Saturday, November 10, 2007

A Theory

OK folks, what do you know about breastfeeding and conception? At this point, Natalie typically nurses 2-3 times a day (before bed, before naps when Jen is home, and in the morning). Our RE said that prolactin levels shouldn't be rising when she nurses at this point, and we were happy to hear that at the time. However, we are now wondering if that is actually true.

Here's the thing-- in the last two cycles, there have been early indicators of success--things that only happened during the cycles in which Coqui and Natalie were conceived. By 7-9 dpo or so, it seemed pretty likely that Jen was pregnant. However, in both cycles, the symptoms waned, and the cycle eventually failed. It could be all in our heads, too.

Prolactin is generally thought to cause problems with ovulation. However, we have seen the ready to pop follie each time, gotten a positive OPK, and seen a temp rise indicating that ovulation did, in fact, occur. I have found a few references to prolactin interfering with implantation, but this does not seem to be a widely held opinion. It does seem to fit what is happening to us, though. It seems as if conception is happening, but for one reason or another implantation isn't working right. Any thoughts about this?

I read a few things that suggested a HCG booster around 5 dpo, or supplementing with progesterone to override prolactin. Everything I've read seems to indicate that once implantation is complete, prolactin should no longer be an issue. Again, your thoughts?

Our plan at this point is CD 3 bloodwork on Monday, schedule an appointment with the RE ASAP, and move forward with an insem for this cycle, assuming bloodwork and RE agree that is makes sense. I really do not want to skip this cycle, even though we had discussed doing so. Yes, we have only tried 3 times, and there is plenty of time left to have a second child, but we already had to wait 5 extra months to even start trying again, so every failed cycle and every delay just takes us that much farther away from the sibling spacing we had hoped for. In that sense, it seems silly to wait.


  • Hmmm. Well, I haven't done any research on this, nor do I have a nursing child anymore. And I got my period back at 5 frickin months post partum, so I am probably not the most reliable opinion.

    I think if your intuition is telling you that Jen was pg these last two months but something went awry, I totally believe it. There was a distintly different tww for me when I was knocked vs not.

    Also, it took Jen's period a loooooong time to come back. This leads me to believe (very unscientifically) that nursing has a pretty strong effect on her hormones and such. This would lead me to believe that in your case, nursing is monkeying with your ttc efforts.

    But what to do? I don't know there. I just did clomid with a trigger, never progesterone or a booster. Maybe Bri would have more info on the booster, she is the only one I know who has done that. I am interested to hear what your RE has to say this month. Did Jen's full bloodwork reveal anything that might be out of whack?

    I am sorry, this is a tough situation. I know how expensive, trying, and unknown this whole process is.

    By Blogger Targetgirl, at 10:10 PM  

  • Wow. Seems like I've missed some small drama. So this sucks. Which you know. I know nothing about prolactin and conception. It makes biological/historical sense that the 2 would not mesh well (did I tell you about the book Mothernature, but S.B. Hrdy?) I am continually amzed at just how little we know about how all this works. Which is amazing and mysterious and all that, but also? Sucks. Why is does it never get easier to see a neg test? *sigh*

    So can I ask y'all for some DC advice? Here in your own blog comments?cup If you wanted to drive into DC and you were scared to death of the prospect, but you *had* to, what time of day would be the best? I'll be (clearly we are talking about me here)coming from the south on 29 and need to get to Brookland. Driving up there makes my head spin.

    By Blogger starrhillgirl, at 8:31 AM  

  • Ummm.... I'm not sure why is says "cup" in the middle of may last comment.... weird.

    By Blogger starrhillgirl, at 8:32 AM  

  • I am curious about why you feel so strongly about a particular sibling age spacing? I'll admit to obsesssiong about sibling age gaps myself, but your last post revealed a lot of frustration that you feel something is passing you by.

    From what I know of prolactin, and based on the amount that Nat is nursing, I agree with your RE that it is most likely not interfering.

    Remember, 50% or more of all conceptions end in early, undetected miscarriage. Only people charting or paying close attention ever even notice. The general explanation is that these would not have been viable pregnancies hence implantation doesn't take place.

    I can empathize with the desire to find a problem that has a solution so you can at least feel like you're doing something more to help achieve a pregnancy, but I am not sure you'll find it in weaning.

    By Anonymous Anonymous, at 9:48 AM  

  • I don't know Jack.
    But Hope just posted a study on her blog a few days ago.

    By Anonymous calliope, at 10:39 AM  

  • I wonder what the safety trade-off would be for you to pop some baby aspirin the next cycle? I'm guessing Hale's will tell about about the bioavailability of aspirin in breastmilk. It is being suggested to fluff up the lining of women with implantation issues. We took it with Q, but didn't do it this time because we decided to do nothing but sperm this time around. Just something to think about. Oh! When they are U/Sing the follies, are they also checking lining depth?

    By Blogger Hope, at 3:00 PM  

  • look, if you can get your hands on some hcg boost, and some progesterone, and it will be covered by insurance? Go for it!

    as we like to say - eh? It wouldn't hoit!

    Sorry I can't be of help in the prolactin action, as I never popped one out on my own, I didn't research this area...

    but I will say go for the progesterone and hcg boost, as circumstances are never the same, so anything you can do to assist will be great.

    And WHY oh WHY do those people that prefer to make judgemental comments do so anonymously? We all have sibling spacing fantasies, so why not try to achieve it?

    By Blogger Shelli, at 3:19 PM  

  • Yes, another post... my other book didn't cover everything.

    I have sibling spacing desires as well. Don would be fine with one, but is happy with a wide space between the two. I will be really sad if I don't get pg sometime this year, but at one point I thought 4 years apart would be perfect. To each their own, and frankly it is one small part of this process that we feel like we can "control." Ok, done. I swear.

    By Blogger Targetgirl, at 4:17 PM  

  • Here's my 2cents as a someone with an honorary medical degree from Fertility Friend and the School of Life:
    -If Jen's getting her period, then prolactin (and thus nursing) isn't an issue. I sense that you're sorta kinda contemplating the weaning idea. Unless N is ready, I'd continue nursing without another thought about how it affects fertility.
    -So much of conception is pure luck. The right egg has to meet the right sperm and land in the right place. It's so frustrating to have so much science and yet still have so many questions. And have so little control.
    -Prometrium (progesterone) and baby aspirin are both easy and inexpensive ways to boost the lining in the 2ww. I took progesterone during the first trimester with my first pg and didn't with my second. It can't hurt.
    -Glad you're moving forward with this month. Like targetgirl, I'm eager to hear what the bloodwork says.

    Hang in there. My wish for you is that this wondering and waiting will soon be a distant memory.

    It's gonna happen.


    By Blogger jean, at 5:58 PM  

  • I have a friend who has naturally high prolactin levels, and has had to take meds to reduce it in order to get pregnant. That's the extent of my knowledge on the subject.

    By Anonymous Amy, at 7:23 PM  

  • I'm sorry it didn't work out this month! Good luck next month.

    I donated eggs to a friend and her RE insisted that I wean completely at least a month before the cycle. For us the timing for weaning was OK: my son was over 2 years old and I was frazzled by any number of events in my life. I did some research on it and there is a tiny tad bit of evidence pointing to lactating and diminished oocyte quality - in cows. Incidentally, in a frozen cycle my friend did before I donated to her, the RE also insisted that she wean as the recipient. Basically, in a situation like that where there are high stakes, her RE won't take any chances. My feeling was that it probably didn't matter - and that nursing a toddler is so much different than nursing an infant, but I wasn't willing to take a risk with her money, emotions & time. This will probably sound goofy coming from a woman who weaned her son so that somebody else could get pregnant, but I would just wait and see. You could possibly also take a middle of a road approach and cut back on how much Natalie nurses. My son was an avid with a capital A nurser and it actually wasn't that hard to wean him. At first I just set very firm limits about when he could and couldn't nurse and just made them more stringent over time. I just made sure to spend a lot of time with him doing puzzles, reading, etc. It took about a month start to finish. However, he is still obsessed with my breasts and any other woman's breast he can get his hands on (literally). He will be a boob man for life. Good luck with your decisions.

    By Blogger Natalie, at 7:35 PM  

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