How to Take Letrozole for Fertility

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As Dr. Eve Feinberg of Northwestern Fertility and Reproductive Medicine explains, one in eight couples who tries to conceive is afflicted with infertility, a potentially devastating diagnosis.

When you’re trying to have a baby, you’ll hear countless methods and infertility choices that may help you build your family. Many women have had success with a surprising treatment option: Letrozole, a drug commonly used to treat cancer. These are five things you should know about Letrozole for infertility.

1. What is Letrozole?

Letrozole, also used under the trade name Famara (Femara), is an oral medication that functions as an aromatase inhibitor. This helps prevent the conversion of androgen to estrogen, effectively suppressing estrogen production. Women who have been diagnosed with hormone-receptor-positive, early-stage breast cancer often take the drug after surgery, chemotherapy or radiation to help reduce the risk of cancer returning. Because Letrozole specifically reduces estradiol levels in the body, it caught the attention of reproductive endocrinologists.

2. What does Letrozole do for fertility?

In the simplest terms, Letrozole induces ovulation. As estrogen levels drop, the pituitary gland senses this decrease and secretes the follicle stimulating hormone (FSH) to increase estrogen in an attempt to maintain optimum hormonal balance. By generating FSH, the ovaries are stimulated to grow more follicles. Letrozole boosts this growth and release of eggs in women who are anovulatory, or not ovulating, and can cause superovulation in women who are already able to ovulate. In both cases, it increases the chances of natural conception. Another benefit of Letrozole for fertility? It improves endometrial thickness.

3. Is Letrozole better than Clomid?

Among women without PCOS, studies have shown that there is no difference between Letrozole and Clomid, or that Clomid is the superior treatment.

Historically, Clomid has been a popular first option to try during fertility treatment, especially for women with Polycystic Ovarian Syndrome (PCOS). Clomid falls in a class of medication called clomiphene citrate, which lasts in the body for an extended period of time and may actually have a negative effect on cervical mucus and uterine lining. Research is beginning to show that women with PCOS do not respond well to it.

For women with PCOS, a 2013 study shared at the American Society of Reproductive Medicine had convincing results. Among 750 women, the cumulative live birth rate was higher with Letrozole (27.5%) as compared with Clomid (19.5%). A study in 2014 showed Letrozole to perform better, with higher live-birth and ovulation rates among infertile women with PCOS.

4. What are side effects of Letrozole?

The majority of the data on the side effects of Letrozole come from women who use it as part of a five-year cancer treatment regimen. Most women who use Letrozole for fertility, however, use it for just five days and find, if there are any side effects, they are similar to Clomid treatments. Side effects of Letrozole can include:

  • Hot flashes
  • Headaches
  • Breast tenderness
  • Fatigue
  • Leg cramps

Some women also find that infertility drugs that improve ovulation may also result in anxiety, mood swings, and irritability.
Importantly, Letrozole cannot be taken during pregnancy or breastfeeding. Research shows it may cause damage to developing embryos.

A 2014 study dedicated to this research found that congenital and chromosomal abnormalities were found in 5 out of 201 (2.5%) of babies conceived with the help of Letrozole, compared to 5 of 171 (2.9%) of babies conceived naturally and 10 of 251 babies (3.9%) conceived with Clomiphene. The conclusion showed no significant difference in the overall rate of congenital malformations for children born to mothers who conceived naturally versus using Letrozole or Clomiphene treatments.

5. What are the treatment protocols for taking Letrozole as a fertility treatment?

Candidates for Letrozole are carefully assessed and evaluated and follow specific guidelines for how and when to take Letrozole. You can read more here.

When do options such as surrogacy and egg donation come into the fertility picture?

Since Letrozole only addresses ovulation, it doesn’t impact other potential root causes of infertility. The odds of achieving a pregnancy are best when both the egg and sperm come from young, healthy sources that have met specific medical criteria. This may mean using an egg donor. According to the US Centers for Disease Control and Prevention, IVF with a donor egg has a success rate of 52%, which is the highest of any fertility treatment. Higher still is the rate of success with a surrogate. IVF clinics in the US have a surrogacy success rate of about 75%, and that number can increase as high as 95% for a birth once the gestational carrier is pregnant.

It’s important to understand your options when it comes to infertility treatment. If you’ve considered surrogacy or an egg donor to build your family, contact ConceiveAbilities. Our team is excited to share more information, success stories and support as you make your decision.

And, are you a woman who enjoyed a healthy and successful pregnancy? Do you have friends or family who have suffered from infertility or need assistance from someone else to build their family? Have you ever considered the role you could play in helping someone else build their family - as a surrogate? Learn more about the process of helping someone else's dream of building a family come true. We would love to talk with you.

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