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letrozole ovulation calculator

What is ovulation?

Ovulation is when your body releases one of your eggs into your fallopian tubes so it is available for sperm to fertilize it.

If you don’t ovulate, there is no egg for the sperm to get introduced to…

No egg for the sperm? You will not get pregnant.

The kicker is that even if you are ovulating, you may not get pregnant. There are just a handful of days in each cycle right around ovulation that you can get pregnant.

How do aromatase inhibitors work?

Estrogens are produced by the conversion of androgens through the activity of the enzyme aromatase. Estradiol (E2, the relevant estrogen) produced by the ovary in turn, exerts a negative feedback effect (inhibits) on follicle stimulating hormone (FSH) release from the hypothalamic-pituitary axis (in the brain).

When Letrozole blocks aromatase activity, there is a drop in E2 levels and release of the hypothalamic/pituitary axis from estrogenic negative feedback. The resultant increase in FSH secretion stimulates growth of ovarian follicles.

Because AIs do not deplete estrogen receptors, as does clomiphene citrate, normal central feedback mechanisms remain intact. As the dominant follicle grows and estrogen levels rise, normal negative feedback occurs centrally, resulting in suppression of FSH and atresia of the smaller growing follicles. A single dominant follicle, and mono-ovulation, should occur in most cases.

How Does It Work?

The most basic ovulation calendar will ask you for the date of the first day of your last period, and the average length of your menstrual cycles. If you don’t know, most calendars will suggest you write in 28 days. This is considered the average. (A normal cycle can range from 21 to 35 days.)

Then, the calculator will usually assume a luteal phase of 14 days. The luteal phase is the time between ovulation and the first day of your period. A normal luteal phase can be as short as 10 days or as long as 15. The nicer ovulation calendars will ask how long your luteal phase is. If you know (from previous basal body temperature charting) how long yours is, be sure to include that information.

Why is Letrozole not used routinely?

It is not approved for ovulation induction by the FDA. It is therefore used "off-label" in specific circumstances only.

Clomiphene citrate has now been used clinically for more than 40 years and remains the most common drug used for ovulation induction.

There is a controversy concerning birth defects with the use of Letrozole. The drug maker (Novartis) has sent a letter to physicians discouraging the use of Letrozole for ovulation induction. Recent data suggest that these fears are unfounded. This will be discussed in detail in my next blog.

What are the signs that show that I am not ovulating?

One must know that regardless of the fact that you ovulate or don’t ovulate, your body’s uterine lining breaks every month and you have your menstrual cycle. The signs that your body is not releasing an egg are:

Heavier or lighter menstrual bleeding for the last few periods

Extremely painful periods

Irregular periods

Sudden changes such as weight gain, drop in sex drive, growth of body hair or development of acne

Effectiveness of Femara

There is increasing evidence that Femara may be more suitable for women with PCOS suffering from ovulation problem.

According to a 2014 study published in the New England Journal of Medicine, 27.5 percent women with PCOS who took Femara had a successful birth compared to 19.5 percent who took Clomid. The same study demonstrated advantages in several other areas:

The ovulation rate was higher with Femara (61.7 percent) compared to Clomid (48.3 percent).

There was a higher birth rate among obese women with PCOS who used Femara.

There were fewer multiple pregnancies in women who used Femara (3.2 percent) compared to those who used Clomid (7.4 percent).

The risk of pregnancy loss, meanwhile, was more-or-less the same for both drugs (Femara 31.8 percent versus Clomid 28.2 percent).

Similarly, a 2015 study published in PLoS One concluded that there was no significant difference in the overall rate of birth defect among children born to mothers who conceived naturally or those who used Femara or Clomid.

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