How to Track Basal Body Temperature: Everything You Need to Know. Progesterone WebOnce your ovarian follicles show the desired diameter, you will receive your HCG shot. Day 21 progesterone level on letrozole S Seemz85 Jul 22, 2018 at 6:01 PM I need some help/advice and clarity. GnRH-a: gonadotropin-releasing hormone-agonist; GnRH-ant: gonadotropin-releasing hormone-antagonist; P1.5: the proportion of women with a progesterone level >1.5 ng/mL. While the use of letrozole in fertility preservation patients has a favorable effect on estrogen levels, no benefit is seen for progesterone levels which are high and comparable with progesterone levels after standard COS in IVF patients. What should progesterone level be on letrozole? Meanwhile, an increase in the number of follicles means an increase in the accumulation of precursors in the presence of LE. Fertil Steril (2018) 109:57782. Unauthorized use of these marks is strictly prohibited. WebStudy design, size, duration: This is a prospective observational study comparing estradiol and progesterone levels of 21 breast cancer patients undergoing letrozole-associated Neuroendocrine regulation of the corpus luteum in the human. Mehdinejadiani S, Amidi F, Mehdizadeh M, Barati M, Pazhohan A, Alyasin A, et al. Progesterone levels of > 1.5 ng/mL on trigger day can affect the results of embryo transfer, and it is recommended to freeze all embryos before transferring (21). found the endometrial thickness was significantly greater in the letrozole group than in the AC group, both on the day of starting progesterone and on the day of ET . Last month my 21 day progesterone was 7.5 and this month it's 26! Bethesda, MD 20894, Web Policies Heres everything you need to know to have a productive conversation with your doctor. Usually, the starting dose of LET is 2.5 mg/day for 5 days (usually starting on day 3 of the cycle). Those are good levels though! The estrogen negative feedback effect on the hypothalamus-pituitary axis and the disruption of steroid biosynthesis and could represent an intriguing reason behind this phenomenon. doi: 10.4103/0974-1208.101014, 18. In the PSM 2 cohort, progesterone levels on the trigger day increased by 0.05 ng/mL with an increase in every retrieved oocyte in the LE GnRH-ant group ( 0.05 ng/mL [95% CI 0.04, 0.06], P < 0.001), whereas an increase of 0.02 ng/mL was observed in the GnRH-a group ( 0.02 ng/mL [95% CI 0.01, 0.03], P < 0.001), with P for interaction being 0.0002. Progesterone levels are relatively easier to increase with the increase in the number of eggs in the LE GnRH-ant group. 4. Got bloodwork done yesterday on day 21 of my cycle and my progesterone level was0.10. The Propensity Score. Comparison of Perinatal Outcomes of Letrozole-Induced Ovulation and Hormone Replacement Therapy Protocols in Patients With Abnormal Ovulation Undergoing Frozen-Thawed Embryo Transfer: A Propensity Score Matching Analysis. Recommendations | Fertility problems: assessment and treatment High progesterone levels during the luteal phase related to High progesterone levels can be related to the use of letrozole independently of the most commonly used trigger regimen. This educational content is not medical or diagnostic advice. Progesterone gets the uterus ready to accept and maintain a fertilized egg. To confirm that if you are ovulating, that you are producing enough progesterone. That depends on when you ovulate. Although using letrozole (LE) during in vitro fertilisation and intracytoplasmic sperm injection (IVF/ICSI) has many advantages, it remains unclear whether LE induces an increase in progestogen during the late follicular phase. All Rights Reserved. Mine have been in the single digits so Im always on progesterone during the TWW. 5. Besides POI, the P/E2 ratio was proposed as important when considering the number of developing follicles in COS cycles. letrozole I am currently continuing at SunAgri as an R&D engineer. I had some issues with my day 21 progesterone levels being low, so I started taking letrozole and it helped. Federal government websites often end in .gov or .mil. Hum Reprod (2016) 31:185965. Vitamin B6 has been shown to help improve progesterone levels and is, therefore, one of the vitamins which women who are trying to conceive often take. eCollection 2020. and transmitted securely. When estrogen is blocked, the pituitary gland gets a message that it needs to produce follicle-stimulating hormone (FSH), which stimulates the ovary to produce an egg. Bookshelf Stress about getting pregnant is real. when the clinic called to tell me the results, Id already had a positive on digital and they said they werent surprised with numbers that high. Frontiers | Role of luteinizing hormone elevation in outcomes of In this study, these indicators were considered to evaluate the potential effects of LE. This is my 2nd iui cycle. The Value of Serum Progesterone Level on Day of Human Chorionic Gonadotrophin Administration/Metaphase II Oocyte Ratio in Predicting IVF/ICSI Outcome in Patients With Normal Ovarian Reserve. letrozole In IVF University referral center, a case series of three breast cancer patients who underwent controlled ovarian stimulation (COS) with recombinant FSH and letrozole were investigated. Letrozole is taken to stimulant ovulation in women who are having difficulty conceiving. Wearable BBT: Is it just as accurate as oral BBT? What is the structural formula of ethyl p Nitrobenzoate? 2015 Jun;27(3):215-21. doi: 10.1097/GCO.0000000000000180. What Causes Brown Discharge and What Does it Mean? reported that the POI is inversely related to pregnancy rate and concluded that the POI is better correlated with IVF outcomes than blood progesterone levels (29). Some studies revealed that clinical pregnancy rates and live birth rates in the LE group are significantly higher, and the rate of miscarriage is significantly lower compared to those in the natural and hormone replacement cycle groups (9, 10). For people who have PCOS, the cancer drug The month I conceived my progesterone level was 22.6. The day 21 blood test is supposed to check your progesterone levels at the time when they should be at their peak. Progesterone levels during controlled ovarian stimulation associated with letrozole in breast cancer patients according to estradiol levels at trigger (<250 pg/ml (a) But what if you dont ovulate on day 14? Once the accumulation of androgens reaches a certain threshold, progesterone accumulates, increasing its levels in the blood, which has also been proven in previous studies (14, 19). WebIn women with regular menstrual cycles, progesterone levels tend to stay below 0.89 ng/mL before rising to 1.8-24 ng/mL during ovulation and the luteal phase. Low Progesterone: Causes, Symptoms, Tests & Treatment Based on different ovulation induction protocols, 1,133 infertile women who underwent ovarian stimulation were divided into the following groups: GnRH-a (383), GnRH-ant (390), and LE GnRH-ant (360) (Figure1). No use, distribution or reproduction is permitted which does not comply with these terms. Is letrozole during ovarian stimulation useful in breast cancer patients undergoing fertility preservation to reduce early luteal progesterone levels following GnRH-agonist trigger? A study has reported that in patients with high responses (the average number of retrieved oocytes is 1213), the progesterone levels significantly increase and the proportion of patients with a progesterone level >1.5 ng/mL also increases significantly (19). J Hum Reprod Sci (2012) 5:1704. Haukoos JS, Lewis RJ. on Letrozole What is Day 21 Fertility Testing and Why Is It Important? In the first cycle of Letrozole, you should have a blood progesterone level drawn on day 21, 22, or 23. Not sure theres a correlation to your progesterone level and multiples. Mukherjee S, Sharma S, Chakravarty BN. Careers. Elgindy EA. A progesterone level of 10 ng/ml considered as ovulatory. Web3. Reports on the effects of LE on progesterone levels during ovulation induction are inconsistent, largely because the above findings are based on RCTs with small sample sizes. Progesterone Level and Progesterone/Estradiol Ratio on the Day of hCG Administration: Detrimental Cutoff Levels and New Treatment Strategy. The matching ratio was 1:1, and the matching range of the score was 0.005. Clomiphene (Clomid): This drug can trigger ovulation. Good luck and baby dust to you! Zhang W, Liu Z, Zhang J, Ren B, Liu M, Li J, et al. The RE started me on 2.5mg of femara. The results indicated that the antagonist protocols that introduced LE increased the risk of high progesterone levels on trigger day. Yang X, Lin G, Lu G, Gong F. Letrozole Supplementation During Controlled Ovarian Stimulation in Expected High Responders: A Pilot Randomized Controlled Study. Reprod BioMed Online (2011) 23:3808. 1) or with GnRH agonist (case No. In the intention-to-treat analysis, women who received letrozole alone had a disease-free survival rate of 73.8 percent at 8 years, compared with a rate of 70.4 percent for women who received tamoxifen alone. A Group Leader is a What to Expect community member who has been selected by our staff to help maintain a positive, supportive tone within a group. Anovulation and Ovulatory Dysfunction - Verywell Family I also started taking estrogen and progesterone supplements (seperate days after the letrozole.) Evaluation and Treatment of Infertility | AAFP In patients with normal responses (the average number of retrieved oocytes is 7.78.0), researchers reported that progesterone levels show a significant increase; however, no increase in the proportion of women with a progesterone level >1.5 ng/mL is observed (14). Conclusions: Third, there is no association between the increase in LH and progesterone levels according to the tertiles stratified analysis. Shufaro etal. doi: 10.1093/humrep/den131, 19. Gynecol Endocrinol (2018) 34:63843. PSM was efficient in minimising bias due to confounding. Thank you for responding! government site. Effect of Letrozole on Moderate and Severe Early-Onset Ovarian Hyperstimulation Syndrome in High-Risk Women: A Prospective Randomized Trial. Before My CD 21 progesterone levels were were up to the 40s and even A small sample size may also be responsible for no difference in the proportion of patients with a progesterone level >1.5 ng/mL in some studies. The day 21 blood test is supposed to checkyour progesterone levels at the time when they should be at their peak. I had some issues with my day 21 progesterone levels being low, so I started taking letrozole and it helped. 1 doctor answer 2 doctors weighed in Share Dr. Gebrehana Zebro (formerly Woldegiorgis) answered Internal Medicine 34 years experience When the lead follicle was 14 mm or more in diameter or oestradiol levels were 400 pg/mL, patients received 0.25 mg of antagonist (Cetrotide; Merk Serono, Switzerland) until they were triggered by hCG (Chorionic Gonadotrophin, Lizhu, China). Your post will be hidden and deleted by moderators. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). Pundir J, Achilli C, Bhide P, Sabatini L, Legro RS, Rombauts L, et al. Female hormone physiology HHS Vulnerability Disclosure, Help Should You Test Progesterone Levels on Day 21 of Your All patients were in the first cycle. Progesterone causes the uterine lining or endometrium to thicken. Peak luteal phase progesterone levels can vary from cycle to cycle, and from Letrozole Supplementation and the Increased Risk of Elevated Progesterone Levels on Trigger Day. Letrozole (Femara If your progesterone levels do not rise, you are probably not ovulating. doi: 10.1093/humupd/dmaa055, 5. Prior to letrozole, my progesterone was really low, like single digits and never higher than mid-teens. Letrozole (Femara): Like clomiphene, letrozole can trigger ovulation. 4) P/E2 0.55, i.e., the proportion of women with a P/E2 ratio of > 0.55. In PSM 2 cohort, patients in the LE GnRH-a group presented higher progesterone levels on trigger day (1.23 0.91 ng/mL vs 0.98 0.61 ng/mL, P < 0.001), with a higher proportion of patients with progesterone level > 1.5 ng/mL (25.45% vs 12.70%, P < 0.001). Second month I was on 7.5mg and I had one dominant follicle my progesterone came back at 33 but not pregnant. Age, duration of infertility, body mass index (BMI), anti-Mullerian hormone (AMH) levels during menstruation, factors of infertility, and treatment intervention features (including total gonadotropins, stimulation days, total retrieved oocytes, and hormone levels on trigger day) were collected from the hospitals medical record system. The site is secure. In the PSM 1 cohort, progesterone levels on the trigger day increased by 0.05 ng/mL with an increase in all retrieved oocyte in the LE GnRH-ant group ( 0.05 ng/mL [95% CI 0.04, 0.06], P < 0.001), whereas an increase of 0.02 ng/mL was observed in the GnRH-ant group ( 0.02 ng/mL [95% CI 0.01, 0.03], P < 0.001) (Figure2), with P for interaction being 0.0018, which suggest, with increased retrieved oocytes, women in the LE GnRH-ant group had a greater increase in progesterone levels than women in the GnRH-ant group. Letrozole has been shown to be superior to clomid in achieving live birth rates in women with infertility and polycystic ovary syndrome. A 33-year-old member asked: Progesteron level 0.3 ng/ml. Front Endocrinol (Lausanne). Hormone therapy for breast cancer Producing one follicle is the aim for women having clomiphene or letrozole to restore a regular cycle, while 2-3 follicles is the aim when using clomiphene treatment for unexplained infertility. Women with regular menstrual cycles are likely to be ovulating and should be offered serum progesterone testing at day 21 to confirm ovulation. Pritts EA. doi: 10.1016/j.fertnstert.2014.11.026, 30. In the follicular phase of your cycle (the first half of your When you take the drug, it stops androgens in your body from converting into estrogen. The recommended dose is 0.4 mg per day. Other studies have shown that progesterone level has a marked negative effect in the group where < 5 oocytes are retrieved; however, this is not observed among high responders (27). Symptoms of high progesterone are similar to premenstrual syndrome and can include anxiety and agitation, bloating, breast swelling and tenderness, depression, fatigue, and weight gain. Graduated from ENSAT (national agronomic school of Toulouse) in plant sciences in 2018, I pursued a CIFRE doctorate under contract with SunAgri and INRAE in Avignon between 2019 and 2022. Letrozole is considered an established treatment for ovulation induction. In a 28-day cycle with ovulation on day 14, progesterone levels will be at their peak aroundday 21. Other RCTs showed that LE supplementation increases the incidence of premature progesterone rise in the late follicular phase of IVF/ICSI (19) or increases progesterone levels (14, 20). After propensity score matching (PSM) for baseline characteristics, 266 patients with gonadotropin-releasing hormone-antagonist (GnRH-ant) were matched to 266 patients with letrozole + GnRH-ant (LE GnRH-ant) (PSM 1 cohort), and 283 patients with gonadotropin-releasing hormone-agonist (GnRH-a) were matched to 283 patients with LE GnRH-ant (PSM 2 cohort). I love to write and share science related Stuff Here on my Website. . XC: Resources, investigation. First, progesterone levels are much higher in the LE GnRH-ant group under the conditions where the number of eggs was similar (Table2). If the theoretical number of counting variables was less than 10, a Fishers exact test was used. The most common protocol is daily dose of 2.5-7.5 mg starting day 3-5 of the cycle for 5 days. It maintains the uterine lining, ensuring that its a friendly environment for an embryo to implant. M MNmomof2 Jan 7, 2013 at 5:50 PM M Myboo99 Jan 7, 2013 at 7:10 PM Usually just a day to get it back. Posted by Roswell OB/GYN August 10, 2020 October 21, 2022 Posted in Uncategorized Post navigation. When trying to conceive, its important to ensure PdG is elevated for a few days during the luteal phase, which is typically on days 7-10 after peak fertility. FOIA Conclusions: High progesterone levels can be related to This study may be useful in improving LE use. The educational health content on What To Expect is reviewed by our medical review board and team of experts to be up-to-date and in line with the latest evidence-based medical information and accepted health guidelines, including the medically reviewed What to Expect books by Heidi Murkoff. Other hormone levels, such as prolactin, also might be checked. doi: 10.1097/GCO.0b013e32833beebf, PubMed Abstract | CrossRef Full Text | Google Scholar, 3. WebI started on my first cycle of Letrozole/Femara in January. Once you are taking the proper dose, you should ovulate between 5 and 8 days after the last tablet is taken. After you ovulate, progesterone starts to rise, reaching a peak about midway through your luteal phase. Our research indicates that LE poses a strong risk of increasing progesterone levels. Studies have demonstrated that an increase in progesterone during the late follicular phase is associated with decreased pregnancy potential (25). To evaluate the hormonal profile in three breast cancer patients who underwent controlled ovarian stimulation in the presence of the aromatase inhibitor letrozole. Using this approach, 49.4%~83.8% of patients ovulated in response to 2.5 mg LET [7, 8]. progesterone eCollection 2021. An mmc followed by a pregnancy about 4 months later that was also an mmc. doi: 10.1016/j.ajog.2021.01.024, 6. Many studies have shown that progesterone produced in IVF/ICSI is related to the number of follicles (23, 24). You should have very low levels of progesterone in your system at this part of your cycle. Zhang J, Wei M, Bian X, Wu L, Zhang S, Mao X, et al. Fertil Steril (2019) 112(2):3717. Letrozole for Ovulation Induction and Controlled Ovarian Hyperstimulation. Aromatase inhibitors in stimulated IVF cycles. Progesterone Iorio GG, Rovetto MY, Conforti A, Carbone L, Vallone R, Cariati F, Bagnulo F, Di Girolamo R, La Marca A, Alviggi C. Front Reprod Health. Prior to letrozole, my progesterone was really low, like single digits and never higher than mid-teens. Finally, the different eligibility criteria of the studies limit extrapolations of the results. doi: 10.1016/j.fertnstert.2019.04.014, 7. If at least 1% of the cells have receptors, you can be considered for Some researchers believe that the number of mature follicles is very important in the evaluation of progesterone, so POI and P/E2 ratio were offered to assess the effects of progesterone. 2020 Jun 5;18(1):59. doi: 10.1186/s12958-020-00614-y. Rose BI, Brown SE. But if your doctor recommends day 21 testing without any information about when you ovulate, its time to advocate for yourself. The dose of Letrozole could be further increased to 7.5 mg per day for 5 days for the following cycles. Heres how to overcome it. sharing sensitive information, make sure youre on a federal A 2015 study concluded that it was remarkable that isolated progesterone blood tests are still used to diagnose low luteal phase progesterone levels, despite the clearly established barriers to its use. You will take Letrozole daily, starting on Cycle Day 3 (the first day of your menses is Cycle Day 1) and ending on Cycle Day 7. WebBut IF you HAVE timed your Day 21 progesterone test correctly, you can be confident youve ovulated if your progesterone level is 3 ng/ml (9.54 nmol/l) or above (depending on the Daily low-dose hCG stimulation during the luteal phase combined with GnRHa triggered IVF cycles without exogenous progesterone: a proof of concept trial. As someone who didn't ovulate on my own after my first child, the cramping I felt during ovulation was like nothing I had ever felt before. Reprod Biol Endocrinol (2019) 17:43. doi: 10.1186/s12958-019-0483-x, 20. A P/E2 ratio > 0.55 affects the clinical pregnancy rate, and the P/E2 ratio is the only independent prognostic factor for cycle outcomes in females undergoing cleavage-stage embryo transfer (30). doi: 10.1080/09513590.2018.1431772, 29. Day Eating a diet full of nutrients and omega 3 fatty acids, such as cold water fish or flax, improves the ability of the body to produce progesterone. Front Endocrinol (2021) 12:676133. doi: 10.3389/fendo.2021.676133, 2. Scenario: Management | Management | Infertility | CKS | NICE My RE wants them at or above 15. There was no statistically significant difference in patient characteristics between the two groups. The low detection limits were 0.100 mIU/mL for LH, 0.100 mIU/mL for FSH, 5 pg/mL for oestradiol, 0.05 ng/mL for progesterone, 0.025 ng/mL for testosterone. Figure3 Relationship between progesterone levels and the number of retrieved oocytes in GnRH-a and LE GnRH-ant groups. More posts from r/TTC_PCOS serum progesterone levels; and an endometrial biopsy. Progesterone Levels Group Black's collective includes Essence, The Shade Room and Naturally Curly. Letrozole is usually used for woman younger than 39 who Youre more likely to get pregnant if you have sex at least every other day between days 10 and 14 of a 28-day cycle. Am J Obstet Gynecol (2021) 225(1):59.e19. Biol Reprod (2019) 100:6418. Zhang J, Liu H, Wang Y, Mao X, Chen Q, Fan Y, et al. A level of 30 nmol/L or more is a good result. Figure1 Patient recruitment flowchart. No. WebI had some issues with my day 21 progesterone levels being low, so I started taking letrozole and it helped. For assessment of ovulation for women with a regular menstrual cycle (2) Measure mid-luteal phase progesterone (e.g day 21 of 28 day cycle; day 28 of 35 day cycle): Fertil Steril (2011) 95:163944. Create an account or log in to participate. Although progesterone has long been considered a protective factor against breast cancer, several studies have demonstrated that progesterone could expand a transformation-sensitive stem cell population in the mammary glands. Progesterone levels in letrozole associated controlled ovarian Patient Information Fertility Treatment using WebNext Day IUI and possible ultrasound Day 21 Progesterone blood test Day 32 If you have not started your period by today, perform a pregnancy test and call us with the result. However, there were significant differences in treatment results between the two groups (PSM 2 cohort, Table2). Im still trying to figure out how a medicated cycle should look. Estimating the Net Effect of Progesterone Elevation on the Day of hCG on Live Birth Rates After IVF: A Cohort Analysis of 3296 IVF Cycles. Your doctor may want to check your progesterone levels for two reasons: Progesterone is a very important hormone for sustaining pregnancy. Mai Q, Hu X, Yang G, Luo Y, Huang K, Yuan Y, et al. Please enable it to take advantage of the complete set of features! A previous retrospective observational study reporting 3 cases of fertility preservation patients suggested that progesterone levels were higher after ovarian stimulation with letrozole in the middle luteal phase [ 21 ], but in one case, recombinant hCG had been used to trigger ovulation. of Estrogen in Luteinizing Hormone Surge and Ovulation WebLetrozole (Femara ) is an oral medication that your doctor has prescribed for the treatment of your hormone-receptor-positive breast cancer. Mean percent intra-assay and inter-assay coefficient of variations, respectively, were 1.8% and 5.2% for LH, 1.8% and 5.3% for FSH, 3.1% and 3.4% for oestradiol, 3.3% and 10.4% for progesterone, 2.1% and 3.2% for testosterone. Thank you so much! High Progesterone Levels During the Luteal Phase Related to the Use of an Aromatase Inhibitor in Breast Cancer Patients. In clomiphene cycles, midluteal progesterone levels should be higher than 15 ng/mL. We respect everyones right to express their thoughts and opinions as long as they remain respectful of other community members, and meet What to Expects Terms of Use. Epub 2015 Jul 23. doi: 10.1007/s10815-020-01892-6, 13. IVF/ICSI: in vitro fertilisation or intracytoplasmic sperm injection; GnRH-a: gonadotropin-releasing hormone-agonist; GnRH-ant: gonadotropin-releasing hormone-antagonist; LE: letrozole. Third, adding LE to normal responders can reduce the dosage of gonadotropins, without affecting gravidity (13). Before you ovulate, high levels of estrogen cause your uterine lining to grow. Taking it day 3 - 7 of my cycle, intercourse days 10 - 20, and then blood work on either the first day of a positive ovulation test or day 21 of my cycle. Implantation Calculator: When Did It Happen? The ovarian response to this therapy was monitored by measuring LH, FSH, serum oestradiol, and progesterone levels and transvaginal ultrasonography. Zhang J, Li Z, Sun L, Guan Y, Du M. Comparison of Pregnancy and Neonatal Outcomes of Single Frozen Blastocyst Transfer Between Letrozole-Induction and HRT Cycles in Patients With Abnormal Ovulation. Efficacy and Safety of Controlled Ovarian Stimulation With or Without Letrozole Co-Administration for Fertility Preservation: A Systematic Review and Meta-Analysis. Web7 If your progesterone concentrations remain low, this indicates that you are still not ovulating in response to the treatment. think twice before sharing personal details, foster a friendly and supportive environment, remove fake accounts, spam and misinformation, delete posts that violate our community guidelines, reviewed by our medical review board and team of experts. Effects of Letrozole and Clomiphene Citrate on Wnt Signaling Pathway in Endometrium of Polycystic Ovarian Syndrome and Healthy Women. Grin L, Mizrachi Y, Cohen O, Lazer T, Liberty G, Meltcer S, et al. Even if you havent been diagnosed with an ovulatory disorder but are experiencing unexplained infertility, your doctor may try letrozole because it increases your chances of releasing more than one egg, which, in turn, improves your odds of getting pregnant. Clipboard, Search History, and several other advanced features are temporarily unavailable. Severe Ovarian Hyperstimulation Syndrome in a Woman With Breast Cancer Under Letrozole Triggered With GnRH Agonist: A Case Report and Review of the Literature. The progesterone level, proportion of patients with a progesterone level > 1.5 ng/mL, P/E2 ratio, and proportion of patients with a P/E2 ratio > 0.55 in the LE GnRH-ant group were significantly higher than those in the GnRH-ant group in each subgroup analysis (Supplemental Table3). The .gov means its official. Results: My day 21 progesterone was 108 and I tested positive 9dpo. Again, could be totally wrong. An official website of the United States government. How is this medication taken? Mayo Clinic Progesteron level 0.3 ng In the PSM 1 cohort, progesterone levels on the trigger day increased by 0.05 ng/mL, with an increase in every retrieved oocyte in the LE GnRH-ant group ( 0.05 ng/mL [95% CI 0.04, 0.06], P < 0.001), whereas an increase of 0.02 ng/mL was observed in the GnRH-ant group ( 0.02 ng/mL [95% CI 0.01, 0.03], P < 0.001), with P for interaction being 0.0018. These evidences eliminate the possibility that the increased progesterone levels in the LE GnRH-ant group are attributed to the increase in the number of eggs. I also started taking estrogen and progesterone supplements (seperate days after the letrozole.) Therefore, we divided LH levels on trigger day into three equal groups (tertile) and compared progesterone levels in each tertile. It is used to induce ovulation in women who cannot ovulate or to help produce multiple eggs in women who already ovulate on their own. 15. Letrozole (Femara Hormonal Therapy - Michigan Medicine . Figure3 provides evidence that the protocol is an effect modifier that affects progesterone levels and the number of eggs in the PSM 2 cohort.