Q: I am 34 years old and married for 6 years. I had a miscarriage after conceiving naturally at 3 months of pregnancy. I have a thyroid problem and am on Eltroxin. Insulin levels are fine. I went through a cycle of infertility treatment for 3 months in which I took clomiphene citrate and HMG during which I ovulated for 2 cycles (as per follicular study). After that I had a laparoscopy done in which everything was found to be normal. We were suggested to go for IUI treatment but opted to try naturally for 1 more year. Now one year is over and I met another doctor. She prescribed Letroz to induce ovulation. I read on some site that it is an illegal drug to be used for infertility. Please advise.

A:Many times, the usefulness of a drug for a particular condition is known and it is used after experts decide it can be , even before the drug controller of the country certifies it. Letroz is one such drug. However, if you have ovulated with clomiphene and HMG, and not conceived, one needs to analyse what has gone wrong. I guess the post coital test was done when you were on clomiphene. If that is not good, there is problem in the compatibility of your cervical mucus and your husband's sperms, and one needs to analyse: 1) is it an adverse effect of clomiphene? 2) is your husband's semen analysis showing normal parameters? 3) are you having poor cervical mucus score per se? Only after checking into these factors can one decide, whether or not, you need IUI &/or induction of ovulation with gonadotropin injections. I suggest you consult an experienced gynaecologist immediately rather than waste time trying to analyse the problem yourself. Your young age is a favourable factor with regard to success of treatment.