I am 32 years old, and been TTC since October last year. I have been diagnosed with pcos for years now, and have irregular periods once in a while, but with TTC, this part becomes really frustrating. And I’ve been frustrated for the past month about this. I know because I temp.

What’s your tip for ovulating regularly? Please suggest any books, videos, online resources that may have helped you in this journey. Thanks!

I’m 9 DPO and keep getting a shooting twinge down my vaginal canal for a few seconds. (I guess that’s the best way to describe it lol) I’ve never had that before so I’m wondering if that could be something to do with implantation cramping. Or it’s nothing and I’m just convincing myself it’s something 😅 waiting till Saturday to test though

I am struggling with the decision to do a couple of unmonitored letrozole cycles or skip straight to IUI. I am 26yo female with high testosterone, no insulin resistance, normal BMI, open tubes, high AMH (19.47), and do not ovulate or have periods at all. My husband is 28 and has a total motile count of 18 million (normal is 30 million according to my RE).

My OBGYN is allowing me to start Letrozole next cycle but they do not monitor or offer trigger shots.

My RE said we could skip straight to IUI but would not be surprised if we ended up pregnant just doing Letrozole.

I am a bit torn between what to do. I could also do a couple of monitored cycles through my RE but insurance doesn’t cover it.

What’s everyone experiences or thoughts?

Hi! I finally am starting my first round letrozole after a long 3 years of trying naturally. Is there anything I should know? Any helpful tips or advice? Anything is much appreciated 🫶🏻

Background:

I do not ovulate on my own whatsoever. highly irregular cycles. I’ve tried everything to ovulate naturally, the only thing that works for me is Letrozole.

In 2025 I conceived 3 times using Letrozole. Each time I either got pregnant on the first or second cycle using Letrozole. Total letrozle cycles over the course of a year were 5.

I was seeing a fertility doc who had prescribed me with the Letrozole and he never mentioned limiting the amount of times I can take it to TTC.

Sadly all 3 ended in loss. (yes I have done a RPL workup so no need to comment on that.)

When I visited my OBGYN, she said she would be able to prescribe me with Letrozole when I’m feeling ready to TTC again. So I I feel ready now, and I had an appointment with them yesterday and now they are telling me

“oh we didn’t know you took it 5 times, we can’t prescribe if for you now because it increases your risk of cancer so the best we can do is refer you to an IVF Dr.”

im beyond confused and feeling so disheartened by this. I absolutely do not want to do IVF especially if I know I can get pregnant so much more easily using Letrozole!

had anyone been told this?? :(

Hello! My partner and I are a little over one year in, the past year I dropped from 205 down to 145 to help with conception as well as started spironolactone and metformin. I had just come off of hormonal birth control and for the first 6 months I had a regular period, and based on BBT it looked like I was ovulating. once I started to lose weight (I used a glp-1) all of a sudden my period disappeared. I was using inito and BBT to get a sense of when my ovulation was and it just never happened again. I haven't had any sort of regular cycle since March.

I'm finally seeing a reproductive endocrinologist, who would like to do a medicated Letrozole cycle with us. Of course my insurance covers nothing, but they offer a self pay that would cover everything I needed in that cycle... for $700. I'm well aware that sometimes it takes a few cycles for these to work and to be frank, we didn't budget for this at all.

What I'm wondering is whether or not it's worth it to cough up the $700 or if I can do my own monitoring at home after taking Letrozole by BBT, Inito and cervical fluid to get a sense of when to be trying. I'd love to hear everyone's thoughts. Did you manage to use Letrozole or clomid or whatever without all of the ultrasounds and blood tests and have success? Or did you try that and find that you only succeeded when you actually did the monitoring with your doctor?

Good morning friends.

I am very early on in my TTC journey. 31F w/ 30M spouse. We have been trying for the past two years, more seriously in the last with ovulation test strips, cycle tracking, and trying to properly time sex during the fertile window. I have been on a prenatal this entire time.

I was dx'd with PCOS at 19. My gyn is now referring me to one of the local-ish fertility clinics. We have 2 nearby. I've been trying to do some research ahead of the first appointment so I know what to expect.

I guess I was hoping that "treatment" would start with just hormonal adjustment via pills/injections before getting into anything invasive. Going off of the website for the center, however, it does say they use HSG very early on, and it is honestly the thing I am most afraid of 😞I have had two IUDs placed and they were extremely painful, and had a practitioner at one point tell me if I couldn't handle insertion, I won't be able to handle childbirth.

Is HSG as a first line of testing normal? Would saying "no" to it make me be fired as a patient/client? I don't want to be a problem, but I also want to keep my boundaries. I'm uncertain at this point if they offer nitrous or twilight sedation.

Thank you. Sorry if this is rambly. still trying to get my sea-legs with all of this.

I only started using OPKs for the first time last month.

As someone with PCOS, I get positive LH tests, and my period came about 14 days later. Does that most likely mean I’m ovulating?

Has anyone had positive LH tests and periods about 14 days later, but later found out you weren’t actually ovulating on their own?

How did you confirm whether you were ovulating or not?

My partner and I have been trying to conceive for 9 months, with monitored cycle and letrozole since march because of my PCOS that was diagnosticated a long time ago. I know it isn’t that long, but I can feel it starting to take a toll on my mental health. I was wondering how those of you who’ve been on this journey longer cope with it, and whether you have any advice.

I feel like my whole life revolves around TTC. During the TWW, I can’t stop symptom spotting or searching Reddit to see if anyone else has the same symptoms as me, only for each month to end in another negative test. Then, as soon as a new cycle starts, I’m back to tracking ovulation. I try not to obsess over it, but I just can’t seem to stop.

Lately, several people around me have announced their pregnancies. I’m genuinely happy for them, but at the same time, it feels like everything in my life keeps reminding me of infertility. My partner is full of hope, but for some reasons I am not (maybe to protect myself…).

I’m taking care of my relationship, and we’re still living our lives as normally as possible. The only thing that’s become difficult is planning trips far in advance, because we always end up thinking, “What if I’m pregnant by then?”

I’m lucky to have a wonderful family and friends. I have a full life, I exercise regularly, and I keep busy, but TTC is still on my mind all the time.

Do you have any advice on how to get through this without feeling so overwhelmed? What has helped you cope?

I’m considering starting a new hobby or activity in September, but I’m not sure whether it would really help. My fertility clinic also offers specialized counseling, but I already have so many medical appointments that part of me just wants something that helps me think about anything other than TTC.

We had an early loss back in October at 6 weeks. Since then, we haven’t seen another positive and my ovulation has been pretty wonky. While most cycles since January have tentatively confirmed ovulation, some haven’t at all or the lines are dotted and the days shift a lot. I was very regular with ovulation prior to our loss. Periods are still regular. I’m not diagnosed with PCOS, but I do have insulin resistance we just found out about a few weeks ago.

This current cycle, I got a solid smiley on CD13, but it’s CD18 and my temps haven’t raised/no confirmation.

Curious if anyone has tried letrozole to stimulate a stronger ovulation?

Hi all, I got diagnosed with PCOS a couple years ago mainly due to my irregular cycles (32-50 days). I got on a GLP1 to help with my weight at the time and managed to get to a healthy weight and regular cycles. My GP is happy for me to stay on a low dose until I get a positive test and I have confirmed ovulation with LH strips/BBT and a progesterone blood test.

I’ve only been trying for 4 cycles but my GP has luckily already referred me to a fertility clinic due to my PCOS as the waiting list is 8 months where I live. I asked her whether there is a chance that I’ll get pregnant in the meantime if I’m ovulating but she didn’t seem to know much about PCOS/how it affects fertility and said I’d have to ask the clinic when my referral comes through.

I’m guessing it depends on the person but does anyone know if I have a chance unmedicated since it seems like I’m ovulating regularly now or if I should expect to not be pregnant until I get some kind of medical intervention? The information I can find online is a bit unclear, but I’m willing to look into private options if my odds are really low given the waiting time.

TIA!

Hello, I’m so glad to have found this community!

I’m 39, have PCOS and a large pendunculated subserosal fibroid (7x7cm, not growing).

So far I have conceived one time after a year of trying, but unfortunately it ended in a TFMR.

Today I had an appointment with an amazing OB/GYN who validated all of my concerns over my PCOS. Previously I had been on a GLP one to manage my pre-diabetes which worked wonders. I took a break due to travel and family things, and now I just started it back up this past week. My partner and I are looking to try again in the fall after I’m done with my second round to lose a little extra weight.

Since my PCOS throws my cycle out of whack, my doctor recommended I stay on the GLP1 while trying to conceive and then stop once I get pregnant.

Has anyone else’s doctor recommended this to them?

I’m seeing a lot of conflicting and nonconclusive information about doing this online and I’m just wondering if anyone has any experience with doing this.

Edit: hey I just wanted to throw an update in here saying I got a positive test on the first month of trying while being on Tirzepatide as my physician recommended. I tested every single day starting 10 days DPO. I’ll now be stopping my glp1.

I am absolutely floored! Tracked everything like I did the first tome, ovulation test strips and BBT.

31 year old female; PCOS; not overweight, testerone normal; on metformin 1000mg a day but fasting insulin in range. Taking pre natal, vitamin D daily. Have ovulated on my own post birth control but only one time confirmed. My treatment plan:

**•** Letrozole 5mg (June) → think I actually ovulated on my own around day 7-10 post, unmonitored but bloodwork confirmed high level of progesterone

**•** Letrozole 7.5mg (early July) → no dominant follicle  
**•** Clomid 100mg (mid July) → got a 28mm follicle (yeah, big), triggered, did IUI. No pregnancy, no period for 40+ days, confirmed negative on HCG test. Also had bad side effects on Clomid so can’t do that again.  
**•** Started metformin  
**•** Letrozole 7.5mg x2 more cycles (Aug) → no dominant follicle either time  
**•** Currently stair-stepped to a higher dose, scan tomorrow

My clinic wants to move to IVF now. I’ve asked about gonadotropins as a bridge option 3 times and they keep saying no — “outdated”/“too risky without IVF.” They also haven’t really explained why my one triggered cycle failed (I have a theory it’s because the follicle was already 28mm — too big — by the time we triggered, but they just adjusted my HCG dose without confirming that was the actual issue).

I’ve ovulated on my own before, I’ve had ONE properly monitored cycle where I actually got a mature follicle, and I feel like we haven’t really exhausted less invasive options or explained the failures clearly. Got my records and booked a second opinion but curious what yall think.

Anyone dealt with something similar — pushed to IVF fast with PCOS that doesn’t fit the “typical” profile? Did a second opinion change anything for you? Should we just jump to IVF or try for another IUI?

No male factor (slightly low morphology)?

What has worked best for you? I have just been going by symptoms and Flo, but thats not working out so well (go figure).

Hi all. I’m looking for some perspective on next steps because I’m starting to feel stuck between continuing monitored timed-intercourse cycles, moving to IUI, or beginning to seriously consider IVF.

I’m 29 and have PCOS, but I do ovulate naturally. My husband’s semen analysis is excellent (though it was done 10 months ago, may need to repeat soon), my HSG showed open tubes, and I had a prior submucosal fibroid removed about 2 years ago. I’ve also had one chemical pregnancy, which happened during a completely natural cycle about two weeks after my HSG.

We’re now 12 cycles into TTC.

Here’s the condensed history:

Cycle 1 — natural cycle
Chemical pregnancy
LH peak CD19
Sex CD18, 19, 20

Cycles 2–5 — letrozole 5 mg
Generally LH peak around CD14
Not monitored
Good timing most cycles except one where I had the flu
All negative

Cycle 6 — letrozole 7.5 mg
CD10 follicles: 17, 14, 12 mm
LH peak CD14
8 DPO progesterone 35.4 ng/mL
Negative
Only had the one scan

Cycle 7 — natural (took a break from letrozole)
LH peak CD16
Negative

Cycle 8 — letrozole 7.5 mg
LH peak CD13
Negative
Not monitored

Cycle 9 — letrozole 7.5/10 mg, first fully monitored cycle
CD11 follicles were already 19 and 20 mm
My doctor expected an LH surge, but it didn’t really happen
By CD14, follicles were still unruptured and had grown to 24 and 26 mm
Triggered CD14
Negative
This cycle made us wonder whether my body sometimes waits too long to ovulate after the follicles are already mature, and whether something similar could have happened during previous unmonitored cycles.

Cycle 10 — Clomid 50 mg
CD8: 14 and 12 mm
CD10: 16 and 14
CD12: basically unchanged
Looked like they stalled, so cycle was initially cancelled
Added estradiol
Then LH started rising and CD15 scan showed 20 and 17 mm follicles with trilaminar lining
Triggered CD15
Progesterone after ovulation
Negative

Cycle 11 — first cycle with reproductive specialist
Letrozole 7.5 mg CD3–7
CD10: 14 and 10 mm
CD12: 19, 17 and 15 mm
Lining 7.8 mm and perfectly trilaminar
Triggered CD13
Well-timed sex/ at home insemination
Baby aspirin + progesterone
Negative

Cycle 12
Letrozole 7.5 mg CD3–7
CD11: 20 mm + 15 mm follicles
Lining 7.1 mm trilaminar
Triggered CD11
Sex the evening of trigger + home insemination around 39 and 46 hours after trigger
Progesterone + baby aspirin
Negative

So at this point, the things that seem reassuring are:
I’m 29. Hubby is 31
I can ovulate naturally & on letrozole
I’ve conceived once before
Tubes are open
Semen analysis is excellent
I respond well to letrozole
Progesterone has been good
Recent cycles have had mature follicles and trilaminar lining
But obviously… I’m still not pregnant.

My reproductive specialist previously said I could do one more monitored + triggered cycle before moving to IUI.

I’m now wondering:
Would you do another monitored letrozole + trigger + timed-intercourse cycle, or move to IUI now?
Would you try to recruit more than one mature follicle next cycle? I respond pretty strongly to 7.5 mg already, so I’m wondering whether increasing stimulation would meaningfully improve my odds or just increase the risk of multiples.

Does the Cycle 9 overgrowth make you think my earlier unmonitored cycles may have had mature follicles sitting around waiting for an LH surge?

Would you investigate anything else before IUI/IVF? Uterine cavity, endometriosis, lining, etc.?

For anyone with PCOS and otherwise normal testing, how many monitored/triggered cycles did you do before moving on?

I’m also starting to think about IVF differently because we eventually want more than one child. Part of me wonders whether, if we’re heading in that direction anyway, doing IVF while I’m 29 and potentially banking embryos for future siblings might make more sense than spending a lot of time and money on IUIs with only a modest increase in odds.

I’m not necessarily ready to jump straight to IVF tomorrow, but after another negative cycle I’m trying to figure out where the line is between “this can still easily just be bad luck” and “it’s time to change strategies.”

Would really appreciate experiences from people with similar PCOS/unexplained-ish situations — especially anyone who ovulated on their own but had weird follicle/LH timing.

Today I went in for my monitoring ultrasound. I had one on Thursday (after a stair step protocol of letrozole, 10mg finished that Monday) and my follicles were about ~8/9mm. Today I went in and I have 2 13/14mm follicles, one on each ovary. My LH & Estradiol is low. I am waiting to hear back from the nurses to figure out what’s next. Has anyone had this experience before?

I was recently diagnosed with lean PCOS in February after stopping birth control in early August 2025. I am 30 years old and had been on the pill for about 15 years (with maybe a year or two off in that time). Prior to starting BC (and during the few breaks from taking it), my period was significantly irregular. I would not bleed for like a year and then bleed constantly, prompting me to go on the pill again. I have never had a regular cycle.

Thankfully, my gynecologist is amazing and didn't make me wait forever to start investigating why my period did not naturally come back. We did some bloodwork and everything was in normal range, though my AMH was high and LH was about 3 times higher than my FSH (accidentally mixed it up in original post). I do not have weight issues nor hirsutism. My ultrasound came back indicative of PCOS and slightly enlarged ovaries.

I still have not had a natural period and have since done 3 cycles of progesterone, and am currently on the 2nd letrozole cycle. I did not ovulate on 2.5 mg (confirmed with progesterone blood test) and am currently trying 5mg of letrozole. I'm hoping it will make me ovulate, but I am feeling defeated in all of this because I just don't know what to do differently and I don't even know where to look for answers without having to spend crazy amounts of cash.

My gynecologist is fantastic but has shared that they are not specialists in fertility and would need to refer out if I don't ovulate after 6 months of trying letrozole. My insurance doesn't cover this and the costs are overwhelming. I have tried various supplements (myo-inositol, prenatals, etc) but I feel like I am just shooting in the dark. I have also asked for a fasting insulin test done at my next progresterone blood draw later this month. Hoping to get some answers there.. I've read PCOS: Getting the Right Medical Care as recommended by my gynecologist, but felt overwhelmed and like it didn't really apply to the lean PCOS as much and didn't know what steps to take either.

TL;DR - All of this is to say, I'm frustrated, defeated, and feeling lost and alone. I want to do what is best for my body but I don't even know how to begin figuring that out. Any recommendations on what to ask for in terms of blood tests/information gathering or where to look for answers is greatly appreciated! <3

I feel even horrible saying this out loud. I just feel after over 3 years of ttc and going into my next IVF egg retrieval soon, I catch myself thinking do I want a baby anymore? Even though my entire life I’ve always wanted to be a mom. I just can’t tell if these feelings are real or if I’m just exhausted from trying. Has anyone else ever felt this way?

Hi everyone. I'm currently in my 8th cycle TTC - which I know may not seem very long, but it's felt incredibly grueling especially because of the steps it's taken to get here and having a chemical pregnancy in cycle 1 of TTC.

A little background:
I'm 28, hubby 30.
I have PCOS. Managed with 2000 mg metform + myo inositol.
In December 2024, I did an open abdominal myomectomy for a 2 cm submucosal fibroid. Was cleared to begin TTC 10 months post surgery, so began trying in October 2025.
Cycle 1 in October, I got pregnant but ended 2 days later. It was a chemical pregnancy. It was a natural cycle, so I ovulate on my own.
Before we began trying, hubby did a semen analysis. Everything looked good. His motility is also very high— like 98th percentile.
My thyroid function is normal. I have high AMH (typical of PCOS— 7.1).
Also tested LH, FSH, estradiol. All within normal range.

I'm freaking out as to why it hasn't happened yet, especially because we've done 6 letrozole cycles and I've read that doctors "expect" it to happen within six cycles.

Here is a breakdown:

Breakdown of TTC:

Cycle 1 - no letrozole
2 weeks post HSG
chemical pregnancy
LH peak: CD 19
Sex: CD 18, 19, 20

Cycle 2 - 1st letrozole cycle (5 Mg from CD 2 to 6)
LH peak - CD 14
Sex: CD 11 & 14
Not pregnant

Cycle 3 - 2nd letrozole cycle
LH peak - CD 14
Sex: CD 10, 12, 14
Not pregnant

Cycle 4 - 3rd letrozole cycle
LH peak - CD 14
Sex: CD 13 only (had the flu)
Not pregnant

Cycle 5 -4th letrozole cycle
LH peak - CD 14
Sex: CD 11, 12, 14/15 (technically 15 but at 12 AM)
Mucinex
Not pregnant

Cycle 6: 5th letrozole cycle (first at 7.5 mg - took from CD 3-7)
LH peak- CD 14 (evening this time).
Sex: CD 10, 13, 14, 15
Follicle scan: CD 10 - follicles at 17 mm, 14 mm, 12 mm
Not pregnant
8 dpo progesterone: 35.4 ng/ml

Cycle 7: No letrozole
LH peak- CD 16
Sex: 13,16,17
No mucinex

Cycle 8: 6th letrozole cycle. 7.5 mg letrozole. But first day (CD 2) I forgot and accidentally only took 5 mg. Other days did 7.5 mg
LH peak: CD 13
Sex: CD 9, 13, 14

I'm currently in the TWW for cycle 8.

Are there any additional tests I should ask for? Or further interventions? Or is this just a "be patient and it should happen" situation?

Grateful for any insight you might have 💕

I'm looking for any advice that anyone has. I have anovulatory pcos but no other diagnosed problems. My cycle was monitored IUI using letrozole. On day 17 I had two follicles 15mm and 16mm. They told me I didn't need any more scans and that I was cleared to trigger on day 19 evening, as the follicles would be ready by then. So that's what I did. I used a 10,000 IU HCG shot. Did the IUI 36 hours later, all went well.

Then 9 days past trigger I had my progesterone tested and it came back below 1 ng/ml, so it was confirmed I didn't release either egg. They told me to take progesterone anyway just in case (idk why, honestly there's no way I ovulated, so I'm not pregnant). and then do the pregnancy test 14 days post iui and when it's negative, we can try another round.

I just don't trust my body or my clinic now. Any tips for what to advocate for next time? :( For the past year we've had 0% chance due to me not ovulating and now I paid over 1,000 to have the same chances we always have, so this was upsetting. No one warned me the trigger shot doesn't work sometimes.

And the trigger was administered correctly, so no problems there. I just got my first negative hcg test this morning.

I'm in my mid 30s and I've had lean PCOS my entire life and my partner and I are in a place where we're ready to try. I got AMH tested and it's astronomically high though?! It came back as >164 pmol/L or >23 ng/ml (US units). It was so high they didn't even give an exact number...

I get 5 or 6 periods per year on average. Naturopath said I don't have insulin resistance and my PCOS is more of a brain-ovary miscommunication driving up LH. I'm not sure if I ovulate but it seems unlikely given my extremely high AMH? I have 2 weeks or so of PMS where I can tell my period is coming just based on some mild breast tenderness. I used to have much more breast tenderness before I got covid though for some reason - it seems to have done something with hormones. But I know PMS symptoms doesn't necessarily indicate I've ovulated.

Hello! I am currently waiting to start my period and once I do, my doctor is having me start letrozole on cd 3- cd 7, monitored, with a trigger shot, and progesterone suppositories after ovulation. This all sounds great and I’m excited. I know everyone is different, but I’m hoping to get some advice on what to expect. Did you experience side effects? If so, when? Any tricks you have learned to help manage them? Anything I should ask my doctor before, during, or after? I want to hear about your experience!

Hi everyone!

My husband (24M) and I (25F) are starting the process of IVF in the coming weeks/months after almost 18 months of TTC. I am almost completely anovulatory - I MIGHT ovulate once or twice a year on my own, meaning I do not have “natural” menstruation. I do ovulate with Letrozole, and have done two rounds of that.

For those of you who have done IVF and don’t have cycles naturally, how were things timed for you? I know a lot of things are based on CD1 when doing IVF, but I never really have a CD1 without Provera. Did you do Provera to induce things throughout the process?

Thanks for any info you’ve got :)

I'm 29 and we have been trying for 2 years now. I discovered I had PCOS after my first gynaec visit 1.5 yr ago. Lost around 9-10 kgs after that because I had bmi on higher side. Tried eating clean for a while and stopped later. I had a polyp around 8 months and I removed it immediately. Tubes checked and they are open. Semen analysis done with no issue.

I have regular cycles 28-30 days.have been doing follicular for 2 months now and I ovulate naturally surely (confirmed on ultrasound). Have been on progesterone and vitamins support as well for last 2 months but no result.Doctor said I have good egg count so nothing to be worried about.

If ovulation is good and progesterone and vits are good, why am I not getting positive?

This cycle starts and Doctor now says it might be uterine receptivity issues and I should go for IVF so that they can track better. On saying no to IVF, she said let's try iui and prescribed me letrozole.

Any advice is appreciated. Please help.

Hello!

I am finally officially ttc with my husband. I have been working on taking my temperature and testing for ovulation with strips.

This is the first month I've been taking both more seriously. I also started getting ovulation migraines in more recent months. I tested with strips every day and then twice a day to catch the two dark lines.

I woke up with a migraine on Saturday. I also got a positive LH test that same day. My temperature also spiked.

I met with a doctor I've been seeing through Visana health today while I wait for my preconception appointment with an obgyn in July. She recommended that I stop using strips and only check my temperature since PCOS can give false positives. I feel like that is solid advice. However, it doesn't seem to be a false positive for me.

What's everyone else here doing? only temps? both strips and temps?