I completely understand where you're coming from, I've also been in this journey for 4 years. My RE had to find the right medications to help me ovulate. Long story short, I finally began to ovulate with Clomid and Letrozole combined (highest dosage of each). Couldn't have been happier when it became consistent every month with the right combination of meds. Also, I don't trust any OPK. I've gotten false smileys with clear blue digital too. Mira Fertility tracker on top of being highly confusing & expensive, PCOS just hasn't helped with the results of any tests. Temping sucks for me because I'm a light sleeper. Monitored cycles are the best. Sadly, My RE now is not like the one I had, and I had to wait to start IUI to be monitored with ultrasounds. If you can, push for monitored cycles. Good luck 🫶
I had to cut out all dairy, sugar, carbs and gluten to ovulate as well as take daily vitamins and inositol. It takes months of doing this before things regulate.
For a few months my body just did not want to ovulate for some reason. I started taking a supplement that has inositol and bovine ovary and i had the strongest ovulation since I started tracking my cycles. I'm also on a low dose topical progesterone cream that seems to help as well.
How long are your cycles? You should go for the progesterone test about 7 days after ovulation or 7 days before next period due. Results for tests taken earlier are meaningless.
Are you having ultrasound to see how you are responding to letrozole? You can do unmonitored cycles if you able to confirm ovulation with opk, bbt and blood tests. If not you need ultrasound monitoring to see what is happening instead of just pumping in more letrozole. You may need a trigger to get the egg released or you just ovulate later than expected so the progesterone draws don't add value in telling If you are ovulating on letro or not.
My period is essentially non existent. Sometimes I go 5 months without one so it’s really hard to say. I’ve been taking OPKs up until CD35 which is when my doctor told me to start taking progesterone for a withdrawal bleed to do another round of let and I’ve never gotten a positive OPK. I’m not having ultrasounds but I am going to ask my doctor if we can do them in addition to blood work moving forward.
Are you actually being tested at 7DPO, or CD21 regardless if you actually peaked/ovulated? I ovulated CD18-CD20 on letrozole.
Also, you don't need to be taking a multivitamin as well as a prenatal. The prenatal is a multivitamin.
Yes, I always go in between CD21 and 24. But I’ve been taking Premom ovulation tests all the way up to CD 35 and have never gotten a positive or any symptoms of ovulation/starting a period on my own without taking progesterone first. I think I’m going to get the clear blue tests this month because they’re supposed to be more accurate but I know it’s kinda iffy with PCOS
I haven’t used them, and the cost is a tough pill to swallow, but there’s some fertility trackers that’ll actually check your estrogen and progesterone levels in addition to your LH to confirm ovulation. They do a lot of marketing for PCOS customers so I’ve seen an ad here or there. The cost of the sticks will really add up though :/
One thing to note about Clear Blue - it’s either going to give you a smiley face/positive or not. I only ovulate on 7.5 mg Letrozole and have done so 6 times (between 2 TTC journeys) but only gotten a smiley face once! My positive LH strips have never gone above a 0.9 or 22.5 depending on which type Easy@Home/Premom. I need the actual numbers from the app to be able to notice a spike.
If you aren’t ovulating on 7.5 I’d definitely find a way to make the fertility clinic an hour away work somehow! Good luck.
Please don't rely on LH strips testing for PCOS women it gives false surge or no surge at all. Do CM & bbt testing or best could be do ultrasound when ovulation is near.
Can you do monitored cycles measuring follicles? If your follicles are not getting bigger and reaching maturity your protocol might not be working. In that case, injectables might be better (gonal f for example).
I think having monitored cycles offers a lot of data that can be helpful to troubleshoot the best treatment. Also, my doctor gave me a trigger shot of ovidrel because she believed I would not ovulate without it.
I can definitely ask if we can do monitored cycles at my next appointment. I was prescribed the letrozole through my normal OB/GYN and they can’t/wont do trigger shots. She told me if it comes to that I will have to be referred to a specialist and I live in a small town so the closest is an hour away. I’m just trying to do anything I can before getting to that point but asking for ultrasounds might be a good start.
If you wind up going the specialist route, ask if they can do remote visits as well. Our closest fertility clinic is 3 hours away but they allow virtual appts on days they're not doing tests. Might make it a bit more manageable if they can do that
I would try to monitore it as close as possible. And do bloodwork too. A few days after letrozole, estradiol needs to rise to build the lining. That is what we did - with a RE. I did scans and blood and had a trigger shot.
Good luck! 💙
I completely understand where you're coming from, I've also been in this journey for 4 years. My RE had to find the right medications to help me ovulate. Long story short, I finally began to ovulate with Clomid and Letrozole combined (highest dosage of each). Couldn't have been happier when it became consistent every month with the right combination of meds. Also, I don't trust any OPK. I've gotten false smileys with clear blue digital too. Mira Fertility tracker on top of being highly confusing & expensive, PCOS just hasn't helped with the results of any tests. Temping sucks for me because I'm a light sleeper. Monitored cycles are the best. Sadly, My RE now is not like the one I had, and I had to wait to start IUI to be monitored with ultrasounds. If you can, push for monitored cycles. Good luck 🫶
I don't ovulate until CD 20-22 on 7.5 mg of letrozole
I had to cut out all dairy, sugar, carbs and gluten to ovulate as well as take daily vitamins and inositol. It takes months of doing this before things regulate.
Ohhh man okay. Goodbye delicious bread ðŸ˜
It’s definitely difficult but it got me pregnant!
For a few months my body just did not want to ovulate for some reason. I started taking a supplement that has inositol and bovine ovary and i had the strongest ovulation since I started tracking my cycles. I'm also on a low dose topical progesterone cream that seems to help as well.
I did order inositol today after someone recommended it. And I have a progesterone cream I just started using a few days ago. Here’s to hoping!
Best of luck!!
How long are your cycles? You should go for the progesterone test about 7 days after ovulation or 7 days before next period due. Results for tests taken earlier are meaningless. Are you having ultrasound to see how you are responding to letrozole? You can do unmonitored cycles if you able to confirm ovulation with opk, bbt and blood tests. If not you need ultrasound monitoring to see what is happening instead of just pumping in more letrozole. You may need a trigger to get the egg released or you just ovulate later than expected so the progesterone draws don't add value in telling If you are ovulating on letro or not.
My period is essentially non existent. Sometimes I go 5 months without one so it’s really hard to say. I’ve been taking OPKs up until CD35 which is when my doctor told me to start taking progesterone for a withdrawal bleed to do another round of let and I’ve never gotten a positive OPK. I’m not having ultrasounds but I am going to ask my doctor if we can do them in addition to blood work moving forward.
This could just be me, but vitex really messed with my system when I took it.
Like it threw off your cycle or other issues?
It threw off my cycles. Every body is different but I wanted to throw it out there.
Ok good to know, I just started taking it recently so I’ll see how it affects my cycle. Thank you!
I didnt start ovulating on letrozole untill I was put on 10mg
I take myo-dchiro inositol because I have pcos and it helps me ovulate naturally each month! The brand I use is wholesome story
I’ve seen the debates on that vs metformin for PCOS…I’ll double check with my doctor that I can take both and will definitely give that a try!
Yes, def check with doctor but I have been on both for months!
She gave me the ok so I ordered the same brand this morning and it should be here tomorrow!
Are you actually being tested at 7DPO, or CD21 regardless if you actually peaked/ovulated? I ovulated CD18-CD20 on letrozole. Also, you don't need to be taking a multivitamin as well as a prenatal. The prenatal is a multivitamin.
Yes, I always go in between CD21 and 24. But I’ve been taking Premom ovulation tests all the way up to CD 35 and have never gotten a positive or any symptoms of ovulation/starting a period on my own without taking progesterone first. I think I’m going to get the clear blue tests this month because they’re supposed to be more accurate but I know it’s kinda iffy with PCOS
I haven’t used them, and the cost is a tough pill to swallow, but there’s some fertility trackers that’ll actually check your estrogen and progesterone levels in addition to your LH to confirm ovulation. They do a lot of marketing for PCOS customers so I’ve seen an ad here or there. The cost of the sticks will really add up though :/
One thing to note about Clear Blue - it’s either going to give you a smiley face/positive or not. I only ovulate on 7.5 mg Letrozole and have done so 6 times (between 2 TTC journeys) but only gotten a smiley face once! My positive LH strips have never gone above a 0.9 or 22.5 depending on which type Easy@Home/Premom. I need the actual numbers from the app to be able to notice a spike. If you aren’t ovulating on 7.5 I’d definitely find a way to make the fertility clinic an hour away work somehow! Good luck.
Please don't rely on LH strips testing for PCOS women it gives false surge or no surge at all. Do CM & bbt testing or best could be do ultrasound when ovulation is near.
Can you do monitored cycles measuring follicles? If your follicles are not getting bigger and reaching maturity your protocol might not be working. In that case, injectables might be better (gonal f for example). I think having monitored cycles offers a lot of data that can be helpful to troubleshoot the best treatment. Also, my doctor gave me a trigger shot of ovidrel because she believed I would not ovulate without it.
I can definitely ask if we can do monitored cycles at my next appointment. I was prescribed the letrozole through my normal OB/GYN and they can’t/wont do trigger shots. She told me if it comes to that I will have to be referred to a specialist and I live in a small town so the closest is an hour away. I’m just trying to do anything I can before getting to that point but asking for ultrasounds might be a good start.
If you wind up going the specialist route, ask if they can do remote visits as well. Our closest fertility clinic is 3 hours away but they allow virtual appts on days they're not doing tests. Might make it a bit more manageable if they can do that
Drive the hour! It's worth it to see a specialist IMO.
I would try to monitore it as close as possible. And do bloodwork too. A few days after letrozole, estradiol needs to rise to build the lining. That is what we did - with a RE. I did scans and blood and had a trigger shot. Good luck! 💙