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How To Take Letrozole For Fertility

How To Take Letrozole For Fertility

You will take two tablets (5 mg total) of letrozole daily, starting on Cycle Day 3 (the first day of menses is Cycle Day 1) and ending on Cycle Day 7. You can take the two pills together, and the time of day is not important

Letrozole for Superovulation

Letrozole is an oral fertility medication.  It can be used to induce ovulation in women who don’t ovulate, or to produce multiple eggs in women who already ovulate on their own.  It is an alternative medication for those who have experienced significant side effects with clomiphene citrate (hot flashes, mood swings, thinning of the endometrium).  The two medications are comparable in terms of ovulation rates, pregnancy rates and risk of multiple pregnancies.

How does letrozole work?

Letrozole is typically taken once a day for five days. When you take the drug, it stops androgens in your body from converting into estrogen. When estrogen is blocked, the pituitary gland gets a message that it needs to produce follicle-stimulating hormone (FSH), which stimulates the ovary to produce an egg. Some women on letrozole actually release more than one egg because they produce more FSH while on letrozole than a woman produces when ovulating naturally.

Who should try letrozole?

Before prescribing letrozole, your doctor should do a consultation and testing, explains Librach. The specific tests vary from case to case, but they can include sperm testing, blood hormone level testing and checking for blockages in your fallopian tubes.

If you’re diagnosed with an ovulatory disorder like PCOS and your doctor decides that letrozole is a good fit for you, they will likely have you try it for up to six months, says Bob Casper, a reproductive endocrinologist and senior scientist at the Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital who led the team that worked out the drug’s use for ovulatory disorders.

Side Effects

Letrozole works by reducing estrogen levels in order to stimulate ovulation. Low estrogen levels of any sort can cause a woman to have symptoms. Those most commonly seen with Femara use include:

  • Fatigue
  • Dizziness
  • Headache
  • Bloating
  • Hot flashes
  • Night Sweats
  • Blurred vision
  • Upset stomach
  • Breast pain
  • Difficulty sleeping
  • Spotting or unusual menstrual bleeding

Clomid vs Femara for infertility?

We've been trying to conceive for approx 1 year. My gyn doesn't think I'm ovulating and suggested putting me on Clomid. I'm very leary of Clomid because of the risk of multiples. He suggested Femara (letrozole). Don't know anything about this drug. He said one study suggested an increased risk of birth defects when using this drug, but he said the study was proven false. It still makes me nervous. Also said not as much is known about Femara because it's only been used for fertility for 10 yrs. Does anyone have any experience with these drugs.

How are Femara and Letrozole Used as a Fertility Drug?

Femara to Induce Ovulation

When the enzyme aromatase is inhibited by the letrozole medication, estrogen levels are suppressed in young women. This results in the brain and pituitary gland increasing the output of FSH (follicle stimulating hormone).

In women that have polycystic ovary syndrome or anovulation (a problem with ovulation) the increase in FSH hormone can result in development of a mature follicle in the ovary and ovulation of an egg. Doctors call this process "induction of ovulation".


As the 12.5 mg/day group was by far the largest, and due to the absence of literature addressing this dosage, univariate analysis was performed for this group. The overall mean for predicted ovulation number was 2.16 per cycle. The data were then filtered to remove nonindependent trials; analysis of only the first 12.5 mg dose for a given patient resulted in a mean predicted ovulation number of 1.91. Both data sets were analyzed for normality with no indication to reject the null hypothesis of the data being normally distributed (data not shown). Linear regression was then performed to determine if this value was altered significantly by age, BMI, or day-3 serum FSH level. Increasing BMI was significantly related to a decrease in predicted ovulation number for all 12.5 mg/day cycles (P = 0.002) and first 12.5 mg/day cycles (P < 0.001). None of the other variables had significant impact upon the outcome.

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