Oh Google, why do you let crazy hormonal ladies that are desperate to become pregnant search for fertility drug information?  I have successfully caused myself to freak out about the drug that I am going to start on Wednesday.  Popping that 6-letter word into the text box and clicking search has led me to some terribly scary articles and warning about using Femara as a fertility drug.  Fantastic.

My RE prescribed me Femara instead of Clomid recently to see if that might have an affect on shortening my cycles, moving up my ovulation date, and causing me to produce healthier eggs.  She told me that the drug was much easier to handle than Clomid, handed me a prescription, and saw me out.  Not a whole lot of guidance there.  :-(

Apparently, this drug has been used since around 2001 by fertility doctors to stimulate ovulation in women who don't ovulate or strengthen ovulation in women who already ovulate.  Femara is approved by the FDA to treat breast cancer patients as it inhibits estrogen production.  When used for fertility purposes, this drug is used almost identically as the drug Clomid is used, but has less side effects such as mood swings, decreased cervical mucous, and a thinned uterine lining.  The success rate is almost identical between the two drugs, but Femara is NOT approved by the FDA for fertility usage.

A Canadian study published in 2005 found that women who took Femara as a fertility med had a much higher risk of birth defects than women who were taking Clomid.  This caused the drug's maker, Novartis, to condemn the drug for fertility use.  Other studies have been done since 2005 and none have shown any higher risk of birth defects unless the drug is taken while pregnant.  It is considered a class D medication and should never be taken while pregnant.  Due to the fact that Femara is taken early in the cycle (usually cycle days 3-7 or 5-9) and it has a short half-life, it is not present at the point where pregnancy begins.  I question why REs would prescribe a drug for fertility that they thought had a high liklihood of birth defects?  I hope they have done all their research here.

I have trolled many different sites over the past few days trying to find success stories and I have found many.  I have also found many stories about ladies who it has not worked for or ladies who were cautioning against its usage.  It is enough to make any infertile woman go crazy and second guess an already tough decision that was made to start messing with nature.  Even after all of the tortuous reading, I am still going forward.  I hope I won't regret it.  Gulp.

Here is my protocol for my "prevention" cycle with Femara that I have researched (my RE basically just said take it from cd 5-9 and call us if you get pregnant):

1. Start 1 pill a day regimen on cycle day 5.  Continue 1 pill a day until cycle day 9.
2. Start opks on cycle day 10.
3. Hopefully ovulate between cycle day 14-17.
4. Wait 2 weeks and take a pregnancy test to make sure I am NOT pregnant.
5. Call doctor to get blood test to BE SURE I am NOT pregnant (I am not risking birth defects).
6. Get period, rinse and repeat minus protection.

Here goes nothing...

References:

The pros-
Letrozole (Femara) for Infertility Treatment:  http://www.ivf1.com/letrozole-femara-infertility/
Femara (Letrozole) for Infertility, Ovulation Problems and PCOS Treatment: http://www.advancedfertility.com/femara-letrozole-fertility.htm

The cons-
Femara: Warning Against Use for Infertility: http://www.drugs.com/news/femara-warning-against-infertility-1636.html
The Troubling Femara Infertility Connection: http://www.fertileheart.com/the-troubling-femara-infertility-connection/