Trying to Conceive with PCOS: Doubts About Letrozole After Loss

I just turned 32. Exactly one year ago, I stopped taking contraception after using it for 15 years. Since I struggled with acne as a teenager, I was afraid to stop too early. I decided to stop three months before trying to conceive, and I had hoped to have a baby in spring.

After stopping contraception, my first cycle was 42 days long, which didn’t worry me since I knew that could be normal after stopping contraception. My second cycle lasted 70 days, but I did ovulate (confirmed by a blood test). At that point, I saw a gynecologist and was diagnosed with PCOS.

Because of a planned vacation, I couldn’t start letrozole right away (in my country, it requires ultrasound monitoring). I ended up ovulating about four weeks later and became pregnant. My due date would have been at the end of April ‘26 and I was so happy. Unfortunately, this resulted in a missed miscarriage, discovered at my first scan at 8 weeks. I had a D&C at the beginning of October after I tried medication to induce a miscarriage.

In November, I started letrozole with timed intercourse, even though we had actually been trying for less than six months at that point. All five cycles with letrozole showed 1 good follicle and confirmed ovulation, but I’m still not pregnant. Mentally, it’s been very difficult.

The monitoring with ultrasounds during letrozole treatment makes everything feel like it’s under a magnifying glass, which gives me a lot of uncertainty. I can’t stop thinking that something might be wrong and wondering why it isn’t happening now. With letrozole, my estradiol levels at ovulation are about half of what they are in a natural cycle (170 vs. 334), and I also have a thin lining.

I keep questioning whether letrozole is the right approach for me, or if I should stop and try naturally again.

Am I making the wrong decision if I stop letrozole and try naturally again?

Has anyone had a similar experience?