug. By nature I’m opposed to hormonal and body-changing drugs for anyone, but I am not opposed to medical progress. Besides, you’ve been on hormones forever, with no bad effects (right?), though whether that creates a pro or con attitude, I’m not really sure.

    Hell, BeeBoo, wish I could be more helpful, but I’ll stop talking out my ass for now…..

  2. X September 14, 2012 at 8:52 pm #

    Hey, I recently started reading here. We did use letrozole; my RE cited studies that showed its effectiveness and, in a low dose, believed it would make my cycles more “clear” without producing extra follicles. I am not a fan of medications at all (even for headaches most of the time) but after doing research similar to what you have done, I came to the conclusion that for me, I was not concerned. A good summary of the use of letrozole and its effectiveness versus Clomid is here:

    That being said, I’m not convinced the letrozole really was what helped me get pregnant even though I used it the cycle I got pregnant. I am far more convinced that in the cycle I got pregnant, the timing was way better; this is evident in my temperature charts and use of OPKs as well as the ultrasounds we took. Unless there is strong evidence otherwise, I don’t think it’s a waste of money to go unmedicated (though I remember having those exact same thoughts, so what do I know?!)

  3. tinyblossom September 14, 2012 at 11:32 pm #

    I have a number of friends who conceived using Femara and they had no issues at all. Some thought it was even more effective than Clomid. I did use it for a few cycles and as I recall, it didn’t thin out my uterine lining as much. My RE was very comfortable prescribing it and I really trusted her medication managment decisions. As far as using medications, after three unsuccessful natural cycles, it made more financial sense for us to use meds to increase my chances of conception because each attempt was pretty expensive. After a few failures, we wanted help, especially because we were using frozen sperm. Although I initially didn’t want to, I got over the drug thing pretty quickly when I realized that I had a short luteal phase and I really needed some extra support (progesterone, an extra egg here and there). Good luck with your decision!

    • weddedwife September 16, 2012 at 12:08 pm #

      I know that my progesterone levels are low but the idea of the medication itself is a little scary. My heart tells me to do it, that there is nothing wrong with it. Then 10% of me says don’t its expensive try another natural cycle.

      We are using frozen sperm and I don’t want to be poked and examined forever. The last attempt really threw me for a lupe and I’m just trying to make decisions based on logic and not emotions.

  4. nobodysperfick September 15, 2012 at 12:20 pm #

    We used femara on our second cycle, which is when we conceived. With all of the extra monitoring to check for mature follicles, it felt like we were literally bleeding money, but I truly feel like it was the femara that made the difference in getting the timing spot on. No matter your decision, I’m thinking positive thoughts for you!

  5. conception 2 birth September 15, 2012 at 4:10 pm #

    I am a TTC person too, and I have read all the study and did further investigation and it was 2 women in the study that was taking femara because they had cancer and didn’t know they were pregnant. The Candian study wasn’t on pregnant women but for cancer study and 2 women just happened to get pregnant while in the study. That’s why several respected medical study will not use that study results.
    I would say you should do what your body and heart is telling you to do… I wish you too all the luck in the world!!

  6. glamcookie September 15, 2012 at 7:27 pm #

    I never used Femara, but I did tries with Clomid and ended up doing both IVF and FET so I’ve used a ton of fertility related meds. My baby boy is healthy as can be, but I remember having some reservations about all of these meds as well. It’s a tough decision.

    If it helps at all, the 2 REs I used considered there might be an issue if you did 6 cycles and none of them resulted in a pregnancy.

    Good luck, Mama!!!!

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