Breastfeeding a Toddler and Specific IVF medications

[GenRN]

Hello,
I saw another thread asking about IVF medication, but not the specific ones I'm interested in.

The toddler in question is 26m old and nurses only a few times a day.

The medications of concern are:
Desogen
Gonal-F
Menopur
Ganirelix
HCG
Progesterone in Oil
Baby Aspirin

Thank you in advance for your assistance. Any references to specific science involving those meds and breastfeeding is also appreciated.

[admin-james]

Hi, thanks for your post.

There is not a lot of information in the medical literature about these medications being used in breastfeeding women. However, I'm not seeing anything on this list that raises a red flag. Toddlers get much less breastmilk relative to their body weights than infants do. Also, their ability to metabolize medications approaches or exceeds that of an adult by age 2.

Desogen, progesterone: These hormones are analogs of normal human hormones. They are commonly used as a contraceptive and found to be quite safe. (1)

Gonal-F, Ganirelix, HCG: These compounds are far too large to get into milk in significant quantities. Also, proteins like these generally do not survive the child's stomach acids.

Menopur: These hormones have very low oral bioavailability, that's why they have to be injected. I am not expecting them to be absorbed by the child.

Baby aspirin: This is quite safe. We discuss details here:
http://mommymeds.com/frequently-asked-questions/aspirin

For anyone reading this, please post again or call us at the InfantRisk Center, (806)352-2519, if this has not completely answered your question. I would also appreciate you filling out a 2 minute survey about your time on the forum:

https://tthsclubbock.co1.qualtrics.com/SE/?SID=SV_bJzhyKVSivVkQZL&Counselor=Web

-James Abbey, MD

(1) Technical consultation on hormonal contraceptive use during lactation and effects on the newborn: summary report, Geneva, Switzerland, 22 October 2008: World Health Organization; 2010. http://whqlibdoc.who.int/hq/2010/WHO_RHR_10.05_eng.pdf?ua=1

[Helene]

Dear Dr Abbey,

Since I have a question quite related to the previous one, I'll post it right here:
I have PCOS and conceived my now 12m old child thanks to the use of Clomiphene. I am still nursing my child a few times per day, but not at all at night. Must I stop the breastfeeding completely before we can start using Clomiphene again, in order to conceive?

Thank you in advance.

Helene

[admin]

Helene:

Clomiphene is a bit risky during breastfeeding for two reasons. One is that it has the potential of stopping milk production. We have some papers suggesting this occurs. Secondly, small amounts may get to the breastfed infant and could potentially have an endocrine effect on the infant. We generally advise moms not to breastfeed while on this medication. Lastly, we also think that breastfeeding "may" reduce your ability to get pregnant. We don't know this for sure, but its a remote possibility.

Tom Hale Ph.D.