Breastfeeding and IVF drugs

[Barbara]

I have been prescribed Utovlan (Norethiserone) 5mg twice daily to induce a bleed so that we can proceed with IVF treatment.
Then,
Buserelin and Fostimon injections. I am still feeding my little boy, aged 15 months ( who was also conceived through ivf). I would like to know what affect these drugs will have on my breast milk and how this may affect my son. I don't want to cause him any harm and this will of course influence my decision whether to start treatment now or wait. I will be 44 in October.

[admin-james]

Hi, thanks for your post.

None of these medications are likely to be a direct problem for your toddler. They are unlikely to get into the milk in significant quantities and are poorly absorbed by the intestines; that's why the latter two have to be injected. However, all three of these meds have been associated with a drop in milk supply. It is possible that you will avoid this effect, but you should make sure your child is getting enough to eat just the same.

Please call us at the InfantRisk Center if this has not completely answered your question.*(806)352-2519

-James Abbey, MD

[Barbara]

Hi James, thank you. So can I be reasonably confident that they won't do my little person any harm? I am not sure what you mean that they are poorly absorbed?? He really feeds for comfort at sleep time. Can I continue to feed during the treatment?

[Barbara]

Is there some actual research on each of these medications and how they affect breastfeeding mothers and their infants?

[admin-james]

No, there is no specific research on these medications and how they appear in the breastmilk. Part of the reason why is that they are all three synthetic versions of naturally occurring hormones. It would be reasonable to assume that they behave similarly to their natural counterparts. Even if we did not assume that, these three molecules are far too large to penetrate the cellular barrier the divides the blood and the milk compartments in your body. Based on similar compounds, we expect them to be poorly absorbed by your child, by which I mean that they will pass through his digestive system without ever entering his blood to a clinically relevant degree.

The few small studies that have been published on these drugs in breastfeeding women focused on the milk supply issue that I mentioned. You should be able to continue feeding throughout your treatment, just be aware that you may begin producing less milk after you begin taking the meds.

[Barbara]

Hi, I am looking forward to starting treatment again next week. I just wanted to ask if the drugs will affect the taste of my milk or if my little boy won't really know any different.

[admin-james]

I don't have any literature or anecdotes that comment on that issue. I suspect that it won't make much difference.

[Barbara]

I also wonder how long I should wait before breastfeeding after taking the norethiserone or injecting the buseralin / Fostimon.

[admin-james]

I don't think you need to wait at all.

[Barbara]

We have started treatment and my milk supply is still satisfying my little mans needs, which is great, however he seems to be passing a bowel movement more often and his stools are much softer than before, does this seem a likely side effect of the buserelin please?

[admin-james]

To my knowledge, Changes in bowel habits have not been reported in adults receiving this drug or in babies exposed via breastmilk.