When a couple has tried to conceive for more than one year, the first step is to seek medical intervention. The fertility expert subjects the couple to tests to find the exact cause of infertility. The following test will be done on the man:
- Sperm and semen analysis
- Physical exam
- Hormone evaluation
- Genetic testing
- Anti-sperm antibodies
Infertility isn’t limited to a man alone, thus a woman will be subjected to the tests below:
- Blood tests
- Chlamydia test
- Ultrasound scan
The results of the outlined tests above done on the woman may indicate all is not well, for example, the hormones are not working as expected, but the outcome of your partner (male) may be okay. What’s next? The outcome may cause panic and lead to stress. Bear in mind stress may lower your chances of conception, take it easy and let the doctor determine the action to take. Ovarian stimulation will be the next course of action, a couple having difficulties causing a pregnancy, yet the test finds no reason (they have unexplained infertility). In ovarian stimulation, hormonal medications such as Letrozole for fertility are prescribed to encourage ovulation; particularly if the female is less than 35 years of age. Thus, Letrozole infertility success rate declines with age. Older women above the age bracket will go through in vitro fertilization or other reproductive technologies as recommended by the doctor.
How Does the Drug Work for Fertility?
Before tackling the issue of how the medication works, what is Letrozole? It is a prescription drug in the form of a tablet and you may purchase it in the name of Femara which is the brand name. It’s approved by the FDA for the management of cancer and preventing it. Additionally, it is popular in fertility centers and falls under the category of medications known as aromatase inhibitors; the starting dose is Letrozole 2.5 mg once daily from the fifth day to the ninth day of the monthly period, although the fertility specialist may prescribe a higher dose of the drug such as 5 mg or 7.5 mg every day. Some doctors prefer the patient to take this medicine for infertility from the third day to the seventh day, whichever the case, what’s crucial is consistency for the five days for it to be effective, whether you start on the third or the fifth day. The physician may direct you to take one to three pills per day or more depending with infertility.
Take note, Letrozole fertility therapy is an off-label use, though it has been used for a considerable time to deal with infertility. Thus, if used for this purpose, a specialist physician should only administer fertility drug Letrozole. The medicine works in a similar manner as Clomid to stimulate ovulation; Clomid is in the first line of medication for infertility, whereas Letrozole comes in second. Clomid attach to estrogen receptor in your hypothalamic-pituitary area, thus a reduction of estrogen in the body; it has an anti-estrogen effect. Letrozole for fertility binds on the aromatase inhibitor, so estrogen production is inhibited; aromatase enzyme changes androgens to estrogen. The body sends a signal in both cases to the pituitary gland to produce higher levels of hormones responsible for ovulation stimulation like follicle stimulating hormone. Estrogen hormone regulates the production of the excess hormones for egg production stimulation, a decrease in estrogen levels triggers production of these female hormones.
Elevated levels of the female hormones that lead to egg production enable this drug to work, thus increasing fertility. The medication prompts egg production from the ovaries, the egg is crucial to meet with a sperm resulting in conception. Increased egg production for women on Letrozole raises their chances of becoming pregnant. The drug is used as an alternative to Clomid because it has negative impacts on the cervical mucus and the endometrium; less cervical mucus is produced making it harder for the sperms to get to the fallopian tube to fertilize the egg. Furthermore, Clomid interferes with the development of the endometrial lining, making it difficult for embryo implantation. However the medication fertility success is almost the same to Clomid, the significant difference is that Letrozole has a better side effects infertility profile when compared to the unwanted effects of Clomid therapy.
Remember, if a woman ovulates regularly on her own, using Letrozole leads to the development of many follicles and release of multiple eggs, this is known as superovulation or controlled ovarian hyperstimulation. In a natural menstrual cycle, the release of many eggs increases the chance of conception when compared to the release of a single egg.
Letrozole and Infertility in Women with PCOS
In the above discussion, it is evident that Letrozole and fertility are associated; the drug is used to bring back fertility and has worked for many, particularly women living with PCOS. Letrozole is effective than Clomid in patients with polycystic ovary syndrome to attain a pregnancy. PCOS affect women of childbearing age and perhaps a leading cause of infertility in women. Females with PCOS have excess male hormones which are linked to infertility since they interfere with ovulation resulting in irregular periods. Letrozole in infertility treatment with females with PCOS works as explained previously; levels of estrogen are suppressed when Letrozole inhibits the aromatase enzyme and the pituitary gland increases production follicle stimulating hormone. FSH triggers follicle development and maturation, consequently, ovulation occurs and monthly periods regulated. What is the success rate of pregnancy in women with PCOS? Letrozole has worked and restored fertility in women with polycystic ovary syndrome, although its success will depend on:
- The age of the woman
- The type of medication used
- How the woman responds to the fertility meds used
- Other infertility factors a couple may be experiencing
The drug dosage for the patient with PCOS is also 2.5 mg as the initial dose. Depending on the progress, the fertility doctor may adjust the dosage for infertility to 5 mg or 7.5 mg. The important thing is to follow the prescription strictly; don’t take it for a longer period than directed nor more or less of it. The medication may be taken with or without food. Although the drug is more preferred than Clomid. Engage the doctor about what to expect as you take the medicine and the remedies of the negative effects. For the patient with PCOS, apart from taking this medication for fertility, are there other ways to deal with the syndrome and increase the chances of conception?
Other Ways to Get Pregnant with Polycystic Ovary Syndrome
Trying to get pregnant with the condition is difficult, but it is achievable with lifestyle changes, a few natural as well as medical treatments to boost fertility, such as:
- Strive to attain a normal BMI – as a result of hormonal imbalance and insulin resistance, many women with polycystic ovary syndrome are overweight or obese, shedding off the extra kilos may be the solution to restore fertility and fulfill the dream of becoming a mother. Remember obesity is associated with infertility.
- Adopt a healthy diet – A low glycemic load diet is the best for a patient with the syndrome to improve the symptoms of the disorder, shed off the excess fat and restore fertility. It also deals with insulin resistance. Cut out refined carbohydrates and go for fruits and vegetables rich in fiber.
- Take a multi-vitamin– physician advises women with the disorder and trying to get pregnant to take a multi-vitamin for a healthy pregnancy and increase chances of conception.
- Eat cruciferous vegetables like broccoli, cabbage, and kales to regulate the monthly cycle, thus restore fertility
- Incorporate vitamin D in the diet – it’s important for the growth of the cells, for example, the growth of your eggs in the ovary. Inadequate vitamin D is common in women with PCOS and partially to blame for infertility in these women. Rich sources of vitamin D are eggs and basking in bright sunlight.
- Minimize stress – stress can increase cortisol levels, which lead to increased insulin and blood glucose making it harder to conceive. Infertility can cause stress, but take things easy and speak to a counselor if need be to cope with stress.
- Take Metformin – Metformin treats type II diabetes and deals with insulin resistance, eventually better your chances of becoming pregnant since it regulates ovulation. The medical care provider may prescribe the drug with Clomid in combination with Metformin.
- Try injectable gonadotropins – they are the last form fertility medication used to restore fertility before going to other options like in vitro fertilization and intrauterine insemination. They are effective, although they lead to high-risk pregnancy such as giving birth to triplets or more. Most fertility specialists opt to use IUI together with the gonadotropins in an attempt to restore to conception.
- Consider surgery to remove the cysts – removal of the cysts lowers testosterone levels and restore normal ovulation; this is a short term solution as the tissues more grow again and at a faster rate.
- Check if the fallopian tubes are blocked – PCOS may cause scar tissues and block the fallopian tubes, it’s advisable to get checked and rule out the tubes aren’t blocked, if they are, the doctor will schedule for a surgery.
- Try out assisted reproductive technology such as in vitro fertilization to boost the chances of becoming pregnant; speak to the doctor about it and he will recommend the best ART which can work for you.
You are equipped with information on Letrozole for fertility and other ways for getting pregnant for females with PCOS; however the information is just to give you the basic guideline, the fertility specialist is the in the best position to determine what will work for you.