So, my doctor has agreed to let me start another cycle. Apparently, the only time a back-to-back cycle would be an issue is if my ovaries were being stimulated (as is done in an IVF with your own eggs). With an FET (frozen embryo transfer), they aren't. And, there is a resting month, because I have to go through one birth control pill cycle. I start my pills on Sunday, and I can go on vacation without a problem. Transfer date is scheduled for 9/8. Or, if that is inconvenient, then they can do it on the 9th or 10th. I wish everything was as laid back as an FET cycle. It's almost like George Carlin describing the difference between football (IVF) and baseball (FET). It's just -- nice.
I do want to share a little bit of drama with you from one of my listservs, but it is very long. Please know that I usually don't get into much back and forth on these listservs, unless someone really, really gets under my skin. If you're not interested in breastfeeding and IVF/FET, and hearing about a**hats, then feel free to just move on.
It all started when someone said that she wanted to have another child (she would have to use ART [Assisted Reproductive Technology]), and she said that she assumed that she would have to wean (her child is 16 months old). I told her about my experience with that issue, and referred her to "Medications and Mother's Milk" (Thomas Hale, Ph.D) so that she could discuss the matter with her doctor. There was a bit of a tiff about that from another member, who flatly stated that you can't take Lupron and breastfeed because it is harmful to the child and it will "dry you up anyway." Um, not quite. I quoted what the Hale publication had to say about Lupron (absolutely no harm to the child, though there is a possibility of lactation suppression [you could "dry up"], but that is more likely to occur with a younger infant [probably where breastfeeding hasn't been established?]). I offered to provide the research in support, but there were no takers.
I have to express a couple of biases right off the top -- if you don't know your a** from your elbow, then you probably shouldn't be giving anyone advice. Or, clearly state that "this is just how I feel, but I haven't researched the issue." (Although who wants to clearly label what they say as a**vice?) The other bias I have is against the medical establishment generally when it comes to breastfeeding. They are oh so quick to tell women to wean, when it is just not necessary. Sometimes, there are no alternatives, but that is usually not the case when it comes to medications (see the Hale publication). But, I digress.
There is a woman who responded to the post. I'll call her "M." M holds herself out as an expert in all matters that have to do with ART apparently:
I think also the success rate is affected by subtle hormonal changes while nursing, even infrequently. No real studies have been done on this, so doctors are mostly erring on the side of caution -- considering what people will spend on treatments, doctors just want you to have the best possible chance, so even if there's a 5% chance that nursing would affect IVF, many people don't want to reduce the odds by that much. I know I feel that way. So I think for me I'd suck it up and wean and then begin my cycle.
Granted these are all really personal decisions.
"Suck it up and wean." Very supportive, eh? Perhaps a bit of a bias against breastfeeding? (She later admitted that she had to take some sort of medication that was incompatible with breastfeeding when her child was two months old, so she had to "suck it up and wean," I guess, so everyone else should do it too -- though it makes me wonder if she had the Hale publication if she would have had to do that, but I digress again.) In any event, she does say "I think," but then she tries to add some weight to what she's saying by adding "doctors are" and "doctors want."
I asked if there was anything, anything to support this little theory, as she did say that there haven't been any "real studies done on this" -- have there been any? Even bad ones? How about surreal studies, in the absence of "real" studies? Her response (and in fairness, I'm only quoting part of her responses):
Like I said in my post there have been no real studies done. This is just from years and years speaking to many different doctors about success rates and IVF and nursing.
Oh, OK. Your "years and years" of speaking with "many different doctors." That is helpful, and very authoritative -- not -- and FYI, what you are doing is called bolstering. (BTW, I did Google her. No medical degree, though she does have some experience in an ART-related area, but not what I would consider "years and years," since it totaled one year and ten months. I'm not even sure if she has a degree, because the education part of the profile appeared rather opaque. In fairness, I might have been looking at a profile from some other person with the same name who lives in the same city who claims ART experience; one never knows.) Despite this, she was trying to sway another human being who was trying to make a very personal decision about whether to sever a part of the wonderful relationship that she had with her little one.
Just for the heck of it, I cut and pasted the text of what she had said into Google and searched on it. Lo and behold, I found the exact same text on a message board, written in 2005 by someone calling herself "AntMom." Again, no references, and nothing to indicate that "AntMom" has any medical background either. With the exception that AntMom used 1% in her post, rather than the 5% that M used, the quote was verbatim, even down to the punctuation.
Since we were in a p*ssing contest, a very polite one I might add (though a bit passive-aggressive), I called her on it, because as I said, when you don't know your a** from your elbow, you shouldn't be giving a**vice -- unless you own it, without borrowing some unarticulated "authority" to bolster it. And, had she said that this was just her personal opinion, I would have simply deleted her response without thinking much of it, other than "that's whack."
I do give her credit, because she immediately admitted to cutting and pasting this woman's comments. She claimed that it was an accident that the attribution didn't copy with the quote. (I guess it wouldn't attach, when you are representing something as your own thought.) She also claimed that she'd quoted AntMom in a paper that she'd written a few years ago, which was properly footnoted (I hope she at least used the woman's real name, but seriously, why would you quote someone who also doesn't appear to know what the h*ll she is talking about?).
But, this response, of which I have only take a part (the rest went on about how she sincerely wished me the best in my upcoming cycle -- yeah, right), sent me over the effing cliff:
I am going to stick my neck out here since we are having such a meaningful conversation:) Do you wonder why your FET's or fresh cycle didn't work? I guess what I am saying is if I was spending thousands of dollars again to attempt to add to my family and my RE who has much more experience in the field of hormones, linings, etc than I ever will said to me, "M, we need you to stop nursing because we feel the subtle hormone changes can affect the outcome of your cycle, and this is why." I'd trust my RE and not like the fact I'd have to wean, but I guess I would have to ask myself "What do I want to do more, continue to nurse, or do all I can to make sure I have the best chances for my upcoming FET or fresh cycle."
Then again [Midlife Mommy], that's just me.
Isn't she a sweetheart? You know, I do believe in God, and I also believe in evil. But I don't think that it comes to us dressed in red satin. I think instead it's that little whispered voice who tries to fill us with doubt when we are vulnerable, trying to decide which path or decision to make. One who makes an appearance by using the words of others when our hearts are troubled, or when there doesn't seem to be any hope for tomorrow. You know, kind of like M when she said, "Do you wonder why your FET's or fresh cycle didn't work?"
Damn! You're right. It must be the breastfeeding. That's why it hasn't worked. But wait! I went through four years of infertility treatment that was just as much a failure without breastfeeding (no baby to breastfeed!!). Clomid, injections with insemination, and IVF. Four f*cking years. And, when I was going back and forth with my doctor (who, by the way, is a pioneer in my state with regard to IVF) about nursing through a cycle, his only concern was that the medications might have an adverse effect on my daughter. Not once did he spin this B.S. "subtle hormonal changes" hypothesis on me. Not once. (Besides, if there are "subtle hormonal changes," and M couldn't point me to a study on that either, then couldn't they have a positive effect? Really, why not? IMHO, the reason that the hypothesis would be in the negative is because in my experience, the medical community doesn't support extended breastfeeding, and they feel a need to explain cycles that don't work.)
I guess what bothers me about this particular person is that her current position puts her in a place to actually influence people! (I would link to her background, but that would just be mean.) Of course I would like my cycles to be successful. Of course! The last time I had seven embryos left, they burned through all of them to get just two for transfer -- and that was unsuccessful. I mentally hyperventilate when I think about it, because I am just not ready to give up on having another child. If you could get something by wishing and praying very, very hard, or by being good parents who have everything to give to a little one, we would have another child. Believe me. I know that I've said that it would be easier to walk away after having my one child, but right now, that is hypothetical. In the real world, dammit, I want another baby! And, seriously, why would God gift babies to crack whores and sex offenders, and not to me (and my sisterhood of infertiles)? Why the f*ck not? (Honestly, between this and my mom's death, my faith is taking a beating, but that's another post.)
I researched this issue. And researched it. And there isn't jack out there. Yet, when I asked my usual nurse, J, about whether there was anything I could do to increase the success of this cycle, she said honestly, there isn't. (I'd just heard yesterday morning about a study that seemed to indicate that men shouldn't eat soy products when trying to conceive, presumably because of the natural estrogen? I eat edamame just about every day, so I wondered if that might have an impact, though they do test my estrogen levels and they are where they want them to be. I also wanted to know what he thought about acupuncture.)
I do give my doctor a lot of credit, even though we don't agree on the bed rest thing (that is his personal bias entering into the process, and it is not supported by current research). He has admitted that while they can work to get good embryos, build a lining, address cycle and physical deficiencies, and control hormone levels, the one thing that no one has figured out yet is why one embryo implants and another doesn't. He's also said that everything seems to be coming back to embryo quality as the best predictor of success, and there doesn't appear to be much that a patient can do, other than following the prescribed medication schedule. I really believe that this little hypothesis is something that doctors use to try to explain why we fail, cycle after cycle. But, it is an inexact science. And the odds are against us in any given cycle. So, it shouldn't be surprising that cycles fail. Often.
But, during my ultrasound, J apparently called the sister office and spoke to another nurse (even though I asked her to talk with the doctor). My, my. What do you think the other nurse said? Why, yes. That I should wean. And she would be more than happy to talk with me about this, because she didn't give J any inkling why she said that. I was really hoping to get my doctor's take on acupuncture, edamame, and anything else that might be useful. Instead, I received some more medical establishment bias against breastfeeding (which never f*cking seems to end).
You know, I didn't start out as such a breastfeeding advocate. I didn't have an opinion one way or another. Breast or bottle. Whatever floats your boat. I don't get exercised about it now, except to the extent that I see moms try to establish and continue a good nursing relationship and they run into a brick wall caused by physicians who haven't a clue. (C'mon, regardless what they say about supporting breastfeeding, didn't you get a container of formula when you left the hospital?)
Frankly, I am glad that there are other reasoned people out there -- Robbin, for one. I won't share her thoughts here, because I don't have permission to do so, but I do hope that someday she might post them on her blog. She did give me an interesting link that I hope to get to hear one of these days: http://mumsright.libsyn.com/index.php?post_id=275049 So far, I haven't had 45 minutes to listen to the talk, but I understand that there is a paper associated with the lecture that I'm trying to get my hands on, and this may be it: http://www.intuitiveparenting.info/cmps_index.php?pageid=bellies-birth-babies-articles-breastfeeding-ivf
I would be very interested in hearing from anyone with any information on this subject. And if you have any research that draws a conclusion, one way or another, please share it. But, M, if you happen to find this site, please know up front that I will delete your comments. I've only done that for spam comments so far, but in your case, I will make an exception. Oh, and M, have a nice day!
