Fertility after weaning

[SKJ2011]

Hi Ladies.   I'm looking for some info on the return to fertility during and after breastfeeding.  My DD is 18 months old.  She weaned herself about a month ago.  I got my first PPAF in April and have had pretty regular cycles since then.  The first was a little long, but the rest have been about 26 days, which was normal for me before I had her.  My DH and I have been ttc since June.  I charted for a few months and noticed that my LP was about 8 days only.  I started taking B6 and am up to 150mg, including a B50 complex.  I am also seeing an acupuncturist and am taking herbs and drinking 2 cups of RRL tea a day.  I have had NO change in my LP. Two cycles back, my LP went up to 10 days, but I had 2 days of spotting before AF showed up.  This past cycle, my LP was only 8 days, and I also had 2 days of spotting.  Also, since starting the RRL tea, my periods have been heavier and longer, although this coincides with when my daughter really started weaning.  

I'm going to be 34 in January.  On the advice of my midwife, I have an appt with an OB on Jan 4.  I really don't want to do any interventions, but I also want to have another child in the next year.  My question is whether or not what is going on with my cycle seems normal.  I am willing to wait it out if there is a good chance my body just needs more time.  I'm just discouraged by the lack of change over the last 7 months.  It has me worrying that something is wrong.  When I got pg with DD, my cycles were about 26 days long and the cycle I conceived her, I O'ed on CD 13.  My O date has been b/t CD 15 and CD19.

Thanks for any thoughts.

Edited by SKJ2011 - 11/10/11 at 12:30pm

[JMJ]

I took a peak at your chart.  Are you just using OPK's and CM?  Did you only have CM on the days you noted?  Did you only check with the OPK's those two days?  If so, I'm not sure that's enough information to be sure you ovulated then (though you very well might have).  Charting a little more information would give us... well... a little more information.  That said, you have not even had a full cycle since weaning, and it is very likely that if nursing was causing your infertility that weaning should fix it pretty quickly.

I think that the plan that you have is a good one.  By a few months post-weaning, your luteal phase should lengthen out, and if it has not by then, it might be time to look at what's going on.  I would chart as much information as you can in the meantime to get a good idea of what is going on, and I would cancel the appointment (or set it a few more months out) if your LP lengthens.  If you are charting well and have a healthy LP with well-timed intercourse for 4-6 cycles and do not get pregnant, you may want the appointment.

[SKJ2011]

Thanks for the response JMJ.  I was charting for a few months, and it got to be too much stress on me emotionally, so I dropped the temping and focused on CF, CP and OPKs.  When I was temping, all the signs lined up well, so I'm fairly confident of the O date the OPKs give me (+/- a few days).  I think if anything, I'm O-ing even later that my charts suggest.  And, I have CF nearly all cycle long.  When it's not right around O, it's strange CF - yellow, stringy, and gelatinous.  It's not creamy, not sticky, and not EW.  It's just strange.  Since weaning, I've noticed my CF decrease, but it's still similar in consistency.  Right around O, it gets wetter, clearer, and stretchier.  Much more clearly fertile.  Also, I check with OPKs well before I get a positive.  

Lastly, I'm about 20 pounds less than my pre-pregnancy weight.  I'm 134lbs and 5'5".  My body fat is between 21% and 25%.  I'm thinking that my weight/body fat may be too low.  Thoughts?

Thanks again!

[JMJ]

Sorry for taking so long to get back with you.  I had to take the time to look up the exact numbers to answer your body fat question.  On the CM, yellow is a less-fertile type CM, and it sounds like it's your Basic Infertile Pattern when you're not ovulating.  That actually sounds very similar to my BIP in my postpartum cycles.  It is most likely completely normal, but if it's accompanied by a bad smell, you might want to get checked out for the possibility of an infection.  Just smell your panties or enlist your husband's help.  If it's not obviously bad, you should be fine.  Sweat doesn't smell great, so don't worry about a little bit of BO.  I'm talking about a truly bad smell.  Really, it's probably just your postpartum BIP.

On the body fat, my first response is that absolutely, that could be your issue.  It is well known that losing a large amount of weight can be associated with infertility.  Fertility hormones are fat-soluble, and if your body fat is too low, you will be infertile.  This is actually one of the natural ways of controlling fertility since a woman can be healthy without enough body fat to conceive.  The numbers are a little bit confusing to me, though.  The recommendation that NFP international and the Couple to Couple League use is to aim for a weight of 100 lbs for 5 feet tall and then add 5 lbs for every inch taller.  At 5'5", that would put you at 125 lbs.  However, based on a personal discussion with Marilyn Shannon of CCL (author of Fertility Cycles and Nutrition), it is her belief that due to different body types, some people may find their optimum fertility approximately 15 lbs more or less than that estimate.

I think that body fat matters a lot more.  Most women need at least 20-22% body fat to be fertile (this is the statistic I had to look up) according to The Art of Natural Family Planning 4th edition, though most fertility specialists believe this number to be lower, closer to 17-20%.  I personally think that the TAONFP estimate is probably more accurate, and I have a personal theory that the amount needed to conceive may be more while breastfeeding (since it appears to be possible in many situations to override natural breastfeeding infertility with extra body fat, and personal experience of being infertile in that range).  It could be quite possible that this could continue for a time after weaning as well since it takes some time for the hormone levels to return to normal.

Another practical piece of advice that I have heard is to aim for your pre-pregnancy weight that allowed you to conceive before.  After all, it worked before, right?  Since either too much or too little fat can cause fertility problems, this isn't bad advice.

Given all of that, I would guess that being a little bit over the 125 lbs estimate is not your problem.  You conceived at far more than that.  However, I'm not sure that gaining back all 20 of the lbs you lost is the best idea either, since that would put you far over the 140 lbs estimate for the maximum amount of weight you should need for maximum fertility.  If you can estimate your body fat percentage any more accurately, that might help to aim for 23-25%, though you may already be in that range.  (While nursing, I wasn't able to conceive until I had about 23% body fat.  I had an inadequate LP at 21-22%.)  If weight is a problem for you, I wouldn't guess that it's much of one, but it definitely might be worth trying to gain a few lbs and see what happens.

[SKJ2011]

Thanks so much for your thorough response!  My plan is to give it until after the holidays (and my trip to Brasil) and then see how things are before trying to gain weight.  I'm sure the holidays and travel will add a few pounds anyways 

My gut is telling me that 1) my weight/body fat is a problem and 2) my body needs more time post-weaning.  Now if only my emotions could accept that reality 

Thanks again!