3 Replies
ttc-bree - February 18

I happened upon this site and have truly enjoyed reading your helpful professional advice. I tried to see if my question has come up before, but did not see it.

I am almost 29 years old - never pregnant. My husband and I have been TTC for 2 1/2 years. Everything looks good w/my hubbie. I've been seeing a Fertility Specialist for almost a year. He thinks I have mild PCOS. I went through all the normal procedures - hsg, us, labs, monthly progesterone, etc. In July I started taking Femara and by October it seemed to be working, however, on day 16 of that cycle I went for an US and they found a fibroid the size of a tennis ball. They immediately scheduled me for a myomectomy and removed it. I was told to start trying again in January drugfree.
Now to my questions...When I asked why the Fibroid suddenly appeared in October I was told it could have been three answers: 1) It was there all along (One question I have for you is does this seem realistic - having monthly US and an HSG - it seems like it should have been caught) or 2) The Femara I took could have caused it to grow (2nd question - have you heard of this before) or 3)bad timing.

This month they want me to start taking Femara again but I'm a little scared since we don't know what happened last time. The weird part is I went in on Day 17 and was showing a good size follicle, however, I never have a surge on ovulation predictors (except for my one good month on Femara). I also always show good progesterone levels on day 21 to justify ovulation (even w/p femara). The Drs office said going back on Femara will help me pinpoint the ovulation day. Should I do this? Also, why or how is it possilbe that I ovulate but never have a surge on the predictor kits (I've actually resorted to performing the tests twice daily but still no surge).

Again, I can't thank you enough for this website and your support. Any info you can give is much appreciated.


B. Jacobs, M. D. - February 19

I doubt that Femara caused your fibroid. The use of Femara for ovulation induction is certainly promising, but still a new process. From data we have collected over the years, if any given treatment protocol does not work in 4 treatment cycles, it probably will not. I do not know that removing your fibroid significantly changed things to make restarting Femara a good effort.
Good luck.


ttc-bree - February 19

Thanks for your advice. I feel much better about starting another round :-)

One more quick question...In your experience have you had a patient ovulate but not show a surge on the ovulation predictor kits? I'm ovulating based on progesterone levels and seeing a good size follicle this month but no surge. Why or how does this happen? Is there a better method for me to do?
Thank you so much!


B. Jacobs, M. D. - February 19

There are only 2 ways to prove ovulation. One is to become pregnant. The other is to use ultrasound to identify a preovulatory size follicle, and then demonstrate its disapearance with ultrasound. It is not uncommon for women with impaired fertility to go through the hormonal changes of ovulation without ovulating. I do not know why you did not identify an LH surge, if you had one.
Good luck.



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