Written by Hamish McLachlan
25 October 2015, page 32
MY wife, Sophie, was involved in a car crash 15 years ago. She was lucky to survive. After a week and a half in hospital, and a long period of rehab, she was told that she may have trouble falling pregnant. After the crash, her body had stopped cycling.
When we were married in 2010, we were given the name of a fertility specialist in Melbourne. We weren’t aware how much the lady we would meet would change our lives. It turns out Dr Lynn Burmeister is one of the best in her field in Australia, and lectures all around the world.
She was very blunt. She told us we had a 7 per cent chance of falling pregnant naturally, and 33 per cent through IVF. Over 18 months, she would work her magic and help us start a family.
We went from an anxious, stressed and uncertain couple to doting parents. Dr Burmeister spoke about the pressure that IVF puts couples under, the stigma surrounding IVF, the joy of helping create families, and wearing the highest of high heels during surgery.
HM: You are integral in creating human life – that is seriously significant.
LB: It is pretty special, isn’t it?
I’ve been lucky to be helping couples create families now for 20 years. I started off doing obstetrics and gynaecology, and during my training I met Carl Wood and he introduced me to IVF. That developed into an amazing passion for what I do now.
HM: You take couples that are at a loss and create hope and often a family for them. There must be a great sense of satisfaction in that.
LB: It’s an amazing privilege, to take couples who are desperate and depressed from not being pregnant, and who can be having relationship issues, and then to be able to transform them into a happy couple with whom you are having these wonderful conversations about heartbeats and when their baby is going to be born. You can change a couple’s life significantly.
HM: It is a significant emotional journey that the couple has decided to go through together. At one stage we were doing 16 pills, pessaries or injections a day. A hormonal rollercoaster! Do you warn couples going into IVF how arduous and tough the process is, and how much pressure it may put on their relationship?
LB: Absolutely, I do, yes. You have to. It is really important they know that it is a tough journey and that they need to look after themselves, and maintain their relationship as best they can. I tell my patients that every road is going to be different, some people will enjoy the easy road, and others will have very rocky ones. It is a hugely emotional journey for all couples regardless, but when the transfers aren’t resulting in pregnancies, often you will find couples start turning on themselves for answers.
HM: Do you see couples who are not able to cope with it?
LB: Unfortunately, there are some couples who fall apart along the way from the stress and the pressures that searching for a child presents. The couples that I see come to me because they are having trouble conceiving, or are aware of a problem. That is stressful in itself, as for many the expectation is that starting a family will be so simple. For the couples who are finding it a burden, we have counselling for them and try to make it all bearable. To be told that you may not be able to have a baby is pretty devastating.
HM: How do you tell a woman that she will not be able to have a child?
LB: With great difficulty. It is horrible. Devastating. I’ve had to do it too many times sadly, and it has never gotten any easier. In many of the cases, though, I think the realisation for the couple can often occur over the journey, so they are almost expecting it. It’s a very painful process when it’s not working month after month after month, and it takes over their lives. It becomes all-consuming. It’s never easy, but sometimes that helps build an acceptance that it’s not going to work. There are tears, and it’s always an incredibly sad situation.
Most girls have dreams of becoming a mother.
HM: Without you there is no Milla, and as a result, no natural pregnancy for Indi – and Soph wouldn’t be pregnant with our third. You are creating families for people and, sometimes, saving marriages.
LB: Sometimes, perhaps. I forget how much it all means until I see people with their family, or they send me their baby photos.
When people come up to you in the street or in a shopping centre and show me their family, you do walk away realising that if I wasn’t able to help, then maybe the family wouldn’t exist. That is pretty weird, thinking that people you are meeting years down the track may not be here if I wasn’t able to help. Sometimes families write me little notes at Christmas time. I was at the hairdresser having my hair done a while ago, and one of my clients was in at the same time, and she told me that not only had I helped her to get pregnant, but also her sister and her cousin as well. Her father gets up every Christmas and has a toast for Dr Lynn Burmeister.
It’s nice to know you are making a difference.
HM: How often after a successful IVF program does the female body “kick in” like it has with Soph, and couples are able to have babies naturally as we did with Indi?
LB: It’s actually quite frequent.
Once the body is set in motion, as such, with a little help and pregnancy occurs, it means many things have fallen into place such as the right hormone balance and right receptors. And, importantly, couples aren’t as stressed about getting pregnant, which can be a factor as well. The body almost reboots. I’ve had a patient who was 40, and she had a donor egg to have her baby. Two years later she had a natural conception.
The body and mind are amazing things.
HM: Before IVF, couples just had to accept that they wouldn’t have children. Then, in 1978, the landscape changed when Louise Brown was born, and Sir Robert Edwards was awarded the Nobel prize in physiology or medicine. How long had he been working on IVF?
LB: For many years and, at the start, it was almost taboo. At that stage, people thought the embryos they were creating in labs were going to be monsters of some kind. No one actually knew that he was going to be able to create a healthy baby and give the gift of life. Thankfully he had the perseverance to show the world that, yes, it could be done, and, yes, the baby can be healthy.
There are stories that in clinics in the States and even in Australia, people were breaking in and destroying the embryos because they thought the doctors were doing the wrong thing.
HM: Where do you get your critics from? Not from a personal standpoint, but from an IVF perspective. What do they say is wrong with IVF?
LB: The main criticism is that it is not a natural process, and therefore it shouldn’t occur. It’s creating life through science, and the critics’ view is that you shouldn’t need science to create life. I find that hard to fathom.
Science is a wonderful thing and can do wonderful things. Science is working on curing cancer and is also curing infertility. Without science, we would have some significant health issues.
HM: Is there still a stigma for couples going through IVF?
LB: I think so. Many couples feel that if they have to go to donor sperm or donor egg, they have failed in some way, and they are reluctant to tell others that. I think though it’s more that they are embarrassed that they can’t get pregnant naturally, rather than a stigma about the IVF program itself. I think couples are still nervous to tell others about their journey; a lot of my patients don’t tell their family and friends that their children are IVF babies.
HM: Soph and I discussed at the start of our IVF journey whether we would tell people we were going through the process, and decided it was much easier to be open about it all. As a result I’ve had friends confide that they are having troubles themselves.
LB: I think it’s helpful for people to talk about it and share their journey with other people as well. The more people talk about it, the easier it is, and the more normal it feels.
HM: We were asked the other day whether we would tell Milla she was an IVF baby. We would never think of hiding it – it is just a part of our journey.
LB: I think one in every 25 children in Australia is an IVF baby, that’s effectively one in every classroom and those statistics are just going to increase. Why wouldn’t you tell her – it is who she is, and she is beautiful. There is nothing to hide in my view.
HM: I remember you telling me there was a 7 per cent chance of getting pregnant naturally and a 33 per cent chance with you.
There must be a fine balance between giving false hope and enough hope to endure the program.
LB: That’s right, you need to be conscious that you are not offering false hope. I never say to a patient that it will work the first time; people have to be aware that it can take many attempts. It’s also important to be honest if it becomes obvious that it is not going to work and that we should stop. That’s my philosophy. We treat people quickly and try to get results quickly.
HM: What is the most common reason for needing you?
LB: Probably ovulation or tubal disorders, something like endometriosis, where it has done a lot of damage to the pelvis.
There is the male factor as well.
Lots of people think it is about the female, but for patients seeing us, about 40 per cent of the time it will be the male factor.
HM: The average number of transfers required?
LB: Age is important. If the person is under 35, generally three transfers, 35-40 is generally five or six, and above that eight or 10 transfers.
HM: Is there an age that is too risky and dangerous to go through as a patient?
LB: One of my oldest clients is Sonia Kruger, who was 49 at the time. We do treat people up to 52, but after 45, IVF with your own eggs just doesn’t work, and the pregnancy rates drop to almost zero. As women get older, there are more chances of complications, higher chances of getting diabetes and blood pressure issues. That’s probably more of a complicating factor rather than IVF causing problems with pregnancy.
HM: Why is your personal success rate so high?
LB: People have talent in different areas, and I think this is what I was born to do. I worked in New York for a couple of years, and my boss used to say to me, “IVF is an art, it’s not about ticking boxes and putting patients on medications. It’s playing a musical instrument and making sure every key and every note is perfect.” It feels as though this is where I am supposed to be.
HM: In layman’s terms, what do you do for an uncooperative female body. What are you trying to create?
LB: Good-quality eggs. Not everyone looks after their health, so initially I put people on high doses of vitamins to help create good eggs. The men, too – you need good eggs and good sperm.
After that it’s about creating a good environment. Some patients have abnormalities in their pelvis that needs to be fixed before we can put the embryo in.
Then, hopefully, if you get those pieces right at the start, the IVF will work in the end.
HM: And from the male perspective?
LB: You’ve got to make sure that they are looking after themselves, not drinking too much alcohol, or even smoking or taking illicit drugs. It’s important to remember that 50 per cent of the embryo is going to be about the sperm.
HM: So they are factors . alcohol, drugs, smoking, they are inhibitors?
LB: Absolutely, huge inhibitors.
HM: Can things like alcohol, drugs and smoking influence the DNA imprint for the child in later life?
LB: Definitely. We know smoking can lead to later problems for that child, things like diabetes and heart disease. If a mum is smoking with a female baby, she can actually influence that girl’s egg bank. Girls born from smokers are more like to suffer fertility issues as well.
LB: Very important, too. If people are overweight, the testicles don’t produce the sperm the same, there are oxidative stresses on the DNA in the sperm. Being 10kg overweight can sometimes be the difference between being able to conceive, and not.
HM: What’s the longest amount of time you’ve spent with a couple to achieve a successful outcome?
LB: I’ve had a patient who came from another clinic who had been trying for a couple of years. She tried with me for a year before we had a successful outcome.
Three years is a big journey, but we got there in the end.
HM: Can you influence the sex of a baby?
LB: No, but we can tell the sex of the baby through genetic testing. We can’t sex select in Australia, but some couples are flying to America for that.
HM: Do you have an ethical problem with selecting the sex?
LB: No, if I did, I think I’d also have to have an ethical problem with IVF itself. I think if a couple have several children of the same sex, three or four girls and they want a boy, I don’t have an issue in that scenario.
HM: How old is the oldest IVF baby that you have produced?
LB: I think around 20.
HM: How many babies have you helped produce?
LB: Thousands now, thousands.
HM: If one of them goes on to become prime minister or win Wimbledon, will an alarm go off in the system somewhere?
LB: Ha! No, hopefully someone will tell me if that ever happens. I hadn’t thought about it like that.
I might need to keep a log.
HM: How many couples a year are you helping?
LB: I have about 1200 egg collections a year.
HM: Is there anyone else in the world that you know of that transfers eggs in the highest of high heels?
LB: Umm . I think I’m about the only one.
HM: I know you don’t quite realise the effect you have on families, but thank you for helping to make our family.
You are the reason we have children, and we will forever be in your debt for what you have done for us.
LB: Thank you, Hamish. It’s nice to hear I have helped you and Sophie become so happy.
Read Dr Lynn Burmeister’s profile here
Book an appointment with Dr Lynn Burmeister here