Struggling to get pregnant can be heartbreaking. Fortunately, modern medicine has given us many tools to help couples conceive, including medications. One of these treatments is a medication called letrozole, also known by its brand name, Femara. In this article, we’ll take a deeper look at letrozole for fertility, how it works, and things to consider when taking letrozole.
How Letrozole Works
Letrozole is an oral medicine initially used in breast cancer treatment. However, it also induces or enhances ovulation, so it’s also used as a fertility treatment.
Letrozole promotes ovulation by blocking a substance in your body called aromatase. Blocking aromatase ultimately lowers the amount of estrogen in your body. When the estrogen decreases, your body secretes hormones that help ovulation induction.
Letrozole’s mechanism of action sets it apart from other common infertility medications, such as Clomid. And, unlike some fertility medications, letrozole is eFDA-approved as a breast cancer treatment rather than a fertility treatment. However, the medication is widely used safely and effectively to increase the chances of getting pregnant.
Uses of Letrozole for Fertility
Letrozole is a common treatment for infertility caused by polycystic ovarian syndrome. It can also be helpful for other ovulation disorders or in cases where the cause of infertility is unknown.
Polycystic ovarian syndrome, or PCOS, is a common cause of infertility in women of reproductive age. PCOS is an endocrine condition that affects certain hormone levels, resulting in irregular or absent ovulation. Since letrozole impacts estrogen levels and stimulates ovulation, it can be a beneficial option for PCOS-induced infertility.
In general, ovulatory problems frequently cause infertility, with as many as 25% of people experiencing infertility due to issues with the process of eggs releasing from their ovaries. Letrozole is useful for such ovulatory disorders because it can help promote ovulation.
Letrozole is also an option for people who experience Clomid resistance. Clomid, or clomiphene citrate, is another common oral medication used for infertility. It works by affecting certain hormones in the body, which leads to stimulating your ovarian follicles to mature their eggs. However, Clomid doesn’t work for everyone. So letrozole can be used alongside Clomid as another way to increase the chances of conception.
Dosage and Administration
Patients can take letrozole by mouth. The tablets come in 2.5 milligrams (MG) dosages. When used as a fertility treatment, you will likely take a higher dose of the medication. Typically, you’ll take letrozole 2.5, 5, or 7.5mg daily for five days.
Your doctor will guide you on when to take letrozole, but you’ll likely start the course of medication somewhere between the second and sixth day of your menstrual cycle. You may also be advised to have intercourse at some point after the five-day regimen.
Letrozole and Intrauterine Insemination (IUI)
In some cases, intrauterine insemination (IUI) is used in conjunction with letrozole to increase the odds of becoming pregnant. IUI is when sperm is placed directly into your uterus during your time of ovulation. This bolsters your chances of pregnancy.
Letrozole and In Vitro Fertilization (IVF)
In an IVF cycle, letrozole may be prescribed to help regulate the menstrual cycle and improve the chances of successful ovulation and subsequent fertilization. It can also help improve the response to gonadotropin medications, which are commonly used during IVF treatment.
Your fertility specialist will determine if letrozole is an appropriate treatment option for you based on your individual circumstances and medical history. They will monitor you closely throughout your IVF cycle to ensure that you are responding well to the medication and to adjust the dosage as needed.
Like any medication, some people experience side effects from letrozole. These reactions are related to the drop in the hormone estrogen induced by the medication. Side effects may include:
These side effects are generally mild. You can manage them with simple steps like keeping your room cool while sleeping, using ice packs for joint pain, taking letrozole with food, and avoiding spicy foods and caffeine. Additionally, avoiding driving while on the medication is best if you experience fatigue or dizziness.
More serious side effects of letrozole include blurred vision or more severe occurrences of the side effects mentioned above. If these happen, seek medical help right away.
One more potential side effect of letrozole is a condition called ovarian hyperstimulation syndrome. This is when your ovaries become overstimulated, leading to bloating, diarrhea, and even chest pain. If you’re ever concerned about any symptoms or side effects while taking letrozole, talk to your doctor.
Success Rates of Letrozole
So how successful is letrozole for infertility?
Statistics and studies show that letrozole is often quite effective for infertility. One study found that 27.5% of women who took letrozole achieved a successful birth. Other studies suggest that compared to women who took Clomid, women who took letrozole had higher rates of ovulation, pregnancy, and live birth.
Research shows letrozole is generally more effective than Clomid in people with PCOS-related infertility. However, for those with unexplained causes of infertility, there does not appear to be a difference in the effectiveness of these two medications. Similarly, the live birth rates are about the same between the two.
Gonadotropins are another common treatment for unexplained fertility. Compared to this form of treatment, letrozole appears to have a somewhat lower rate of live births. Gonadotropins are associated with the highest risk of higher-order multiples and are therefore used sparingly for ovulation induction.
Risks and Precautions
Letrozole is generally safe to take and doesn’t raise the risk of having a baby with birth defects. However, you should avoid taking it if you’re currently pregnant, as it can harm the unborn baby. It’s also important to consider any other medications you may be taking and discuss these with your doctor, as letrozole can interact with certain medications.
For example, if you take hormonal birth control, herbal supplements, vitamins, or any medication that also affects estrogen levels, be sure to let your doctor know.
Using Letrozole For Fertility
In summary, letrozole could be a good treatment option if you live with PCOS or another ovulation disorder and you’ve been experiencing infertility.
Letrozole may not be the best option if you take other medications that might interact with letrozole or affect your hormonal levels. Letrozole is safe for most people, but it can come with some side effects, which are typically mild and hormone-related.
If you’re considering letrozole, talk to your doctor or schedule a consultation with ORM Fertility. Our experienced team of caring reproductive specialists can discuss letrozole and other treatment options and put together a personalized treatment plan for you. Whatever your situation, ORM Fertility is dedicated to helping you grow your family.