Dr refusing fertility assistance as I'm still BF

[1940s]

My periods returned when I was EBF my 6 month old (first baby is 26 months old now)

I've had fairly regular cycles 30-41 days long and use OPKs and temperature check every month and see from that data set that I am ovulating.

But after a long time we're still not pregnant.

I breastfeed maybe once a day for a short feed and Dr said that it's definitely that which is stopping me falling pregnant and is refusing to help until I stop breastfeeding.

Surely the fact it looks like I'm ovulating is enough? She also said 'in Africa breastfeeding is a contraception'?! Lots and lots of women get pregnant if breastfeeding and their periods have returned!

Anyone faced similar feedback?

@GeorginaTheGiant

Agree with PPs-much as I sympathise with your difficulties getting pregnant, I’m struggling with what answer you want other than the one you’ve been given. You’re doing something that actively suppresses fertility (no one is saying it’s a reliable contraceptive but there is a middle ground) and refusing to stop it. That may be for very valid reasons but it’s for you to weigh up that choice and I’m sorry but the NHS is on it’s knees and it is not going to prioritise funding tests for your fertility while you are actively putting a potential obstacle in the way of a pregnancy!

If you want to carry on breastfeeding then you need to accept the consequences of that decision, one being that it is potentially (not definitely, but potentially) a factor in why you’re not getting pregnant. Stamping your feet about how breastfeeding isn’t a reliable contraceptive isn’t helping anyone. Yes people get pregnant while bf but your doctor is right in that many people around the world use it to help avoid pregnancy. So of course they’re not going to start doing tests on you until you stop, and as PPs have said, with a child already they may unfortunately not do anything even then.

I’m sorry you’re dealing with this but I think you need to be a bit realistic and listen to what people are saying.

Yes I agree with this.

GP obviously didn't word it like that, but getting annoyed seems quite selfish to me actually. You're not entitled to investigations when you want them when you're actively doing something that suppresses fertility.

I conceived my second while EBF my first. Fed throughout the pregnancy too. BF is not a form of contraception.

@titnomatani

I conceived my second while EBF my first. Fed throughout the pregnancy too. BF is not a form of contraception.

FOR YOU. Lots of women don't get pregnant under those exact same circumstances.

It's not a form of contraception but it is a suppressor of fertility.

@1940s have a look here. Private blood test to see if your cycle is doing what it should, you can take it yourself with a finger prick, £88. Then make an appointment with a private IVF clinic if they have any space and not taking over all the NHS people, like cancer patients trying to harvest their eggs pre treatment etc and delayed due to you know, pandemic.

medichecks.com/products/preparing-pregnancy-blood-test

I'm struggling with secondary infertility too, we have been trying for almost 2.5 years now and have had three miscarriages. Sadly there is very little that can be done by the NHS aside from bloods which will confirm whether you are ovulating. You may get a referral to a fertility service if it's funded in your area but again this is a lengthy process and priority is given to women who haven't a child already. We ended up having some private tests done at a local fertility clinic, they do a package of tests that arent available on the NHS (scan, AMH, sperm analysis) for around £200 which was good value. I'm now waiting for my recurrent miscarriage appointment which has been booked and cancelled and then revoked about 6x so far due to covid. I understand how frustrated you must feel but you have to appreciate that this area of medicine isn't a priority for the NHS

Every woman is different. For many women it is a contraceptive but there will obviously be lots for whom it isn't.

Even with one feed per day it will be effecting your hormones. It's not that common to breastfeed for this long in the UK but if you find women who have and ask about their periods, I'm sure you will get many saying their periods were different a few months after the completely stopping breastfeeding. Mine were far heavier after stopping and I had forgotten before then that was normal for me.

I've had 7 years of fertility treatments. It's quite normal to be told what to do, if you agree with it or not. You can either listen and get the help they offer or be stubborn and don't. In the end the choice is yours. It's not just ovulation that needs to occur but a whole lot of other things as well and bf does prevent conception in some women. The problem is, we don't know which group of women you fall in and neither do you.

How big is this problem exactly? How long do you want to keep on breastfeeding? Maybe you should choose to breastfeed and postpone TTC if it's that important to you. You sound young enough to wait a little longer.

I’m sorry but if you’re that desperate to get pregnant then you would take on board the advice your GP has given.

You think you know best and are pissed off that you’re not being taken seriously.

OP, I’m sorry that people have not been more sympathetic to you on this thread. We are all in the same boat, after all, and perhaps you weren’t to know that the NHS would not investigate secondary infertility breastfeeding or not.

Private blood tests would probably be a good and relatively cost effective next step. I managed to get pregnant whilst BF my 22 month old, but miscarried recently at 8 weeks. I do not know if that was connected to breastfeeding but my private consultant has prescribed me progesterone to take as soon as I next get a bfp just in case. Worth looking into perhaps?

And you may get more support on groups specifically dedicated to breastfeeding older babies. Well done for bfing through all this

@frangipani13 £200 is good value! The places I’ve been looking at near me are more like £500 (London).

Do you mind me asking if you’re in the southeast? Wondering if it’s more expensive in London and cheaper outside - and I should travel out!

To be honest I dont think the GP latched on to the easiest thing nor did she dismiss you, but in her experience (and textbook guidance) has given you fertility advice which is to stop breastfeeding in the first instance.

She is right, breastfeeding is used as a form of contraception in countries with less access to modern contraceptions and for women of certain religions.

Clearly this is not the answer you wanted to hear, but it is the first step you need to take to ensure your hormones return fully to normal. Going off OPKs and temp doesn't guarantee you are ovulating every month. And if you are ovulating every month, having had successful pregnancy and no previous endocrine health conditions, then there is less reason to consider fertility investigation at this time.

You can pay for private tests. the answer could still be the same.

In your shoes I would take your GP's advice and return if after 6 months you are not pregnant. Are you over 35?

kellymom.com/ages/older-infant/fertility/

For those of you who assume that breastfeeding = infertility, here is an article which talks about how and when breastfeeding affects fertility, how fertility gradually returns and why it is unlikely that a woman has to fully wean to her pregnant. This website is a fantastic source of breastfeeding information generally - well researched and intelligent advice.

I’m amazed at the lack of understanding and sympathy for OP amongst those posting here. Good old mumsnet.

Breastfeeding is part contraception for many but if ovulating, agreed it may not be that. What's your age? Can you get a second opinion?

Thanks so much @greytminds this is why I was so disappointed in the GPS response. Especially the crass 'Africans use it as contraception'
There is a pandemic but it doesn't excuse the Dr of not assessing my issue correctly and being so blade about breastfeeding. I had my 'five minutes' with the Dr and it should have been discussed further than just 'stop breastfeeding and come back later'

Will you stop bf?

And also given your cycles are up to 41 days long that further supports you might not always be ovulating every month , but your uterus has to end the cycle eventually to allow the next one to start. Some months you might ovulate some months you might not be. Breastfeeding suppresses the release of hormones so in this case you produce enough oestrogen for the LH surge to commence (and get positive opk) but not enough to complete the process. Secondly is it can surpress the progesterone release to support implantation so even if you were lucky to conceive it again might not complete to pregnancy.

You don't know you have a fertility concerns until the above is definitely ruled out.

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

@1940s

Thanks so much *@greytminds* this is why I was so disappointed in the GPS response. Especially the crass 'Africans use it as contraception' There is a pandemic but it doesn't excuse the Dr of not assessing my issue correctly and being so blade about breastfeeding. I had my 'five minutes' with the Dr and it should have been discussed further than just 'stop breastfeeding and come back later'

Kellymom is a website all about encouraging breastfeeding. Of course it’s going to report lots of information about how you can still get pregnant while breastfeeding. And no one is arguing that some people can and do, just that if you’re not getting pregnant, breastfeeding may be a factor in why.

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

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

@greytminds

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 was the racist statement the doctor made?

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.

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

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.

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