What is the implantation dip in a woman undergoing fertility treatment with letrozole (aromatase inhibitor)?

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Last updated: January 25, 2026View editorial policy

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What is the Implantation Dip?

The "implantation dip" is not a medically recognized phenomenon or term in fertility treatment or reproductive medicine, and it does not appear in any clinical guidelines, fertility preservation protocols, or letrozole treatment literature.

What You May Be Asking About

If you're referring to temperature changes during early pregnancy:

  • Basal body temperature (BBT) patterns during conception cycles sometimes show a brief temperature drop around 7-10 days post-ovulation, which some lay sources call an "implantation dip" 1
  • This is not a reliable indicator of implantation or pregnancy and has no clinical utility in fertility treatment monitoring 1, 2
  • No medical guidelines recommend tracking or interpreting this pattern for fertility treatment decisions 1, 2

What Actually Matters in Letrozole Treatment Monitoring

Ultrasound monitoring is the essential clinical tool during letrozole cycles, not temperature tracking 1, 2:

  • Mandatory ultrasound monitoring during each treatment cycle to ensure appropriate follicular development and reduce multiple pregnancy risk 1, 2
  • Monitor follicle size and number during each cycle to confirm adequate response 1
  • Ovulation typically occurs 7-9 days after the last letrozole pill (around cycle days 14-16 if starting on day 3) 1

Critical Monitoring Requirements

The American College of Obstetricians and Gynecologists mandates specific monitoring that has actual clinical value 1, 2:

  • Follicular development assessment via ultrasound
  • Endometrial thickness monitoring (letrozole maintains adequate endometrial development even at high doses) 1
  • Prevention of multiple pregnancies through proper cycle monitoring 2

Do not rely on subjective temperature patterns or "implantation dips" for clinical decision-making in fertility treatment 1, 2.

References

Guideline

Letrozole for Ovulation Induction: Dosing and Protocols

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Guideline

Letrozole for Ovulation Induction: Key Prescribing Considerations

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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