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11 May 2023

Today we celebrate International Nurses Day

In this article, Christine Martin, Charge Nurse Manager at Fertility Plus and Fertility NZ Board Advisor, shares the history of in-vitro fertilisation (IVF) nurses and their essential roles over the last 40 years.

It has been more than 40 years since the birth of the world's first baby born through in-vitro fertilisation (IVF). Louise Brown was born in July 1978.


Nurse embryologist Jean Purdy and sister Muriel Harris were pioneers of IVF alongside biologist Dr Robert Edwards and obstetrician and gynaecologist Patrick Steptoe at the Royal Oldham Hospital in the United Kingdom. These nurses played crucial roles in developing the technology that has gone on to help hundreds of thousands of people worldwide realise their dreams of building a family. Dr Edwards received a Nobel Prize in 2010 for the development of IVF and was knighted in 2011. He described Purdy as indispensable and campaigned to have her contributions acknowledged.


Jean Purdy was the first person to witness the embryonic cells of Louise Brown divide under the microscope. During her career as the world's first clinical embryologist, she developed critical processes that are still used in IVF today. Three hundred and seventy children were conceived, largely in part to her work.  


As the superintendent of the Oldham Royal Infirmary and District General Hospital, Muriel Harris organised volunteers from the nursing staff to assist in egg collections. She was instrumental in acquiring the necessary medical equipment. She established the Bourn Hall Fertility Clinic along with Patrick Steptoe and Robert Edwards in the United Kingdom, and they have been creating families for more than 40 years.


It is estimated that more than 8 million children have been born with the help of IVF since its introduction over 40 years ago. Over 2.5 million cycles are performed worldwide, resulting in 500,000 deliveries annually.


In the past 40 years, nurses have been an integral part of the IVF team, offering emotional support on an often long and challenging journey, educating patients on complex procedures and medication regimes, support and encouragement with self-administration of injections and the long periods of waiting for news, expertise and advise from pre-conception to pregnancy and assisting and performing procedures to aid in conception.


The first IVF clinic in New Zealand was at the National Women's Hospital in Greenlane, Auckland, which opened in 1983 with the first baby born with the assistance of IVF born in June of 1984. It was the only clinic in the country, and in the first years, around 25% of the patients came from the South Island. Now about 3% of babies born every year in New Zealand are born with the help of Assisted Reproductive Technology.


When speaking with the many IVF nurses that I have met throughout my career, I find that nurses that choose fertility as a career path are both passionate about the science behind IVF and also feel very privileged to be trusted to support and walk alongside patients going through, often the up and down physical and emotional roller-coaster that is fertility. An incredibly humbling but satisfying area of medicine is a partnership between a multi-disciplinary team and our patients.  


Many nurses have special memories of patients that they will always carry with them and that have shaped the way they practice. Sometimes this has been helping them on their journey to pregnancy or helping them find closure. We understand that we are uniquely privileged to make a monumental difference in people's lives. One of the most beautiful patient testimonials I have ever read and that I carry with me in my practice is below:


“Do not ever underestimate the place you have on this earth – the influence you exert most unexpectedly – this remarkable thing. It is easy to know how you impact your family, your friends, and your colleagues, but do you ever wonder how your presence – the work you do and the way you carry yourself when you do it – can entirely transform the destiny of a life, of a family, of people whose name you will forget in a year or a decade.


I am only one, but there are no doubt countless others that feel, but perhaps cannot place in words, our gratitude for the transient but extraordinary role you have had in our lives.


One small word of compassion, an act of kindness, a humorous exchange, or a gesture of understanding has over and again lifted my spirit, disconsolate and worn down by so many failures. You have no idea the strength you have imparted to me, the willingness to forge ahead because I knew I would be nurtured with kindness and grace. You have been a cocoon that comforted no matter how ferocious the world outside, no matter the stark reality that the likelihood of success for many of us is indeed slim.


We who have failed to conceive by traditional means have not arrived on your doorstep out of weakness but out of strength, determination and perseverance. And after months and years of these small tortures of injections and surgeries and endless ultrasounds, we have learned stoicism because we had no choice and because we are inherently hearty stock. But I, for one, have had many cracks in my armour, yet I have always felt safe and unjudged by you in the decisions we have made. You have been the warm blanket in the coldest hour, solace in times of mourning. Your ministrations have always been genuine, and we have never felt humoured or placated. We only cared for deeply. I sometimes wonder if we would have persevered so long had you not made this journey liveable. And had we not endured -had not your ministrations have been so tender- we would not have the family -born and unborn-that grows around and within us now.


In this way, take due credit for the miracle you have so carefully crafted. Know that your presence, in a very tangible way, in even the smallest expressions of being, has profoundly influenced the course which our lives now take.


So, when you wake up fatigued and cranky, reluctant to come to work, anticipating tedium - just remember that in ways which you cannot even fathom: a word, a tender look, an empathetic hug- in a fleeting moment invisible to you, you may very well transform the path -the very destiny, the entire course of life of another human being that will fulfil them and bring them immeasurable joy for the years they have left on this earth. This is a remarkable thing.”


Fertility nursing is such a unique field of medicine to work in. It takes extraordinary people passionate about the science behind reproductive technology with its ever-changing technologies and advancements whilst also considering the underlying deep emotional aspect of our patient's journey. Working in this field is incredibly rewarding, and a true privilege to work with our amazing patients who put their faith and trust in us every day.


In honour of International Nurse's Day, I would like to celebrate all the amazing nurse colleagues and friends who walk alongside our patients, offering their support and expertise. It is a privilege to work and collaborate with incredible colleagues from all over the Fertility world.


-        Christine Martin, Charge Nurse Manager at Fertility Plus and Fertility NZ Board Advisor.

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