<<Mother, 40 years old, breastfeeds her 17 m.o. daughter. She wants to be a
surrogate for her friend in America (Ca). ...The surrogate mum has not had her
period yet and has no evidence of being fertile whatsoever >>

Renate,

I have no experience, but here is what I think:

If she has not yet had a period, is she producing the hormones necessary to
support a pregnancy?

According to my understanding (based on the chapter on return of fertility in
Kathy Dettwyler s book), we regain our capability of getting pregnant in four
steps during lactation.  This is because high prolactin in the blood

1. makes the hypothalamus and pituitary less sensitive to estrogen
and
2. makes the ovaries less sensitive to FSH and LH, the hormones that come
from the pituitary and control the menstrual cycle.

The four steps are

a.    Follicular activity without menstruation     (The ovaries are making
some hormones, but not enough to have any effect on a target organ.)

b.    Menstruation without ovulation    (The uterine lining gets lush, then
sloughs off as a menstrual period.  This can happen for one or more cycles.)

c.    Ovulation without luteal competence   (She releases an egg, and there
is a nest ready for the egg in her uterus, BUT her ovaries do not follow
through and send enough progesterone to support a fertilized egg in that
nest.)

d.    Luteal competence  (Now everything is ready--the egg, the nest, and the
support system--and she can get pregnant.)

High prolactin comes from frequent nursing, from not going for long periods
without nursing, and/or from a higher total number of minutes spent nursing
per 24 hours.

So   I would think she needs to be at least having periods before it is worth
the trouble and expense to try implanting an embryo.  And if there is a test
to determine the level of luteal hormone (progesterone, I think), probably
they should do one.

She might not need to wean completely, but in order to work toward fertility,
she needs more and longer spaces between nursings (> 3 hours long).  It takes
about 3 hours for the prolactin surge from a nursing to drift back to
baseline in her bloodstream.

And, oh yes!  Would she want to start using some contraception?  Otherwise, a
home-made baby could move in and occupy the place where she is hoping to put
the borrowed embryo!

Regards,
Chris Mulford
Eastern USA

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