Thanks guys. For the people asking why, I already stated the cost is 2 orders of magnitude more.
If OBGYNs are fine administering clomid unmonitored (and we had success with it) I'm not sure what the monitoring on a drug that has a statistically less likely chance of multiples is all about. That's why I'm looking for OBGYNs or not REs who prescribe it.

I did clomid and letrozole unmonitored but I'm not in the D.C. Area so I can't help. My OB and later my RE both independently were willing to do it unmonitored saying risk of higher order multiples is low. We were fine w the idea of twins. We did also get monitored once for response.

Monitoring isn't just for the risk of multiples. Without monitoring, you have no idea how you respond to the medication, be it Letrozole or Clomid. I cycled with both, multiple times. I ovulated anywhere from day 12 to day 20. I would have had no idea if I hadn't been closely monitored.
In fact, when I was first diagnosed with PCOS, my OB refused to prescribe Clomid and referred me to an RE...specifically because he couldn't monitor me, and he insisted on the necessity of it.

http://www.cbsnews.com/news/fertility-drug-clomid-success-rate-healthy-births/

"Women in the letrozole treatment group had fewer live births, but four times as many multiple pregnancies as women in the clomiphene group."

I know you think you have the proper dosing down, but that's not how it works. I started on 2.5 mg and got pregnant, then had a miscarriage at 10 weeks. Then I took 2.5 mg again and had a chemical pregnancy. Then I did two rounds on 5 mg and my body didn't respond at all! Some follicle growth but no ovulation. Then I bumped up to 7.5 mg and got pregnant and it stuck. It's weird, you wouldn't think after conceiving twice on 2.5 mg my body would straight up not respond to 5...but that's what happened, and if I wasn't being monitored I would've had no idea. And would've wasted a lot of time / emotional stress just being totally in the dark. It's not a good idea

Read the recent thread on here about the poor woman who was in the situation of being pregnant with triplets (from fertility meds) and having to decide if she should selectively reduce for the benefit of the remaining fetus(es). She'll have to live with that forever (and she was being monitored! An egg split...) 3 is not the upper limit either...

You need to be monitored. It's stupid to take fertility drugs and then just go for it / leave it up to chance without knowing how your body is responding. Come on, think about it

Anonymous wrote:I think if you look at the studies with Femara, higher order multiples are not common. I am not sure how to find an on who will prescribe tough. I guess you just have to ask when interviewing or get recommendations.

Good luck.

With femara, multiples are half as common as with clomid. But that's still pretty common.

Why the hell would you not want to be monitored? Do you want quintuplets? I wouldn't mess around with Femara unmonitored.

Spending 1k for monitoring is a lot cheaper than having twins, triplets or more.

I think if you look at the studies with Femara, higher order multiples are not common. I am not sure how to find an on who will prescribe tough. I guess you just have to ask when interviewing or get recommendations.

Good luck.

Anonymous wrote:Monitoring is critical - it is irresponsible for REs to administer fertility drugs without monitoring.

+1 I got femara from shady grove, but it was monitored (heavily.)

Monitoring is critical - it is irresponsible for REs to administer fertility drugs without monitoring.

Anonymous wrote:The monitoring is pretty important, though....

+1

I wouldn't want to risk my future children's health by forgoing monitoring

The monitoring is pretty important, though....

Hey all, first time poster here.

We just moved to NoVA and my dearest wife needs an OB/GYN anyway. Wife recently went through an RE to ovulate and responded well to letrozole. She previously conceived on clomid but the side effects seemed worse than letrozole.

Anyway, now that we have letrozole dosing that appears to work and diagnostic info that yes, really she JUST needs help with the ovulating part, how can I help her find a normal doc who will offer letrozole without monitoring?

While REs may have good reasons for only offering with monitoring, I'd at least like the option of doing it through a normal OBGYN or other doc. The drug without monitoring is 2 orders of magnitude cheaper, all in.