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le5466 - February 20th, 2008 9:56 AM

I have charted for 4 cycles of metformin/letrozole and 2 cycles of met/clomid. I think I consistently ovulate around d21-25 based on neg LH kit then positive LH kit for 2days (back to negative after that),corresponding cervical fluid changes, and basal temps. After no luck, decided I needed more help. Had testing. HSG clear, Clomid challenge results good, thyroid panel normal.

Today is cycle day 13 of first injectible cycle. I have no follicles greater than 8mm after Letrozole d3-7, Foll.@50 d7-9, and Foll.@75 d10-12. Estrogen is 43. Any hope for this cycle? Any hope beyond this cycle if not responding to Follistim? Nurse was not encouraging - said I obviously had poor quality eggs. Thanks!

B. Jacobs, M. D. - February 20th, 2008 4:37 PM

Letrozol blocks the enzyme that makes estrogen. That is explanation enough why your estrogen is low. I would expect follicle growth with letrozol, unless you ovulated before the ultrasound was performed. There are number of different tests for ovarian reserve. The clomiphene challenge test is only 1 of them. If that was good, I would expect you to respond to an FSH product.
Good luck.


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