Trying to Conceive While Breastfeeding: What You Need to Know

Wanting to conceive while breastfeeding?

Hello doctor, I have been postpartum for one year and four months.
I had a cesarean section for my first child and am still breastfeeding.
During the day, I pump twice, totaling about 300cc, and my baby drinks on demand when we are together.
I have not had a menstrual period since giving birth.
Since I want to conceive, I started tracking my basal body temperature in mid-September, and my temperatures have been below 36.7°C, with the lowest being 36.2°C and the highest reaching only 36.68°C.
The temperatures have been fluctuating in a sawtooth pattern.
After the postpartum lochia ended, I only experienced one instance of mucous discharge last week; prior to that, there was no discharge at all.

I would like to know if there is a chance of getting pregnant under these circumstances, or if it is more likely to conceive after my menstrual cycle returns.
Today, my temperature dropped again to 36.33°C after maintaining at 36.68°C for only three days.
If I continue breastfeeding, how long should I wait without menstruation or ovulation before seeking medical advice? I have heard that prolonged amenorrhea due to breastfeeding can lead to ovarian atrophy, and I am concerned about the possibility of needing treatment to conceive.
Is that possible? Thank you, doctor.

Xiao Xiao, 30~39 year old female. Ask Date: 2015/11/03

Dr. Lü Lizheng reply Obstetrics and Gynecology

1.
I want to get pregnant, but I don't have obvious ovulation.
Gradually reducing breastfeeding may make it easier to restore ovulation.
2.
During breastfeeding, ovulation is typically suppressed, but this usually does not lead to ovarian atrophy.
However, the speed of restoring ovulation varies from person to person; some may need several months to resume ovulation.
Sincerely, Dr.
Li-Cheng Lu, Taoyuan Hospital.

Reply Date: 2015/11/03

More Info

When trying to conceive while breastfeeding, there are several important factors to consider. Breastfeeding can significantly influence a woman's menstrual cycle and ovulation patterns, which in turn affects fertility. In your case, since you are still breastfeeding and have not yet resumed menstruation, it is essential to understand how these factors interact.

Firstly, breastfeeding can suppress ovulation due to the hormonal changes it induces. Prolactin, the hormone responsible for milk production, can inhibit the secretion of gonadotropin-releasing hormone (GnRH), which is crucial for the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These hormones are necessary for ovulation to occur. As a result, many breastfeeding mothers experience a delay in the return of their menstrual cycles, which can last for several months or even longer, depending on the frequency and exclusivity of breastfeeding.

In your situation, you mentioned that you have not had a menstrual period since giving birth and that you are monitoring your basal body temperature (BBT). The BBT can provide insight into your ovulation status; however, it can be erratic during breastfeeding. The temperatures you recorded (ranging from 36.2 to 36.68 degrees Celsius) suggest that you may not be ovulating regularly, as a sustained rise in BBT typically indicates ovulation has occurred.

Regarding your question about the possibility of conceiving without the return of your menstrual cycle, it is indeed possible, although it may be less likely. Some women do conceive while breastfeeding and before their periods return, but this can vary widely from person to person. If you are experiencing cervical mucus changes, such as the appearance of sticky or stretchy discharge, this could indicate that your body is preparing to ovulate, which is a positive sign.

If you continue to breastfeed and do not resume menstruation, it is advisable to consult with a healthcare provider if you have concerns about your fertility or if you wish to conceive. They can evaluate your overall health, hormone levels, and any potential underlying issues that may affect your ability to conceive. Additionally, if you are worried about the duration of amenorrhea (absence of menstruation) and its potential impact on ovarian health, a healthcare provider can offer guidance and possible treatments.

In terms of ovarian health, prolonged breastfeeding and amenorrhea do not necessarily lead to ovarian atrophy; however, it is essential to monitor your reproductive health. If you find that you are unable to conceive after a year of trying, especially if your menstrual cycle has not returned, it may be time to explore fertility options or treatments.

In summary, while breastfeeding can delay the return of ovulation and menstruation, it is still possible to conceive during this time. Monitoring your BBT and cervical mucus can provide valuable information about your ovulation status. If you have concerns about your fertility or the duration of your amenorrhea, consulting with a healthcare provider is recommended to ensure that you receive appropriate care and guidance tailored to your situation.

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