Letrozole has been used for ovarian stimulation by fertility doctors since 2001 because it has fewer side-effects than clomiphene ( Clomid ) and less chance of multiple gestation. A study of 150 babies following treatment with letrozole or letrozole and gonadotropins presented at the American Society of Reproductive Medicine 2005 Conference found no difference in overall abnormalities but did find a significantly higher rate of locomotor and cardiac abnormalities among the group having taken letrozole compared to natural conception.  A larger, follow-up study with 911 babies compared those born following treatment with letrozole to those born following treatment with clomiphene.  That study also found no significant difference in the rate of overall abnormalities, but found that congenital cardiac anomalies was significantly higher in the clomiphene group compared to the letrozole group. Despite this, India banned the usage of letrozole in 2011, citing potential risks to infants.  In 2012, an Indian parliamentary committee said that the drug controller office colluded with letrozole's makers to approve the drug for infertility in India and also stated that letrozole's use for infertility was illegal worldwide;  however, such off-label uses are legal in many countries such as the US and UK.  
In adults with GHD, the FDA-approved labeling states that the starting dosage of GH should be very low ( to mg/day). The product labeling further states that this dose should be increased gradually on the basis of clinical and biochemical responses assessed at monthly intervals. The biochemical marker generally relied upon for GH is the IGF-I level in serum. Values of IGF-I should be maintained in the normal age- and sex-adjusted range. The literature indicates that the dose may be increased, on the basis of individual patient requirements, to a maximum of mg daily in patients younger than 35 years of age, and to a maximum of mg daily in patients older than 35 years of age. Of note, this dose is substantially less than GH replacement doses in children and adolescents, in whom the dose is based on weight.