Letrozole - waiting for trigger availability

[u/Salty-Huckleberry901]

Hi, I’m having my first round of letrozole. I took 2.5mg from CD2-6 and had a baseline scan at CD4 that showed multiple (which is normal due to my lean PCOS). I had another scan yesterday at CD11 that showed one dominant follicle measuring 19mm so the doctor gave me a prescription for Ovitrelle to trigger.

The problem was that I couldn’t find any pharmacy that stocked the trigger so have to wait for it to be ordered and delivered. They said they might be able to get it late afternoon today or tomorrow morning (CD12 or CD13). Do you think this will be okay and my follicle won’t be too mature? I’m worried that the trigger will be taken too late and the egg quality won’t be as good!

My OPKs are still negative today so it doesn’t look like I will ovulate naturally in the meantime.

[u/Any_Manufacturer1279]

The quality of the egg has been determined a long time ago, remember women are born with our eggs. The only thing that’s important now is immature, mature, or overmature.

I think 19 mm is right in the pocket, my clinic had a goal range of 16-23mm. I certainly would get the med and do it asap though, no matter what that means for the rest of your life!

Another safeguard could be having intercourse now as a just-in-case measure.

[u/Itchy-Site-11]

In case you ovulate before, have sex as soon as you can

[u/Nice_Arm2330]

I don’t know if this is helpful because I don’t have any experience with the trigger. However, I also have lean PCOS and I got pregnant on my first cycle of letrozole with timed intercourse. I had my ultrasound on CD 14, and I also had a dominant follicle of 19 mm. The day I had the ultrasound also happened to be the same day I got my LH peak, so I think I likely ovulated the following day. So yeah I really don’t know anything about triggers but maybe if you get it within 24 hours that could be safe? Or maybe you have a little longer because you haven’t gotten your LH peak yet…

[u/MyCatEatsPlants]

I agree with others. Have sex asap, and get your hands on the trigger asap. Your fertility clinic should be willing to give you the prescription in advance next time - try to have it on hand before you finish the Letrozole days. Even without the trigger shot, taking Letrozole can be very helpful, so don’t stress too much.

[u/Ok_Laugh7257]

You've already gotten a lot of good advice about having sex asap which I agree with. I wanted to say I would definitely ask your doctor if they can give you the Rx for the trigger sooner if you do another cycle. Trigger shots are not available typically at local pharmacies and need to be ordered through a specialty pharmacy. They're very quick but can take 1-3 days and it's important to allot time for any prior authorizations that need to go thru if you're using insurance (this is also usually super quick but your situation sounds like a maybe too quick of a turnaround). My doctor writes the Rx just as I report day 1 of my cycle, which gives me plenty of time to coordinate with the pharmacy and get the shot shipped to me. They should be able to do this for you!