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IVF/ART drugs and BF - can you?


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#1 Lokum

Posted 08 July 2011 - 03:05 AM

I've BF longer than I expected, and at 12 months+ we're still strongly reliant on 2 feeds a day, and sometimes additional ones.

BUT - we have a FS appointment in a couple of months for TTC#2. I'm not at all sure whether either/both of us will be ready for weaning by then, but I would like to fit in a medicated FET this year.

So? Are meds incompatible with BF? Any ART/IVF veterans made the choice?

(also posted this in breast feeding section, but you know...)

#2 barney34

Posted 08 July 2011 - 04:58 AM


No you cant unfortunately. And from memory you have to stop Bfing then have 1 complete menstrual cycle then start the ivf cycle but someone else can confirm that for me!

All the best

#3 emmsie78

Posted 08 July 2011 - 09:50 AM

I did 2 FETs (using Clomid) whilst breastfeeding my DS. My FS said he was fine with doing it. Maybe some are not though. Phone your clinic to check what their protocol is.
Best of luck x

#4 Lokum

Posted 09 July 2011 - 07:04 AM

Thanks ladies. Will check with FS/clinic, but wanted an idea of what we are in for. I will need more than Clomid, as I definitely have luteal phase issues, so it'll probably be a choice between BF or IVF... things to think about.

Cheers

#5 fooiesmum

Posted 09 July 2011 - 07:36 AM

Hello Lokum,

I spoke with my FS and Mothersafe in Sydney about the drugs - I wasn't able to take them whilst breastfeeding.  

I looked into it just after my daughter turned 1.

I too would have to do a full medicated FET wasn't prepared to stop feeding her & do the drug cycle and have the embie not survive thawing and with only 1 on ice that was a real possibility

I was (am still) breastfeeding my daughter - she usually has 2 feeds a day.

For me the price was to high - I didn't want to stop feeding my daughter.   I want her to wean when she's ready (though I will wean her by Christmas this year if she hasn't stopped by her self -  extended breastfeeding in our case - her choice..........)  

I've really enjoyed feeding her and think she's benefited from feeding, she a March birth, so I've always said, we'll stop around her birthday - then up comes winter (and cold & flu season) and I think, well we've gone this far - may as well go through winter.

I struggled whilst in labour and ended up in ICU, so again a risk if I did get pregnant - to leave a baby & a little girl with their dad & no mum or just love my life the way it is now.

We are very happy with the decision - 1 child family, works with our life.

Hope that helps original.gif


#6 Lokum

Posted 10 July 2011 - 04:29 AM

Thanks Fooiesmum - though I don't know if it is helpful - you've raised interesting issues to weigh up. It feels like a bit of a disservice to DS to cut his BF short - but delaying IVF could be denying him a sibling as well... and we're definitely hoping to be a multi-kid family.

I have only 2x day3 embryos on ice, so the risk of finishing up feeding, doing the medicated cycle and then having nothing to transfer is real... but then I guess I would try to go straight into a stim cycle anyway.

It's so crap, with IVF you feel the weight of loudly ticking clock bearing down.... and have far less luxury to let things take their natural course. Even the decision about whether or not to try for another child, or what the total number of kids might be is made under unusual pressure of $$$ and time.

Glad you've made a good decision for your family - obviously your health and safety was a pretty important factor.  smile1.gif

#7 Nobody Cool

Posted 10 July 2011 - 01:52 PM

Our situations are very similar. I weaned my DS earlier than I would have liked at 14 months so I could go back for another FET (unmedicated).

I also had to weigh up the costs of continuing an extended breastfeeding relationship versus trying for another baby. My DS took 4 long years to conceive and as I am 34 I do feel the pressure of time being against me.

My FS wanted me to be fully weaned 2 months prior to commencing any AC treatment. Might be worth some research and I am no expert but I think that some of hormones related to breastfeeding (oxytocin in particular) can impede implantation?

I guess the reasoning is when doing AC to try and control for all the things that you can actually do to help maximise your chances of success. In my case I was willing to give up breastfeeding and allow my hormones to go back to "normal" for a couple of months before doing my FET.

Best of luck OP.

#8 Lokum

Posted 11 July 2011 - 07:42 AM

Thanks for the good wishes Shady Lane.

So...
Have done some more research and found some good news! While most FS' standard answer is wean, or wean and wait 3 months, or wean and have one proper AF - there shouldn't be one standard answer! We are all different, with babies at different ages, doing different cycles, with different types of IF!

Whether or not to wean, it seems, depends on a range of factors. If you are already menstruating and ovulating, then BF will probably not inhibit egg production or uterine lining preparation. If you are having a FET, medicated or not, then you don't need to be stimmed, so your situation is more akin to a woman TTC naturally while BF, and we know there's lots of those who are successful with no risk to themself, the BF child or the new pregnancy.

RE: drugs passing to BF baby - I need to discuss more with pharmacists who provide IFV drugs in Melbourne, and not just Pharmacist Google, but it seems that -

- drugs which are taken other than orally (so injectibles, pessaries or nasal sprays) are those which cannot readily be absorbed through our digestive systems, ie our digestive systems would break down and excrete the drugs before they get into our bloodstream and do their work. Therefore, if those drugs did turn up in our milk and our baby ingested them orally, they would likely have the same effect - be broken down by baby's gut and not make it into their bloodstream.

- most ART drugs are hormones which are naturally found in the bloodstream of a menstruating or pregnant woman - and plenty of pregnant/menstruating women BF their babies safely. The differences may be that the ART ones are synthetically produced not naturally, and that the dosage is higher.

- The half life of most hormone injectibles is around 4-6 hours, so if you are only feeding every 12 hours (twice a day), you can time feeds and shots to minimise the drug in your bloodstream at the time of BF.

This leaves the issue of whether or not BF may reduce the chances of implantation - specifically prolactin produced in response to a let down. Women DO get PG when BF, and a medicated cycle takes over ovulation and then provides luteal support, so those factors suggest there is no such prolactin problem, but there hasn't been any research on this in humans.

Therefore, there are some risks, about which there's no conclusive research, but also clearly some ways in which they can be mitigated.

On the other side, early/premature weaning might be seen to carry its own risks - guilt for the mother, grieving loss of BF r'ship, loss of comfort/antibodies etc for baby, etc.

I got some of this from a couple of American fertility sites, but the best source was from a podcast from an ABA seminar - see

http://hw.libsyn.com/p/a/b/e/abe3c979a045b...p;l_mid=2133541

(sorry, couldn't put a link without the whole URL, stupid proxy server,. You can apparently get it from the ABA website as well.)

This at least provides somewhere for me to start discussions with the FS. My FS's single minded commitment to producing viable pregnancies is admirable and part of why I chose him. However, on occasion I have noted he doesn't always see the bigger picture and other considerations, and this may include placing a low value on BF.... so I"ll be mindful of that when coming to decisions about this.

Put this here for future reference, for others who search this topic.

#9 jules095

Posted 15 July 2011 - 02:06 AM

QUOTE (Lokum @ 11/07/2011, 07:42 AM) <{POST_SNAPBACK}>
Therefore, there are some risks, about which there's no conclusive research, but also clearly some ways in which they can be mitigated.

On the other side, early/premature weaning might be seen to carry its own risks - guilt for the mother, grieving loss of BF r'ship, loss of comfort/antibodies etc for baby, etc.
Exactly. There is some risk, but no conclusive risk that BF & taking AC meds WONT harm the child, or that you wont be wasting your time taking the meds, while BF (as in BF inhibiting implantation with the synthetically hormones when doing a stim or medicated FET).

The same goes for the correlation between taking AC meds & ovarian cancer. ART is still in it's infancy, so we really don't know the risks.  


As for premature/early weaning guilt/risks Vs infertility... I never thought I would see the day.

Not all women are successful at BF for many reasons, so the 'early weaning risks, loss of BF relationship, comfort/antibodies etc for baby, etc..' as you say, really doesn't have a whole lot of credit & just brings the breast V bottle debate into here. Women choose to FF over BF for both medical & personal reasons. just because a child (conceived naturally or through ART) has been FF, it doesn't mean they are less loved, less healthy & have a less comforting relationship with their mother, than those who are BF.


As someone who was not successful at BF (and did try), I'm offended by the above. As for weaning over cycling, I wouldn't put my child at risk of ingesting medication, that may be harmful to them in the future. As you said, there's no conclusive research one way or the other.

#10 Lokum

Posted 15 July 2011 - 03:44 AM

Jules095 - I am glad you posted. We are all going to be ART parents for a long time, and it's not obvious what the long-term consequences, challenges and sensitivities are going to be -  so it's great to share perspectives. You have every right to feel offended about anything you want - your choice, but it raises interesting questions for me.

The fact is, there are health benefits to BF, which would obviously be missing if I weaned. We can place different value on those benefits, but it is relevant to consider weaning as a 'risk' in the sense that it's not a neutral action taken to avoid the risks of ART drugs passing to baby - rather they are competing choices/risks.

Personally, I think it's surprising that you would be offended by my post. I am enjoying a BF r'ship with my much longed-for IVF baby. I would like to continue BF, but would also like to have a FET. I would prefer not to have to choose between them and I am exploring the issue.  

How does that relate to FF in any way? DS is 12 months old, so weaning would not lead to FF. This is something I place value on (and research supports me), and may have to give up; but it's not a competition between your feeding method and mine.  

If I didn't have to do ART, I would just keep quietly BFing at home, in private, and keep shagging away hoping to get pregnant. Would you be offended then?

You should listen to the podcast I posted the link to. The woman speaker has 3 IVF-conceived children, the first of whom took 10 years. She discusses the angst of infertility. She talks about how after a while, you come to fully KNOW it may never work.

Therefore, she heavily weighed her feeding choices for baby#1, knowing it was possible that baby#2 would never eventuate.... and she didn't want to compromise on what SHE felt was best for her living baby at that time, in favour of a hypothetical child.

Ironically, since I started this topic, DS has refused 3 evening feeds, even screwing up his nose and blowing raspberries, in a most hurtful way, wink.gif . It may turn out to be moot for us, which would probably be for the best.



#11 jules095

Posted 16 July 2011 - 09:05 PM

QUOTE (Lokum @ 15/07/2011, 03:44 AM) <{POST_SNAPBACK}>
The fact is, there are health benefits to BF, which would obviously be missing if I weaned. We can place different value on those benefits, but it is relevant to consider weaning as a 'risk' in the sense that it's not a neutral action taken to avoid the risks of ART drugs passing to baby - rather they are competing choices/risks.

Personally, I think it's surprising that you would be offended by my post. I am enjoying a BF r'ship with my much longed-for IVF baby. I would like to continue BF, but would also like to have a FET. I would prefer not to have to choose between them and I am exploring the issue.
What I read from this, is that (IYO & in the opinion of those who push the breast over bottle debate) I obviously didn't consider the health risks of my much longed for & in the end, premature babies, when I chose to FF them (after expressing with little result for the first 12wks).

Show me where is says that those who were FF are unhealthier, unloved & uncomforted anymore than those who were BF.


After 5-5yrs TTC (3.5yrs IVF) I wanted (like I suspect other IVFers would), to have a normal pregnancy/birth, like those who conceive naturally, after conceiving the non-natural way. I was told I would need a C/S throughout my pregnancy, due to it being a multiple pregnancy, but I ended up giving birth vaginally like I wanted.

With my twins being born prematurely, the only way for them to be fed in the beginning was EBM or FF through a NGT. I expressed with my hand, then bought a pump, but even expressing every 4hrs, I didn't get anywhere near the amount to feed 1, let alone 2.

When the time came for them to learn how to suck fed, my supply had dropped again & after 5wks of daily hospital visits, the stress of trying to BF, attachment/supply issues, I just wanted them home, so learning to BF just was an added stress. At home, the attachment issues continued, my supply was down again & it just wasn't worth it.

I wish I could have & it's people like you & posts like this, that make those who do try to BF & who are unsuccessful, feel guilty (and especially again those who wanted the natural way after a non natural start) & I'd say that's where some PND issues start. If there is a next time for me, I will try again, but as I have FF my twins & they have NO health issues from their FF start to life (or their prematurity [as far as we know. Touch wood] for that matter), I wont feel guilty for choosing to FF over BF.

That's mainly what I am offended about & now you have added the "enjoying a BF r'ship with my much longed-for IVF baby" & "The fact is, there are health benefits to BF, which would obviously be missing if I weaned", it reads like those who have not BF for what ever reason, did not care enough for their "much longed-for IVF baby". I hope you can see why I am offended.


No one should be made to feel guilty for choosing FF over BF. The same goes for those doing ART, who should not be made to wean, over cycling. But you have to make a choice. If you want to TTC again more than BF, then you would wean. If BF means more, than so be it. Your embryos (if there are any), would be around 2yrs younger than your current age, but we all know that there is no guarantees (accept those who have a 100% strike rate). If you are 38+ & will need to stim again, then again it would be a matter of what's more important. BF your live child or try for another, that may or may not be.


Just like the woman you described in your post (she didn't want to compromise on what SHE felt was best for her living baby at that time, in favour of a hypothetical child), my 2 are my everything. I have 2 frozen embryos remaining & feel I owe them a chance at life, but for me (& I suppose I am different as I have 2 & not 1) if either of those embryos don't make it, then I will be happy with what I have (even though I would like to be pregnant again), because all I ever wanted was a baby & lucky for me (which I am luckier than a lot women who will not be successful), I finally have that.


I know it's OT, but I never understood how people could say SIF was the same/worse than PIF & still can't understand it. We (parents) can at least get a kiss & hug to take that pain away, where as those who are yet to be parents, can not.


My main point of replying last post, was just to say that even though I have put myself at risk of future medical issues (re: IVF meds), I wouldn't be prepared to BF while cycling again & putting my child at possible risk, when FF or weaning really doesn't cause a risk.

Good Luck with your next cycle.

#12 Lokum

Posted 17 July 2011 - 04:52 AM

QUOTE (jules095 @ 16/07/2011, 09:05 PM) <{POST_SNAPBACK}>
I know it's OT, but I never understood how people could say SIF was the same/worse than PIF & still can't understand it. We (parents) can at least get a kiss & hug to take that pain away, where as those who are yet to be parents, can not.


I totally agree. I am going into TTC#2 with deep gratitude for the blessing of DS, and some acceptance that he might be the only one. I could never arrive at anything close to acceptance while TTCing him.

I don't mean to drag this out, but I don't claim that BF is the be-all-and-end-all and FF babies are unloved or uncomforted. The fact is, BF DOES have benefits. You wanted to BF your babies, and made huge efforts to do so, presumably because you believed in some benefits of BF too.

I understand wanting a 'natural' start after an assisted conception. I had a c/s, and DS was FF for his first few days, and then would only take EBM for the next few weeks.

I laughed and called him my 21st century baby, said he came out of a plastic packet, and would only take milk out of a plastic bottle - but I wasn't laughing on the inside. I was gutted. I hadn't conceived him, hadn't given birth to him, and then I couldn't feed him!

Later, we luckily got going at BF, but I didn't deny him formula in his early days, because he needed it. He was 5lb9oz and had low blood sugar levels. It was about weighing up the benefits and risks, and making the best choice. I don't feel guilty about those early FFs - it was the right choice for the health of my son.

In your case, clearly it was a choice of starving the babies or sticking with breastmilk - so the choice was obvious. How could you feel guilty about that?  

I just supported/encouraged my own sister to wean her 6 week old for similar reasons. Obviously breastmilk is best ONLY when it is actually best. When it doesn't allow the baby to thrive, then it's not the best feeding choice.

I'm glad your twins are healthy. I don't doubt they're well looked after. But if you HAD succeeded with BM for your twins for longer, you would probably place a positive value on that BF relationship too - and it would be nothing to do with any other mother who ended up FF.

When I know people have carefully considered their children's welfare, I generally don't judge their choices. I certainly don't judge my sister harshly for FF my new nephew, as I know she struggled hard to BF and is now worrying that she should've given him formula sooner!

I desperately hope she doesn't allow other people's choices for their babies to give her any pause or feelings of guilt. Same goes for you.

And thanks for your good wishes for my cycle. Fingers crossed!

#13 imamumto3

Posted 17 July 2011 - 07:49 AM

I took one drug whilst bf, for the life of me I cant remember what it was called.

#14 Earth-Angel

Posted 27 July 2011 - 08:30 PM

Ive just got to say MOST of the benefits of BFing occur BEFORE starting solids which is why it is WHOs and most 1st world countries recommendation not to start solids until 6m of age. Sure there are still some after starting solids but they are not anything like that prior to solids.

I personally choose to wean ds when he was 7.5m to do a medicated FET. That was almost 6m ago now and I'm still not pg. Had one cancelled cycle, went on hols and then had a chem pg and then fs went on hols and getting ready for another FET in Aug. I don't regret when I stopped at all. My FS has found over the years that the chance of pg is reduced dramatically with more than 1 BF a day so that is what she recommends. I tried this but my supply dropped too much for ds so completly weaned.

#15 crankypantz

Posted 29 July 2011 - 12:22 PM

Hi

I think I have the same FS as Earth Angel, but when I spoke to my FS, I explained I wasn't willing to wean DS2 on a maybe, so she suggested we do a tracking cycle and try a natural frozen cycle, if the tracking cycle found I was ovulating.  Unfortunately the cycle found I was all over the shop and I was told in April to come back in a few more months when I had either stopped BF'g, or things appeared to be in a good routine in terms of my cycle......

Maybe your FS will consider a tracking cycle to see whether a natural FET will be an option for you?

Good luck with your decision.  I completely understand all the issues you have raised as I too considered them in detail prior to deciding to try to use my frozen embies.

All the best.

Warning - pregnancy mentioned:
PS - now months have passed it's all a moot point.  So much for my cycle being all over the place. I got pregnant that next month naturally (after 8 years & 2 IVF babies) ohmy.gif ....... I am still BF'g DS 2 overnight (just turned 12 months) and really wished he had been weaned prior to getting pregnant!!!  biggrin.gif

#16 Lokum

Posted 30 July 2011 - 12:41 AM

That's interesting crankypantz. I would consider that, except that I was always ovulating before, with pretty regular cycles and a hormone profile closely resembling normal - but with a slightly dodgy luteal phase.

27 natural cycles and 5 IUIs resulted in nothing, not even a sniff of a BFP. I have unexplained IF, and I reckon I am ovulating dud eggs - and it was the supercharge of a stim which actually produced eggs which could be fertilised. (After my many years studying in unrelated fields and no medical quals, that's my scientific opinion, LOL.)

So for me, I would consider it a waste of embryos to go unmedicated even with a FET. Still, I think it's a very useful consideration for others and something to discuss with their FS.

On the upside, since I started this thread DS has basically dropped night feeds unless over-tired or thirsty on a hot night - and then my supply is so low I top him up with water. His morning feeds are getting very, very short as well so I think by early October this will be all over and we can throw ourselves whole-heartedly into the FET.

Wouldn't complain if I had your lucky surprise of a natural PG though!!! Well done, congrats and good luck. Hope it's nice and uneventful.


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