Expert Voices: Interview with Natalie Burger, M.D., Reproductive Endocrinologist

Editor Sharon had the opportunity to interview Natalie Burger, M.D. about her work with couples.
Natalie Burger, M.D.

Natalie Burger, M.D.

Sharon: What services do you provide to women?

Dr. Burger: I am a reproductive endocrinologist — most people know us as fertility specialists.  My primary practice is taking care of women and men who wish to become parents.  However, I also have specialized surgical and hormonal training to take care of patients with other kinds of reproductive health problems (e.g. endometriosis, premature ovarian failure, polycystic ovarian syndrome (PCOS)).

 

 

Sharon: Is there some bit of information that you find women tend not to know that you wish they had known prior to coming to see you?

Dr. Burger: Probably the most common misperception that we see is that we have overcome the challenge of ovarian aging.  Because there are more and more women in the news who appear to be having children in their 40s and even 50s, it may appear that we can overcome ‘tired ovaries’.  We can overcome many things (e.g. blocked fallopian tubes, low sperm count, etc.) but we cannot reverse aging of the ovaries.  Many of the older women in the media who seem to be achieving pregnancy are actually using donor eggs (eggs harvested from a young donor in place of their own.).  This certainly is a very private decision — and understandably one that many people may not want to reveal to the general public.  However, it is important to understand that ovarian function continues to decline with time, no matter how healthy or fit an individual is.

Sharon: Do you find yourself giving advice to women experiencing infertility to complement their diagnosis and treatment plan? What are some examples (e.g,. supportive words)?

Dr. Burger: Dealing with infertility can be incredibly challenging.  People often think first about the financial stresses, but even more important are the psychological ones.  Going through infertility (with or without treatment) can place huge emotional pressure on women and their relationships.  Men and women often approach the struggle of infertility differently, and we try to help them understand each others perspective.

After I discuss medical aspects of infertility, I try to also address some of the emotional aspects as well.  

First and foremost, it is important for my patients to understand that they are not alone.  

Fortunately, it is becoming more commonplace for people to talk more openly about their fertility struggles — but there are many, many people who are dealing with infertility who are not necessarily disclosing their challenges.

We are lucky to have many counselors in the area who work with a lot of our patients — and who understand some of the more specific issues our patients are dealing with.  This is especially helpful if someone is not yet ready to talk in a more public forum.  We also have an infertility support group that is run by a nurse at our clinic — it can be very cathartic to talk face-to-face with someone who understands the monthly highs and lows that an infertility patient faces.

Strengthening emotional health can give patients the stamina they need to get through the infertility journey successfully.

Sharon: Is there any advise that you routinely share with your patient’s partners?

Dr. Burger: Men and women commonly deal with infertility differently.  I think it’s important to recognize that even though your partner is not dealing with the situation the same way you are, it doesn’t mean that they don’t care.  They may just not understand your perspective.  If a couple is really struggling, I would highly recommend talking to a counselor or other third party.  It can prevent or at least mitigate some of the hurt and anger that can occur when it seems like your partner doesn’t understand.

Sharon: Approximately, how many of the women who come see you (%) have been older than age 35 and trying to conceive their first child?

Dr. Burger: As it is more common these days for women to defer childbearing to focus on career, it is very common for us to see women in their later 30s and 40s.  I would estimate that about 25% of the patients I see are women over the age of 35 who are trying for their first child.

Sharon: How often do you see women experiencing secondary infertility, even if they have conceived successfully after age 35?

Dr. Burger: Secondary infertility is very common.  As ovarian function continues to decline with time, what might have been easy a few years ago can turn into a real struggle with time.  In addition to the ovaries getting older, other medical issues can become more common with age (e.g., fibroids) and these things can also thwart fertility.

Sharon: What, if anything do you see as different about the older mothers? This could be about their health or attitudes toward health and pregnancy.

Dr. Burger: Older mothers have the benefit of life experience.  Mature women tend to be especially motivated and committed to the success of the process.  They are prepared to do what it takes to get to the end goal. 

 I would say that there is also a certain strength and resilience that I see in this group of (AMA) women.


Sharon: Thinking about the questions that they ask you in person (or by phone or e-mail), what if anything is unique or thoughtful about their questions? Is there any wisdom in advanced maternal age?

Dr. Burger: I think that many of the questions are similar no matter what age of patient I am working with.  Oftentimes more mature patients have already done their homework so to speak — and come especially prepared to discuss infertility evaluation and treatment.


Sharon: What else can you share about your observations and interactions with women of age 35 or better?

Dr. Burger: I would tell my current and future patients that their journey to motherhood may not happen in the way that they initially felt it would — however it will happen the way it was meant to be.  Be open to the different paths that can lead to you becoming a parent.

Natalie and Sons

Dr. Burger is married with 2 kids and a Board Certified Reproductive Endocrinologist with Texas Fertility Center in Austin.  

Interview with Holistic Health & Fertility Writer, Jess Pedersen

Recently, Co-editor Sharon posed some questions to Jess Pedersen of Be Mama Be Well to learn more about her work and support of women.

Sharon: What services do you provide to women?

Jess: I am currently studying Holistic Health Coaching at the Institute for Integrative Nutrition (IIN). I recently received my pre-certification to provide nutrition and health counseling and will receive my final certification in December 2012 from the American Association of Drugless Practitioners. With that being said, the focus of my health coaching practice is infertility and women’s health. I will be providing one-on-one health coaching services and group workshops in and around the Pittsburgh area starting in September. I am actively sharing my knowledge about nutrition and fertility by blogging about holistic health on my own website, www.BeMamaBeWell.com, as well as serving as a contributor to other fertility focused sites, such as www.WithoutChild.com.

Holistic Health & Fertility Writer, Jess Pedersen

 

Sharon: Why did you choose this as your work?

Jess: I rode the “infertility roller coaster” for several years in my mid-thirties and wore the Advanced Maternal Age label during my two pregnancies. I was diagnosed with Polycystic Ovarian Syndrome (PCOS) in my twenties.

When I married my husband at the age of 33 I knew it wasn’t going to be easy to conceive. I made my rounds through the local fertility specialists, injected fertility drug cocktails into my abdomen, and eventually gave up on traditional medicine just before going down the IVF route. I found a Naturopath in my neighborhood that specialized in infertility. 

With changes to my diet and several other holistic protocols, I was pregnant within five weeks. It was miraculous.

That pregnancy ended at ten weeks and within eight months I was pregnant again. Sadly, that pregnancy ended at 26 weeks due to a condition called Preterm Premature Rupture of the Membranes (PPROM). I won’t go into detail about my history, but my story can be found on this blog.  Although my husband and I chose not to attempt to conceive again, I was amazed that my body responded so well to the natural fertility methods and treatments. 

The ability to change my fertility and improve my health through nutrition was something that I felt compelled to share with other women dealing with the heartbreak of infertility. That experience led me to find IIN and start a new career in my forties as a holistic health coach.


Sharon:  What percentage of the women you are helping are age 35+ and seeking to conceive their their first child?


Jess:
Although I am not actively practicing yet, I am connecting with a lot of women regarding the topic of fertility nutrition. The majority of these women are over 35 and either struggling to conceive their first child or are experiencing secondary infertility while attempting to have a second child.


Sharon: Are many experiencing secondary infertility after successfully conceiving at age 35+? How are their experiences and attitudes different, if at all?


Jess:
Yes, secondary infertility is often an issue with women over 35. I know from personal experience that infertility is emotionally and physically challenging no matter why or when you experience it. But I have seen that this population of women has a unique frustration in that they don’t understand why they are struggling when they conceived easily the first time. They typically ask, “What is different now? What am I doing wrong?” No one likes being labeled by their doctor as infertile. But having this label after easily conceiving in the past is shocking to most women. 

Secondary infertility can also cause a lot of emotional pain because people tend to be less sympathetic toward couples who already have a child. These women often suffer privately and seek support only from their closest friends, family, and health practitioners.

Sharon: What, if anything do you see as different about the older mothers? This could be about their health or attitudes toward health and pregnancy.


Jess:
Older mothers are excellent at taking charge of their health and their pregnancies. They seek out practitioners that will help them reach their fertility and pregnancy goals. From my own personal experience, I had a “whatever it takes” attitude regarding my hope to become pregnant and was willing to make sacrifices, eliminate allergens from my diet, and follow strict protocols to reduce the symptoms of my PCOS and improve my chances of conception. This type of persistence exists in this community of women as well. [Read more…]