Ovulation Testing with Femara

Hi.  My husband and I have been trying to conceive for about 2 years now.  I was prescribed 50 mg of Clomid and took that for 4 months.  For the first time ever, I was getting positive OPK's, but not until day 16 of my cycle.  I had ultrasounds 2 months that showed follicles, but my doctor felt I was ovulating too late.

She prescribed Femara for me, and I am now in my first month.  I took 5 mg on cycle days 3-7.  She told me I should ovulate earlier with the Femara, so I started my OPK's on day 10.  On that day, I got a very faint line, but yesterday, day 11, it appears that I got a very positive test.  Does this seem reasonable?  I've been charting my temperature too and it went up a little today, but not as much as usual after ovulation.  If anyone out there has taken Femara or knows what to expect, I would really appreciate your thought and/or advice.

Thank you so much!  I know infertility is a long, hard road for everyone, so my thoughts and prayers are with you all

[stillwaiting52]

I have taken femara and am now on my 6th month. It actually pushed ovulation out for me, from day 14 to 16 or 17. I have not tried the OPK's though. I went by temperature charts and it was very apparent in my case. We are in the 14th month of ttc. I wish you the best of luck!

[jnitro26]

my dr also put me on femara. 5mg from days 3-7, today is day 7. my dr told me to bd on cd 14,16, and 18. then on cd 17, i have to get blood work to check my levels. best of luck to you.

[candie429]

I just wanted to thank you both for your responses.  Best of luck to both of you too!  To update, my temperature went way up on CD 13, 2 days after my apparent positive test, so that seems to be promising.  Did anyone else out there who is on Femara ever ovulate this early?  Hopefully this is a good thing!  I guess now all we can do is endure the 2WW!

[HeathJo]

I just started Femara this month as well, yesterday in fact. I will ask my RE about this, as I o'd on CD 16 w/ Clomid as well. I'll let you know what I learn, and thanks for posting this question!

[candie429]

I would love to hear what your RE has to say.  Thanks so much!  Sometimes I get frustrated with my OBGYN, but since all of my tests have come back normal, I know there is not much more she can do.  We live about 2 hours from the closest RE, so that's not really an option right now.  We decided to not move onto the IUI and just try naturally, so hopefully the medication alone will be enough!  Good luck ot you.

[HeathJo]

I will be going to the RE tomorrow, and ask her what she thinks. Jnitro, who also responded on this post, had asked the same questions, and I wrote her a long answer in a recent post about all the general info I had about Femara/Letrozole. If you search letrozole on this site, it should come up. Since this med is used off-label for fertility, it is hard to find accurate info on how it works from the medical community. The info sheet my RE gave me was from a professional association on reproductive technology, and that is the source I used to answer jnitro's questions last week.

If you search and can't find it, I will find it and paste the info for you. In fact, I will just send you a pm with the info!!

[candie429]

I did see your other post about Femara and it had a lot of good information.  You're right in that it's hard to find information, and of course there's a lot of scary stuff out there about birth defects, but after reading all of the posts on this site, it really seems to work for so many.  Hopefully it will work for all of us!

[G_S]

I was on Femara for the first time after 6 unbsucessful cycles on Clomid. I ususally was given ahsg trigger on cd 16-17 on clomid. With femara when i had my cd 14 u/s unexpectedly my follicle was 32mm...so i think with femara , your follicles grow faster.

[bny807]

whats the difference between femara and clomid?? Thanks!

[G_S]

They both are used to induce ovulation...they work a lil differently internally though...dont know exactly how

[candie429]

Thanks G_S for your input.  Unfortunately, AF showed up today (12dpo), so I guess it didn't work this time.  I was thinking about requesting an ultrasound next cycle to make sure it's working the way it should.  Do you think that's a good idea?

To answer your question bny807, Heather Jo shared this info with me and I think it would be helpful to you: "Clomid works by binding to the estrogen receptor and acting sort of as a "pseudo"estrogen.  This binding makes your body "think" estrogen level is low (although it really is not) and causes a cascade of events that lead to ovulation.  Femara is not a new drug...it is actually a breast cancer drug and they discovered it could be used for fertility because many of these breast cancer patients were  getting pregnant.  Femara acts in a different way than clomid.  It actually inhibits an enzyme that makes the real estrogen in your body.  In this way it actually reduces the level of estrogen and like clomid this induces a cascade of events that lead to ovulation.  This is why femara works better in some people than clomid does (maybe in people resistant to clomid the drug does not bind the receptor very well and hence the clomid does not induce ovulation as it should).  Clomid also has a very long half life, so that if you take it one month some of it is still around the next month and so on.  This can lead to a thin lining.  Femara has a very short half life and therefore does not lead to a thin lining.  Femara DOES cause birth defects if you take it when you are ALREADY pregnant.  If you are NOT already pregnant when you take femara it does not cause any more birth defects than clomid or general infertility.  So if you take it on days 3-7, it is gone by the time implantation occurs (due to it's very short half life) and theoretically it cannot cause birth defects because it is not even around anymore.  Therefore it is very important for your doctor to verify by ultrasound that you are NOT ALREADY pregnant before prescribing this drug for fertility."  

[bny807]

WOw, that was really helpful! thanks so much!!  i wander if femara is better for people with endo?  from what i've read one of the theory's of endo is estrogen dominance, so if it blocks real estrogen, it sounds like it wouldn't essentialy double the estrogen in your body like it sounds like clomid kinda does.. Anyone know if femara is a better choice for endo patients?  This stuff is all amazing, now if they could just gauantee to get everyone pregnant that would be perfect!!!

[jen_KE]

I was thinking the same thing about endo and Femara.  I'm on Femara and had endo, so I'm crossing my fingers that your theory is right!!

[HeathJo]

Candie, thanks for passing that info along! I was fortunate that my doctor had this handount from some Assisted Reproductive Technology Society organization, as there is little info online because femara is used "off-label" for fertility. As in, it's primary use is for breats cancer. My point is that paying it forward is the best feeling, and I am so glad you and these other ladies found this info valuable.

jen_KE, bny807--I don't know if femara is better for endo patience, but I WOULD like to know, out of curiousity. Can you ask your RE about it?

SSBD to al!

[candie429]

I'm not entirely sure about the link between endo and Femara, but it almost seems to me that I read something on the internet saying that Femara is a better option with that condition.  Reason being is that sometimes I worry that I may have a touch of that based on some of the symptoms I get, so that fact caught my eye.  I honestly can't remember where I saw that though.  Maybe try Googling that.

To Heather Jo:
I'm glad you didn't mind me sharing your information.  It is a good feeling to share as much info as you can to try to help others.  I saw that you have a lot of follies and are going to have an IUI, so best of luck to you.  Thanks again for all of your help.

[bny807]

well i wasnt able to find one particular website that had great info on femara used as fertility drug (of course there were lots of warnings about the birth defects - however it said that the birth defects weren't more numerous than the control group!) But there was a lot of info as using femara constantly for 3 months (like lupron) but it had less side effects and they re-lapped patients at the end and the endo was gone!  So i'm sure if it works that great used like that then its gotta be a good choice over clomid!  humm, i wander how many dr's use it since its black label for fertility..  Here is one of the articles i found that is interesting http://women.webmd.com/endometriosis/news/20040213/breast-cancer-drug-may-ease-endometriosis

[candie429]

That is definitely a very interesting article.  Thanks so much for sharing.  I guess it's safe to assume then that you have been diagnosed with endo?  Do you mind me asking what your symptoms were or how they diagnosed you?  I tend to have very painful cycles with lower back pain and sometimes I even have this really tight feeling in my abdomen whenever AF starts that makes me feel like I can't stand up straight.  I mentioned my concern to my doctor, but she just brushed me off and said that since my hysterosalpingogram looked good, I should be fine.  Any advice?

[bny807]

well, we have been ttc for 12 months now (as of today : (   )   without luck, but i have premenstrual spotting, my dr didn't really seem concerned about that when i told her 7 months ago!   Then last cycle around O time i got really bad pain on my right lower pelvic area that got worse and worse i could barely stand up, it lasted about 7 days or so, then went away. but i went to the DR she scheduled a hysterosono (for the spotting) and a TVUS, we thought we would find a cyst, which they did a 5.5cm one that they are suspicious for an endometrioma. I have since switched Dr's (she didn't want to do anything else till the end of march!!!) and the new dr has me scheduled for another US next week, if its still there then they wiill do a lap. I dont' have any other symptoms besides infertility and spotting (which some people can have severe disease and have no symptoms)  I sometimes have very mild cramping the day before af, in my low back too (i thought that was normal!) and then i'll have to take aleve the first day in the morning and thats it... So next week the US will confirm (or hopefully not confirm!) my gut tells me its endo though : (    I don't want to get years down the line and then them figure out thats what my prob is, i'd rather attack it now.   How long have yall been TTC?  Do you see an RE or obgyn?  

[candie429]

Thanks for sharing your experience with me.  I wish you all the luck in the world with your ultrasound next week.  Like you said, you don't want there to be something wrong, but if there is, it's definitely better to get it taken care of now.  To answer your question, we have been TTC for about 21 months.  I see an OBGYN for treatment, so it's sometimes frustrating since they don't do as much monitoring.  I think it's especially the case for me since they can't find anything wrong, so all she can really do is suggest these different drugs and see if they help.  I'm starting my Femara for the 2nd time today, so hopefully it will work this time.  Just to be safe, I am going to call today and request to have an ultrasound done this cycle.  I had ones done while on Clomid, so I'd like to have one done while on Femara to see if it's any better.  Keep in touch and keep me posted on your progress.  My prayers are with you.    

[bny807]

Thanks so much!!!   I'll be watching for your updates as well!!  good luck with the 2nd roucd of femara!!!

[lori3486]

Has anyone who has taken Femara ever accidently started on the wrong day - I am supposed to take it on day 3 but accidently took it on day 1 - any thoughts we greatly appreciated

[candie429]

To be honest, I'm not sure what to tell you.  I would think that if you just took one dose, you could hold off until day 4 and finish the rest of the meds, but maybe that's not the right way to think about it.  If I were you, I'd call your doctor and get their professional opinion.  I think that's the only way to really be sure what to do.  I'm sure they'll have an answer on how to fix it.  Best of luck to you!

[G_S]

U should check with your doc immidiately. I know there is regime to take Femara starting day 1...maybe he can put you on that instead

[jlabom]

Hi, I planon starting my first dose of Femara in the up coming week, my Dr. put me on Provera to onstart my sysle since they were running as long as 6 months in between. He suggested I start on day 2, but if everyone is running long on cycles, wouldn't it be better to wait a few days? I bought HPT's to take starting day 10, any thoughts?

  Jess

[MrsTKing]

Hey my case is similiar to yours I am on my first cycle of femara and took provera to induce my period i would love to hear what happened with you since now I am on CD16 and still no O did anyone experience late Ovualtion?

[Kimberleigh2208]

I am also on my first round of Femara but no Provera since I get regular periods (except while I was taking Clomid).  I also have not got a positive ovulation test yet and today is day 16 (though the line WAS darker today).  Also, yesterday I noticed (sorry to be gross) cervical mucous like egg whites which should mean ovulation.  I am just worried since we are trying IUI with Femara that I am not going to ovulate this month but I will wait one more day (day 17) after reading all of these posts and see if I get a positive ovul. test tomorrow.  Praying that you had luck last cyle and if not, that this helps to know someone experienced what you are going through.