Q: My wife, aged 29 years old, has a problem of secondary infertility. The test for rubella is positive. Her eggs are fine and well developed and the fallopian tube too is open. We are trying for a second child from the past two years but no success. Now a days she is taking medicine like Letoval (5 days) and Lycotom (30 days). Please help.

A:Letoval (Sun Pharma) is the brand name of a medicine called letrozole, which is an anti-cancer drug for use only in elderly post-menopausal women suffering from breast cancer. It is not approved for use in female infertility anywhere in the world and has got some very serious side effects such as embryotoxicity (toxic to eggs), fetotoxicity (toxic to foetus) and teratogenicity (formation of deformed baby). The drug can also cause liver cancer, ovarian tumours, heart attack, paralysis, stroke and lung clots that can be fatal. The drug is a research product of Novartis and these side effects have been reported by the innovator company to US Food and Drug Administration (USFDA). The drug is contraindicated (not permitted) in pre-menopausal young women. In India because of lax laws, the drug was illegally and unethically being promoted for female infertility by the manufacturer to gynaecologists. The Drugs Controller General of India issued notice to the Company and sought explanation. The Company apologised and accepted its mistake and promised not to do so again. Letoval can be legally sold against prescriptions by cancer specialists, not by gynaecologists. The Drug Control Department of Kerala is currently prosecuting about 30 chemist shops for violating this rule. I suggest the exact cause of failure to conceive should be determined and managed appropriately. Lycopene is an anti-oxidant. The brand name Lycotom does not appear in the national or international data bank of products. The only brand that appears on the list is Lycored (Jagson Pal). General statement on selection of brands: There are scores, sometimes hundreds, of brands of the same medicine. Against about 300 pharmaceutical manufacturers in western countries like Britain, there are over 20,000 producers in India that market more than 40,000 brands. Most manufacturers do not have quality testing laboratories. Hence selection of brands is important. Many companies give incentives to prescribers to patronise their products. Patients should check the reputation of manufacturers before consuming medicines.