Letrozole Cycles

Letrozole is an oral medication (taken as a tablet by mouth) which can be an effective fertility treatment for women with ovulation issues.

How does it work?

Letrozole is licensed in New Zealand for breast cancer treatment; using Letrozole for fertility treatment is therefore an “off label” use.

In Women with polycystic ovarian syndrome or issues with ovulation, the increase in FSH can result in development of a mature follicle in the ovary and ovulation of an egg.
This process is called ovulation induction.

How effective is it?

Livebirth rates for women taking Letrozole (27.5% live birth rate) are higher than Clomiphene (19.1% live birth rate) after five cycles (National Institute of Health, 2014).

Some women are ‘resistant’ to Letrozole, which means that they may not ovulate in response to increasing doses. Because of this, it’s important to have a three month review with a doctor to decide if you should continue with Letrozole packages of care.

Risks and Side Effects

Multiple pregnancy
There is a small increase in the number of multiple pregnancies when taking Letrozole. The chance of twins is about 3.4%.


Side effects
Commonly reported side effects are:

  • Hot flushes,
  • Breast tenderness,
  • Headaches

Side effects are usually mild and symptoms quickly improve after stopping the tablets.

Is a Letrozole right for you?

Letrozole may be worth considering if you:

  • Have polycystic ovarian syndrome
  • Are a couple having ovulation issues and wish to try Letrozole as a first line fertility treatment

How much does it cost?

Letrozole packages are NOT covered under public funding.


Letrozole package of care
Cost: $485
Includes three email reviewed and monitored cycles and review clinic appointment. Does not include ultrasound.


Single monitored cycle
Cost: $180
Please note; there is also a prescription cost from the pharmacy with both options. If ovulating regularly, you can think about unmonitored cycles. This involves no blood tests and you can get repeat prescriptions from your GP.

Doses and tests

  • Usually for your first cycle the Letrozole dose will be 5mg/day. Women differ in their response and so the dose may be increased to 7.5mg/day. f you ovulate, your dose will remain the same.
  • All blood tests are carried out at Lab Tests.
  • Letrozole is usually given for a maximum of 12 months.

It is important that you record the dates of any periods or vaginal bleeding and bring this information to any appointments.