Me and my partner have been TTC for over 2 years (for 3 years before this we weren't on any birth control and were casually TTC). We have recently seen a fertility Dr where I have been diagnosed with PCOS and my partner has been diagnosed with a low sperm count (initial test was 11mil (0% NF) and repeat was 6mil (2%NF)).
We have been offered the decision of if we want to try Letrozole for 6 months, and then if that doesn't work, we can move on to trying IVF. Or we can skip Letrozole and start IVF immediately.
We are really struggling with this decision as our fertility Dr said there is a 'slim' chance of Letrozole working in our situation but looking online I'm struggling to find any information on people in our situation and if Letrozole worked for them. Of course, IVF is a gruelling process to go through so if Letrozole might work then it may be worth it to hopefully avoid the pain of IVF but if the chance is so slim, is it worth possibly wasting 6 months to just end up doing IVF anyway?
If the chance is so slim then it just feels like we are wasting our time trying Letrozole but as I can't find much information online about trying Letrozole with PCOS and low sperm count, we are struggling to make a decision.
If anyone has any insight or advice, we would be extremely grateful.
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fingerscrossed123
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Hi fingerscrossed, we had a similar situation with low sperm count, we were offered IUI first or go straight to IVF. Sperm numbers were similar. With my own further research it looked like IUI chances were next to nothing so I'm not even sure why they offered it - maybe just to give us some kind of choice. We decided to go straight to IVF. IVF really hasn't been as physically taxing as I thought, and it feels so much better to be doing something that may realistically lead to a child in the near future! If you have PCOS (I have PCO but not PCOS) you are likely to get a good number of eggs to work with. I'm not sure if you are thinking of private or NHS, but NHS waiting lists are long so better to get on them sooner.
Everyone is different though and it depends on so many factors - age, whether you feel you have 6 months to spare, finances, ease of juggling IVF with work etc, but for us, straight to IVF was definitely the correct choice. We've had a few hurdles with low fertilisation due to sperm quality, so I really don't think IUI would ever have worked. We are currently in the TWW after our second transfer 🤞
Forgot to say, sperm numbers were around the 5mil mark but less than 1% normal and hardly any progressive motility. So in our case that was why IUI would be very unlikely to work.
Hi, we were offered clomid or IVF - I have PCOS and we’ve no male factor. We chose clomid and I massively regretted it. They have similar success rates (I think Letrozole is very slightly higher) and unfortunately both are low. I think I calculated it at about 11% for our circumstances compared to IVF at 30% but only after we decided to come off the ivf waiting list to try it 🙈! We wasted a year on it but obviously I’m biased as it didn’t work for us! I’d just be careful to look into the odds based on your circumstances before deciding, you’re likely to have a much greater chance with ivf. Also I’d say drs seem to push ovulation induction as much more gentle but the monthly disappointment took a toll on me mentally. Xx
I wasted 6 months with Clomid (same as Letrozole) and we did not even have problems with sperm, so I would definitely recommend you go straight into IVF. You might be offered ICSI because of male factor, which is even more specific than regular IVF. Good luck xxx
Hey - we used Letrozole and Cyclogest while we were waiting for our FET and got BFP after 3 months of trying.
Only 5 weeks pregnant so far, so lets see.
We fully intended to go to the FET. But ot felt good to try in between sessions naturally.
We have no known issues with sperm or with me.....well, they haven't found anything. But I am old 🤣 42....
We didn't even know about Letrozole and were intending to go straight to FET, but had to transfer the embryo from another clinic so was just using up the admin time.
When we tried initially our consultant said don't waste time on anything else but IVF.....
But I don't know your age or the waiting time for IVF....
Hey, we also tried Letrozole and Clomid (several rounds), and I had no luck either. I've got PCOS and my DH has low numbers / low morphology. I've since found I have more issues so I don't think it would likely have ever worked for us. Best of luck to you xx
Hello fingers crossed. I have PCOS but partner's sperm is fine so slightly different situation, however we were encouraged to do 10 months of clomid/letrozole and timed intercourse. We were living in the Netherlands where they aim to be as minimally invasive as possible. It was ok for a few months, I had a regular-ish cycle but I started to respond less successfully to clomid and found I didn't respond at all to letrozole. It was pretty traumatic going through the cycles where I started to not respond to be honest. We back moved to the UK and did two IUI rounds with clomid then moved to IVF.
I'd say the pros are that it is less invasive and you're trying to conceive 'naturally' at home which is good psychologically for most people, and you get a 'chance' more often than with IVF where a single shot at being pregnant can take 3+ months if you do a freeze all cycle which you're likely to with PCOS. I started IVF at the end of April and I'm due for embryo transfer on Monday. It's a long ole time to wait.
Cons are that there are still side effects of the drugs, and you still have scans etc to go to which mean holidays and living life is tricky (although not quite as tricky as IVF!). It also was a year of trying with no progress whatsoever which drained our emotional resources so we went into IVF feeling already exhausted. I found that the rounds of timed intercourse really affected our sex life too, and only now doing IVF are we starting to get that back.
Final thought is that something that drove us to be ok with IVF was the extra information we'd get about what's going on. Timed intercourse presumed that the only issue was PCOS but our first IVF round we had a low fertilisation rate (only 4/12 mature eggs fertilised) which probably contributed to why we've never had a positive in 2 years of trying. Not to worry you even more, but I think it's important to have that info, and had I known that I think I would've started IVF/ICSI last year.
Good luck with making this choice, none of this is easy!
I was diagnosed with PCOS but I have always had periods every month. Have you? If so, then you won’t generally have a problem on your side and definitely not for IVF. Personally if it were me I’d go straight to IVF and not waste time. Especially if you’re not having periods as actually they can probably gather some good eggs from your ovaries. In my case a medicated FET didn’t work but a naturally modified one did (because I was having periods every month). During IVF my partners sperm had improved after not being right for over a year. It’s your decision but I would go straight to IVF if it were me.
Similar situation here, but we’d been TTC for a few years so I was told to skip Clomid and was put straight on Metformin to regulate my cycle and then (once lockdown lifted) straight into IVF.
1st cycle didn’t take, 2nd cycle was ectopic and 3rd cycle resulted in my 5 month old son.
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