Can Femara be taken while treating infertility?

Posted on Tue, 1 Sep 2015 in Medicines and Side Effects
Question: First Round 1- Took femara 3-7, had a vaginal ultrasound CD 11, was told I had no mature follicles, biggest was only 11mm ... and must of not responded to this round of femara. I used Clearblue advanced, clear blue digital regular OPK and ovacue fertility monitor with oral & vaginal sensor and all 3 sources gave me a peak positive result on CD12... I had another ultrasound CD 14, but largest follicle was only 12mm..So I assume I had a false surge?
I now started my period and this cycle ended up being a 34 day cycle. I am currently on day 2 of my new cycle. My doctor said he will be ordering a FSH, Estradiol, and anti-mullerian hormone level for me to take on Day 3 of my cyle, but did not want to have me start femara this cycle until these labs are done. Why is this? Wouldnt it be better for me to try 3 rounds of femara back to back?
Answered by Dr. Jacqueline Brown 1 hour later
Brief Answer:
Femara is not recommended for use without full workup

Detailed Answer:
Hello. My name is Dr. Brown, and I hope I can answer your question.

Femara is a medication that can help make your pituitary gland make more FSH, or follicle stimulating hormone, that can in help the development of ovarian follicles. It works in a similar way to Clomid, with fewer side effects.

Femara is designed to be a medication used in the treatment of breast cancer. Its uses in fertility treatment is controversial, however, because it is not FDA approved for treatment of infertility. There is limited data on its effectiveness as well. Therefore, some physicians do not feel comfortable using it at all or for extended periods of time without a full hormonal evaluation. The company that makes the drug also has a legal disclaimer on their website that Femara may also be associated with birth defects if taken during pregnancy. Of course, if you are taking it for infertility, in theory you would never take the drug during pregnancy, but because of medical/legal issues, physicians may not again feel comfortable with its use.

To explain your lab results and follicle size, you are correct in that your LH surge will not result in ovulation if you have no mature follicles. However, you may also ovulate later in your cycle than day 14, especially if your cycles are long. Your follicle size may have been adequate even as late as day 20-21.

The bottom line is that your doctor is just trying to be thorough and fully evaluate the cause for your infertility/anovulation in order to get you the best result from the medication he/she is prescribing. Medications like Clomid (which is FDA approved) and Femara are not recommended for use for more that 3 or 4 cycles because they can thin the endometrium and make implantation more difficult over time. Most fertility doctors do these kind of blood tests before beginning any type of fertility treatment because they want to make sure the treatment is going to work and not jeopardize your success with other methods if it doesn't.

I encourage you to follow the doctor's advice and take the recommended tests. You are quite young so I know you have been trying for a while but there is plenty of time to get a complete and thorough evaluation before proceeding with further treatment.

I hope this reassures you and I hope you and your doctor are able to come up with the safest and most effective way for you to conceive.

If I can be of any further assistance to you, please feel free to contact me again.

Sincerely, Dr. Brown

Above answer was peer-reviewed by : Dr. Raju A.T
Answered by
Dr. Jacqueline Brown


Practicing since :1996

Answered : 1425 Questions


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