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letrozole pregnancy

letrozole pregnancy


Letrozole is used frequently as an infertility treatment. It is a recent addition to the drugs that are currently used for fertility treatment. This medication is a helpful aid to induce an egg to develop and be released in women who are not ovulating naturally; this is known as ovulation induction. Fertility drugs can also be utilized to increase the probability of pregnancy in women who are already ovulating.

Clomiphene Citrate or Serophene  has been the drug of first choice for both ovulation induction or superovulation for several years. By and large, letrozole-300x135it has been a relatively effective medication. Clomid is known to last longer in the body and so may have an adverse effect on the cervical mucus and uterine lining.

Pregnancy rates with letrozole are similar to those seen with clomiphene citrate and are lower than the pregnancy rates seen with gonadotropins. Older patients will have a reduced chance of success than younger patients.

What is Femara - Letrozole?

Femara (generic name is letrozole) is an oral drug which can be an effective fertility treatment for women with ovulation problems, or for those with unexplained infertility.

This medication is in a class of drug called aromatase inhibitors. Femara has mainly been used to treat certain cases of breast cancer.

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.

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

Good to know

Clomiphene has been used for over 40 years without any evidence of an increased risk of birth defects. It is unclear whether clomiphene could increase the risk of ovarian cancer or breast cancer – as a precaution most experts recommend that clomiphene should not be used for more than twelve months.

Letrozole was originally designed to help treat breast cancer and it is not yet registered to treat infertility in New Zealand. Because of this, we will ask you to sign a consent form.

Ovarian Cysts

Due to the ovarian stimulation caused by taking Femara, it is possible even though it’s rare, for a woman to develop ovarian cysts after taking the medication. An ovarian cyst is a buildup of fluid inside the ovary and may occur when one or more eggs mature but fails to release into the fallopian tubes. Cysts are more common with other fertility treatments, though they are still a possibility with Femara. They will usually resolve without treatment. (Reference 3)

Have Other Studies Confirmed a Letrozole – Birth Defects Connection?

No. Since that preliminary report, other studies have shown no increase in birth defects. Mitwally and co-workers in 2005 compared the outcome of pregnancies achieved after letrozole and other ovarian stimulation treatments with a control group of pregnancies spontaneously conceived without ovarian stimulation. There were 394 pregnancy cycles in 345 infertile couples (63 pregnancies with 2.5 mg of letrozole alone or with gonadotrophins, 70 pregnancies with 5.0 mg of letrozole, 113 pregnancies with clomiphene alone or with gonadotrophins, 110 pregnancies with gonadotrophins alone and 38 pregnancies achieved without ovarian stimulation). Pregnancies conceived after letrozole treatments were associated with similar miscarriage and ectopic pregnancy rates compared with all other groups.

In a large retrospective study conducted in five fertility centers in Canada (Tulandi et al., 2006), the incidence of congenital malformations among children of mothers who conceived with CC (n = 397) or with letrozole (n = 514) treatment for infertility was assessed. Overall, congenital malformations and chromosomal abnormalities were found in 14 of 514 newborns in the letrozole group (2.4%) and in 19 of 397 newborns in the CC group (4.8%). The major malformation rate in the letrozole group was 1.2% (6/514) and in the CC group was 3.0% (12/397). In addition, the rate of all congenital cardiac anomalies was significantly higher in the CC group (1.8%) compared with the letrozole group (0.2%) (P = 0.02).

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