Dr refusing fertility assistance as I'm still BF

I think your GP could have been more helpful with this OP - and I write as someone who is very supportive of GPs (see username). I'm unsurprised as fertility and breastfeeding are two areas in which GP knowledge AND biases vary quite markedly between individual professionals.

I second the suggestions of other to go on to some of the relevant breastfeeding and fertility Facebook groups and seek advice and experience from other people in a similar position to you, with similar motivation to both breastfeed and attempt to conceive.

After that you can make a decision about whether to approach a private provider for initial assessments or not.

Hello, just wanted to share my experience, I was still breastfeeding my first baby of six months when we fell pregnant with our second. My periods had returned (although irregular) and my baby never had bottles but had begun to try 'solids' so your doctor is wrong. Breastfeeding can be used as a form of contraception (but it isn't reliable) if all the below factors are done together: periods haven't returned, baby is under six months, baby is exclusively breastfeeding and baby is still waking for night feeds. I would ask to speak to another doctor. Hope you manage to get some answers.

I really don’t get the issue, are gps busy and sometimes dismissive, yes! Welcome to the nhs!
Do you want to see if breastfeeding is hindering you conceiving- if yes then give up bf- if not, pay to go private but equally I think even with going private it’s a good idea to stop breastfeeding before laying out hundreds of pounds you may not need.

Oh my god OP, welcome to Mumsnet....
I can't believe some of the responses on here! Would you actually dare say this to OPs face if she was your friend in real life? Guess not. Then why say it on here....

Yes. O/p is breastfeeding. If she is to start with fertility investigations she needs to stop as that may be preventing conception, regardless of whether she is ovulating.

You wouldn’t expect someone to start fertility treatment if they were using condoms or had a coil placed. If there is something that is likely to be preventing pregnancy, in this case breastfeeding, that needs to be eliminated as a first step.

I thought it was a crass and factually incorrect comment sweeping all women across an entire continent....and quite frankly also didn't have anything at all to do with my body and my circumstances.

I 100% agree with you here @1940s. I posted yesterday when you originally started the thread, and I still think that what the GP said to you was entirely unreasonable. It does sound like she didn't actually listen to what you had to say, however I do honestly believe that even if she had listened and taken what you were saying on board she would have still concluded that there wouldn't be anything they'd be willing to do without you stopping breastfeeding.

Everyone on here (even the rude ones) have listened to you, and the resounding response is that although breastfeeding may be a complete red herring it absolutely can't be ruled out. It could be affecting much more than just ovulation unfortunately, even if it does seem like you're breastfeeding a really insignificant amount.

By the sounds of it you're unlikely to get much further through the NHS if you're breastfeeding and also as you already have a child.

But if you are able to go down the private route then you can probably have a really good conversation with a private GP where you feel you have been heard and are then given advice you trust. Also if you feel tests would be helpful they'll be more inclined to do them if you're the one footing the bill.

Good luck with everything.

And to the PP who insists that the OP is ovulating therefore the dr doesn’t know what they’re talking about-as another PP has pointed out, bf can affect fertility in other ways not just preventing ovulating.

Imagine having to sit all day listening to people who know far better than you despite zero medical training in most cases, and having to remain polite to someone jumping up and down that the NHS won’t find tests for something that she is actively choosing to impede.

OP I’m sorry things aren’t panning out for you like you hoped but you and the other posters who seem to think that it’s perfectly reasonable to expect the NHS to test you for infertility while you’re doing something with KNOWN potential to prevent conception....the mind boggles. I just hope you weren’t out clapping each week.

Listen to the poster who pointed out that even if you have tests, the only outcome whether they find an issue with you or not, will still be that you’re told to stop bf. So why on earth not try that as step one?! I understand, you want to be one of the women who falls pregnant while bf and it feels unfair, but you have to make a choice here. You could give up bf and still not get pregnant but at least you’d have ruled it out as the issue.

Good luck and I don’t mean to be blunt, but your posts do read a bit like someone going to the Dr and demanding help losing weight while refusing to stop eating chocolate every day. It’s a bit frustrating to read, but I’m sure you feel worse so I sympathise and wish you all the best.

OP, clearly your GP's manner and approach here has rubbed you up the wrong way, and that's unfortunate. I'm worried that might be clouding the issue a bit for you, though - it sounds like you're focusing more on the crapness of the GP than on practical next steps.

If I were you, I'd get in touch with a fertility clinic, explain the situation and enquire about whether it's appropriate to begin any investigations now. I think you need to be prepared to be told that they can't assist until you stop breastfeeding, but they may feel they can do some aspects of those investigations beforehand. Either way, you'll know where you stand in that regard. Yes, this would have a cost associated with it - but in the grand scheme of the potential costs of infertility it's peanuts, and it would give you a little more control over the situation and enable you to make informed decisions.

I'm anticipating that my fertility clinic will expect me to stop breastfeeding before I can have an FET to try for #2, and this is likely to mean some trade-offs between when I'd ideally like to feed until, and when I'd realistically need to be pursuing treatment. I plan, though, to ask that certain investigations (like ultrasound to check in on how some known prior issues have fared post-pregnancy) be done before I commit to stopping feeding, because it would be a bit pants to do that and then learn that I couldn't go ahead with any treatment anyway.

BBT tracking while breastfeeding isn’t going to be at as reliable as when not. There’s a piece on fertility friend about it. It can work but getting decent charts relies on a block of about 4 hours sleep before you take your temperature and feeding hormones can affect it. I don’t have any experience of OPKs and haven’t temped since having DD. We’re not ttc so I’d like to go back to it for predicting my periods but haven’t bothered while still having broken sleep and feeding (a lot still in my case).

Oh my god OP, welcome to Mumsnet....
I can't believe some of the responses on here! Would you actually dare say this to OPs face if she was your friend in real life? Guess not. Then why say it on here....

OP, I totally get where you're coming from and I'm sorry you're struggling. I fell pregnant with no 2 when I was still breastfeeding. I'm actually appalled by the comments your GP made - any chance you can speak to another GP?

If you're temping and get a rise then you are ovulating, so that's not the issue. How long is your LP? Anything that could suggest potential progesterone deficiency eg LP on the shorter side...?
My second pregnancy didn't work out (tfmr at 14 weeks and I've since had 3 consecutive chemicals). I had to push my GP very very hard to get a referral for further tests which she has finally agreed today is the right step ahead. Since you're temping, I would suggest a progesterone test to be booked in 7-9 days after your ovulation. And don't let them fob you off with "we don't do them" or "come on day 21 of your cycle", go by your cycle and stand your ground. Again, if you can see another GP maybe try and get seen by them. Or if you can afford it, go private.
I really hope you will be taken serious soon and get some support.

'If you had fertility struggles...'

Does 8 rounds of fertility treatment count as enough?

Seriously - you do not want to go down ANY kind of fertility investigation/treatment until you have to.

It is heartbreaking.

I would love to have been given the 'give up breastfeeding' option.

What your GP knows and you don't is that prolactin (produced when the body is still making milk) is not necessarily dependent on how often you are feeding. As well as this, prolactin inhibits both ovulation AND the development and maturity of eggs.

So even if you are ovulating, breast feeding may be preventing implantable eggs from releasing.

I hope for your sake you never need to know as much as I do about fertility.

Now you need to decide between bf and TTC. And see the doc again in a year if it hasn't happened:

Good luck
Good luck.

Nobody is going to do any fertility investigations while you are bf.

End of.

It’s time and financially intensive. There’s just no point if you’re bf as stopping may solve the problem.

My doctor told me this too and I laughed and replied "i conceived two children whislt breastfeeding!". This is such BS advice.

I’d be interested to know the Dr’s precise wording about ‘women in Africa’ so let’s not assume racist undertones or whatever. There is a very big different between ‘lots of women in the developing world who don’t have access to contraceptives use breastfeeding to try and avoid conception’ and ‘African women breastfeed as contraception’.

@Tiletiletile1 It's the Bourn Fertility Cinic in Cambridgeshire x

I got pregnant a month after stopping breastfeeding, my periods had long returned and I wasn't taking precautions. Your dr has a good point!

I think your GP is 100% correct and I say this as someone who had fertility issues. My first was conceived via IVf and I have just called my clinic to arrange a frozen embryo transfer. They have told me I need to stop breastfeeding and wait 3 months. Whether you are ovulating is not the be all and end all of fertility. The hormones in breastfeeding may effect implantation and so stopping breastfeeding will always be the first step. An NHS doctor should not waste funds investigating something unless the very significant factor has been ruled out first

OP - I think you are being a bit naive here. I agree your doctor didn’t give you fantastic advice but GPs are notoriously poor on infertility even at the best of times. A couple of things (btw I’ve had ivf for both my kids and breastfed both, I had to stop breastfeeding for no 2 as had a miscarriage with my first embryo while breastfeeding)

1 your cycles are not regular at all if they are 30-41 days - anything over 35 days is problematic and the fact they are not all the same is very problematic.
2 in terms of next steps it’s not really worth doing testing while you’re breastfeeding. This is because one of two things will happen - (1) the tests come back normal, so no intervention unless you’re ready to go to ivf. (2) the tests come back abnormal, in which case you’ll be told that breastfeeding may be affecting the results so you’ll need to repeat them after you stop. You will not get a doctor to prescribe things like clomid while you’re breastfeeding, and nor do you want them to.
3 the exception to (2) above is thyroid and amh testing. I would be tempted to do both of these. Thyroid in particular which is often awry after kids - GPs have a range of “normal” but the range for optimal fertility is much narrower. Would go and get these done.
4 as others have said breastfeeding isn’t just about being able to ovulate, it’s the hormonal balance across your whole cycle. Impossible to test this and say definitively that Brest feeding is/isn’t causing any imbalance - the only way to know is to stop.

Breast feed isn't going to help your fertility so common sense would tell you to stop it.
It not unreasonable to try everything you can to improve your fertility before they crack on with tests .
It's the same as smoking for men reduces there fertility they wouldn't test a man who refused to stop smoking

Some of these comments are awful.

Yes, breastfeeding can prevent pregnancy, usually by preventing ovulation. The OP believes she has evidence she is ovulating, so presumably was hoping the GP would either say: actually, that evidence doesn't mean you're definitely ovulating, so it would be best to stop breastfeeding, or, actually there are other steps breastfeeding can interfere with like implantation so it would be best to stop breastfeeding, or, hmm, if you're ovulating then it probably isn't the breastfeeding but it might be x y or z so let's do tests for those.

Saying 'it's because you're breastfeeding' but ignoring the fact the OP believes she's ovulating isn't v helpful and just sounds like the GP wasn't listening, nor is the 'African women use it as contraception' line which I agree has some dodgy undertones.

That being said, on my first I tracked my temp which made it look like I was ovulating and I definitely had anovulatory cycles. It's also the case the tests they do are done on certain days which assumes a regular cycle so may not actually be informative. I'm in a somewhat similar position in that I'm still feeding a 22 month old with allergies, but in my case I want to postpone ttc until I wean her which I plan to do at 2 (mostly so I can ttc as I'm late 30s) as I honestly feel like I'm still a bit wiped out from the feeding and my cycles aren't back to normal and I don't want to have to abruptly start weaning.

I'd recommend 'Taking Charge of Your fertility' by Toni weshler, I cant remember if it says much about breastfeeding but it's helpful for all the secondary signs of fertility, eg do you have abundant cervical mucus? My periods have returned, if anything they're more regular than they were before, but I don't have the cervical mucus and I definitely think some months I'm not actually ovulating. I also found it starts with the egg quite useful though a bit intense, and daily yoga.

I think it's easy to underestimate the hormonal effects breastfeeding can have, I don't think it automatically means you need to stop but I wouldn't rule out it having an effect and I'd start looking at ways to ensure you're not deficient in any nutrients, doing some natural things that can help balance your hormones like exercise, yoga. And maybe it's worth having private tests. But as unhelpful as I think the GP is, my personal feeling is a lot of the time there's just a v slight imbalance in hormones that can cause something to go wrong, and breastfeeding may be that little extra pressure on your system throwing it out. It's worth trying other things first, but I wouldn't dismiss the connection out of hand.

Wow, I’m not sure I’d be able to take any doctor seriously who made throwaway racist statements about Africans birth control methods.

What exactly did you expect the doctor to spend their valuable time sitting and mulling over with you? You are choosing a course of action which may well be affecting your fertility but expect a response from the doctor other than ‘stop doing that and then we’ll talk’. I’m at a loss

Sometimes what you want to hear is not what you need to hear.