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Why am I having difficulty in conceiving?

Q: I am a 28 years old female, married for the last 4 years. I am suffering with PCOS. I met a doctor in India. She tested me and everything is normal. She has suggested to use (G-REG SR 500, Letroz, Dexona, ETS-500, Progynova). I read about these tablets at another site. These tablets are used in cases of infertility. I am using these for 4 months now but have begun with intercourse only 2 months back. Why am I having difficulty in conceiving?

A:In Polycystic Ovarian Syndrome (PCOS), one major issue is insulin resistance; hence metformin (sold as Glyciphage, G-Reg SR) is usually the first and in most cases the only medication required. Once the insulin resistance is tackled, it is much easier to concieve. Letroz (letrozole) is an anti-cancer drug used for the treatment of breast cancer in post-menopausal women only. Globally its use in pre-menopausal women of child-bearing age is prohibited (contraindicated). Both, the Canadian government drug authority and the innovator company Novartis (letrozole is the research product of Novartis) have warned gynaecologists all over the world never to misuse it for female infertility. Research on 150 pregnancies has shown that babies born to mothers who had consumed letrozole to increase fertility have suffered from bone malformations, cardiac stenosis and cancers. Oral ETS (progesterone) is indicated when there is proven, documented deficiency of progesterone. Progesterone is used for certain disorders in postmenopausal women Its use during known or suspected pregnancy is contraindicated (not allowed). If used during early pregnancy, progesterone can cause congenital anomalies including cleft palate (hare lip), ventricular septal defect in the heart, patent ductus arteriosus (another type of heart defect) and other congenital defects. Some cases of foetal death and spontaneous abortion have also been reported in pregnant women prescribed progesterone for unapproved indications. A recent American study investigating cases with genital defects has suggested at least a 200 per cent increased risk of second/third degree hypospadias (urinary and genital defects) among boys born to mothers who took progesterone shortly prior to or during early pregnancy. Some advanced countries like Australia have not permitted the use of oral progesterone for any indication. Dexona (dexamethasone) is a steroid. Progynova contains oestradiol, a female hormone. It is normally used to prevent climacteric symptoms in post-menopausal women as part of the Hormonal Replacement Therapy (HRT). Its use druing pregnancy is contrainidcated (prohibited). If there is no documented, proven deficiency of the oestradiol hormone, then overexposure of the male foetus to this hormone can lead to defects in the genito-urinary organs of the foetus. Since you are planning pregnancy, you should take folic acid (Folet) 5mg daily which is absolutely essential. At least one brand prescribed to you is not listed on the data bank of national and international producers of quality medicines. 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.

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