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Bill2Recently, I spoke at REX during Grand Rounds regarding why we feel Letrozole is a better choice than Clomid for ovulation induction cycles at Carolina Conceptions. A number of OB/GYNs have since asked for notes on the subject- including dosing, etc. We hope this helps. If not, you know where to send them!

 

Bill Meyer, MD @ Carolina Conceptions 


Why You Should Consider Using Letrozole Over Clomid? Letrozole presents FEWER SIDE EFFECTS for the patient, fewer multiples, less effects on the endometrium, fewer birth defects, has a shorter half-life, and has easy dosing.

How to Dose Letrozole: Don’t use 2.5mg.  Use at least 5mg on cycle days 3 – 7. If the patient weighs more than 200lbs., we recommend dosing 7.5mg on cycle days 3 – 7.

Want to Get More Involved? Bring your Letrozole patient back on day 12 or 13. If her dominant follicle is more than 17mm, have her take a prepackaged syringe of HCG (ovidrel 250 ug) to induce ovulation 36 – 40 hours after administered.

How Many Cycles of Letrozole Should OB/GYNs Monitor Prior to Sending a Patient to Carolina Conceptions? No more than 4 cycles of Letrozole, if the patient is ovulatory. There may be something else going on.

Do you recommend the anovulatory patient complete any other fertility tests prior to attempting Letrozole? No. Sometimes this is all a patient needs. If not, we will take care of the more advanced fertility testing and treatment once she gets here.

What else can Letrozole be used for? Letrozole 2.5mg and Aygestin (norethindrone acetate) 2.5mg daily can be a very effective treatment for endometriosis. This allows you to continue antiestrogen and progestin therapy to treat this condition.