Several years ago I had an emergency surgery due to an ovarian torsion. When the doctors were operating they found out that I had endometriosis stage 4. After the surgery was completed I was informed that it would be impossible for me to conceive naturally and that IVF was my only option due to the damage that was caused my endometriosis and the fact that they had to remove part of my left ovary and fallopian tube. My husband and I did two rounds of IVF at Pacific Fertility Center in San Francisco, CA and on the second round we conceive my now 16 month old daughter, Stella. I always knew that I wanted another child, around the time she was 10 months old, I contacted by IVF doctor to ask him what a fresh cycle would entail on my end as we did not have any frozen embryos. He said that I would need to wean before beginning my cycle. I remember getting off the phone with him and thinking "No I just can't imagine weaning my daughter." I contacted my acupuncturist, two family friends who are into eastern/alternative medicine and everyone said it would be better to wean. But this advice never felt right for me, because it wasn't given based upon evidence. I wanted evidence based research to tell me that I had to ween, not someone's opinion who was not well informed. So, I spoke to a lactation expert in Australia via Skype and asked her professional opinion and she said that there was no evidence that I must wean to execute a successful IVF cycle. I then contacted several people at the La Leche League and they provided me with the number of the InfantRisk Center in Texas. I called and inquired about the medications that were on my protocol and doses, please see below: Estrace (orally) Lupron MD (10 units AM and PM) Follistim AQ (425 IU PM only) Menopur (150 IU PM only) Prometrium (vaginal) 200mg Vivelle Dot 0.1mg Patch The InfantRisk Center said that all of these medications fell into categories of L1 or L2 which meant that there would be no risk or negative impact to my nursing child. Once I had this information I knew that I was going to go forward with my IVF cycle without weening my daughter. I talked to my mother and my husband about it and everyone was supportive of my decision, although honestly it wouldn't have mattered either way. I felt strongly that I was not going to sacrifice my breastfeeding relationship with the child I had for a maybe child in the future. As anyone who has gone through fertility treatments knows, nothing is guaranteed. a I decided to increase my acupuncture appointments and take my nutrition to the next level. I also decided to lie to my doctor and inform him that I had weaned when I had not. My period returned at 14 months after the birth of my daughter. I only had one period before I began my fresh IVF cycle. I breastfeed my daughter throughout my cycle and a lot. She was sick and teething so there was an increased need for the boob. I have extremely low AMF .320, so we always knew we wouldn't get a lot of eggs. They retrieved three eggs, two fertilized and two grew out to day three. Those two were grade 1 with 8 cells each. We transferred both of them and I received a positive HCG beta with my levels at 241 and then on my second beta my levels were at 665. I am now waiting my first scan which will be on July 22nd. I think as mothers the best gift we each have is our gut. We have to follow our gut, it guides us. When people were telling me that I had to wean my child I knew in my gut that I didn't. I knew that my body was strong enough to continue to breastfeed and have a successful IVF cycle. Doctors make the recommendation to ween not because of evidence based research. I sincerely believe that I had a successful cycle in part due to the fact that I did not wean. I can only imagine the extra stress that would have caused me prior to my IVF cycle and during. Continuing to breastfeed allowed me to be calm and happy that I was continuing to provide for my daughter.
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My experience of breastfeeding through IVF and resultant conception, pregnancy and tandem feeding After a long journey of infertility and treatment we were delighted for our 2nd round of ISCI to be successful. The pregnancy and birth were relatively smooth despite heightened anxiety probably stemming from the difficulties of conception. I was always going to breastfeed, like my school friends, sister, mother and grandmother before me. Breastfeeding went well, very well in fact, and at one year, I had no wish what so ever to wean. Having discovered the concept of extended breastfeeding, it was not something I was willing to give up. Although I'd always wanted two babies, giving up breastfeeding would be sacrificing the best interest of the precious baby I had for one that may never exist. Not an option. I wanted both, so I did some reading. I found out : (1) that IVF whilst breast-feeding had been done, i.e. was possible. (see ref 1) (2) Regarding the effect of IVF on the nursling - the IVF medications would not harm the nursing child. Most are not given orally as are destroyed by the liver (first-pass effect). Thus if any were to pass via the breast milk, the babies liver would prevent the drugs being active. The only oral medication is given to induce a period and is hormonal, that same as in contraceptive pills. These are commonly used in breastfeeding women. (3) Regarding the effect of breast feeding on fertility- natural hormones are not likely to be relevant in IVF. In early stages of breastfeeding the raised prolactin suppresses ovulation. This is the basis of the natural contraceptive effect of breast feeding. In long term breast-feeding the prolactin levels stay only slightly raised and ovulation and periods usually resume. This is of no bearing in my case as due to polycystic ovary syndrome, I do not ovulate even when not breastfeeding. In any case of infertility treatment the whole process and hormone balance is managed artificially, so pre-existing levels may not be relevant. My conclusion was that there is no absolute requirement to stop breastfeeding. At our consultation breastfeeding was not mentioned (my baby was 14 months old so there may have been an assumption of weaning made). So we proceeded. There was a sudden drying of milk supply when my oestrogen levels soared, but it was temporary. After successfully conceiving there were the further issues of painful nipples and dry sucking, but that was unrelated to the IVF. A couple of years down the line I am now happily tandem feeding my three and five year olds.
references (1) Elliot, Jeanette., 2008. Breastfeeding through IVF treatment: A case study. Topics in Breastfeeding: Australian Breastfeeding Association |
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June 2019
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