What helps fertility naturally?

There’s a lot of conflicting information with varied levels of “research studies” behind them on the internet when you search for what you should eat, food and supplement wise, when trying to conceive. A few things are obvious: eat a well-rounded, nutrient dense diet, which means lots of vegetables, fruit, legumes, whole grains. Women need folic acid/folate as well as all the usual vitamins and minerals (A, C, D, etc.) to support a healthy, developing baby. Men should stay away from tight underwear (!!) and hot tubs/jacuzzis when trying to conceive. But what about the difference between CoQ10 vs. ubiquinol? Selenium is known to be a needed mineral for healthy sperm and eggs, and as such, is included in pretty much every pre-conception supplement for both men and women. And somehow, in nature, the densest food source of selenium is Brazil nuts. Should we all eat 1-3 Brazil nuts a day? What the heck are you supposed to do to “help” because again, everyone just wants to feel “in control” of SOMETHING?

I’m not really open to investing money in things like fertility acupuncture or fertility massage because I don’t think I would enjoy it, nor is there really that much evidence that it actually works (both those things are attempting to increase blood flow, and so don’t I exercise and stretch enough to get my blood flowing properly…?!!), but I’d be open to adding certain supplements or eating more of certain foods… just because it would give me some sense of control that I’m at least attempting to do something, anything within my ability to help.

When work is the escape

I feel weird saying this, but having a day job is actually a relief to me now. Work is actually a time and place where I can get things on my to-do list done, there’s not that much uncertainty, and I feel like for the most part, I have control over my day and how successful things are. Having control and insight is very empowering…. It’s even more empowering when I know I feel like I have zero control over our fertility situation. Work is like an escape from thinking about the unpredictably and total turmoil that is the TTC (“trying to conceive”) journey. But once the computer turns off, I feel like my mind goes back into the same thought process…. wondering when anything is going to work for us.

One day when I’m a mom…

When I did sex education in eighth grade, I was 13, and I naively estimated that I’d have my first child by age 27. Well, that means I’d need to get pregnant by age 26, and for me, I would want to be married before getting pregnant. So, no, that did not happen, and that was never going to happen for me once I reached my 20s and realized how ridiculous that thought was.

Then when I got married, I thought, well, maybe we’ll start trying when I’m 33. I’ll be pregnant at age 33 or 34, and it would be perfect! Well…. That didn’t happen. Another naive thought. They say you get older and wiser. That clearly did not apply here.

Now, I’m 35. I have no idea if I will get pregnant at this age. Now, I’m more wondering if I’ll be 36, 37, or even 38 when it finally happens.

Or, in the very back of my mind… the darkest thought sits… will I ever get pregnant and be able to experience a successful live birth, ever?

IVF Warriors

Infertility is a hard concept to understand or wrap your head around until you actually experience it yourself. It really feels like you’re fighting a war, whether that war is with yourself, your body, some higher power — who the heck knows? But it feels like a war, a battle of some sort, and you have no freaking idea when it will ever end.

We still don’t know whether our remaining embryo is genetically “normal” or not, but regardless of its status, I still feel defeated. Having only one embryo make it to blastocyst seems like a failure after all the injections and medications, all the ultrasounds, all the bloodwork… everything. This whole process is really a mind fuck (and frankly, a body fuck if you have bad side effects from all these treatments) when it ends, and you have little to nothing to show for it at the end.

It’s why in many fertility/infertility groups, they call women who go through IVF “IVF warriors.” There’s even a non profit I found on Instagram founded by a couple who were on an 8-year infertility journey (they are expecting their first child in a few weeks, fingers crossed) called Cozy Warriors, which raises infertility awareness and also funds for couples who need fertility treatments but cannot afford them/have no insurance coverage. To raise money, they make socks… because according to ancient Chinese medicine, a woman must keep her uterus warm (and thus her feet warm…?) to ensure an embryo successfully implants and grows into a healthy baby.

So what does that mean — I’m an IVF warrior now? I don’t really know what I am. I feel like a fallen warrior if that is the case.

And then, there was one.

Only one embryo survived until day 6.

One. One. One. One. One. Not even two.

One lone embryo out of three that progressed well on Day 3. The other two arrested, meaning they just failed to continue developing. This typically happens due to chromosomal abnormalities.

I just feel like I got told that I’m never going to be a parent, ever. This whole week has been shit.

“Defeated” is the only word that comes up to express how I feel right now.

Not day 5, but day 6 blastocysts

The embryology lab let me know on the phone on Monday that we’d wait until six days of culture rather than 5 to give me the final blastocyst update because I had so many immature eggs.

Well. That is not promising. That just makes me feel even worse.

This week is truly one of the worst weeks I’ve experienced.

Thinking about Charlotte’s fertility journey from Sex and the City

While I was in college, I can assure you that I never, ever thought about the concept of infertility. I naively thought that one day, I’d just get pregnant naturally, and poof! I’d have a baby!! Well, fast forward 16 years later, and here we are, trying to conceive with nothing to show for, not to mention annoying relatives and family friends who keep asking when they can expect us to have a baby. My mom actually said to me that if I “waited too long, your baby will have ‘problems.'” Thanks, Mom.

Unfortunately, you can’t just say something like, “We’ve been having tons of sex every day! You’ll know eventually!” because that would be rude… but hey, isn’t it rude for them to constantly ask and plant hints every chance they get?

So when I got addicted to watching Sex and the City, Charlotte York (eventually Goldenblatt’s) fertility journey was completely new territory to me. She struggled to conceive with two different partners, and after many tests, they discovered that she had some condition where her cervical fluid attacks sperm instead of fostering it along to merge with her eggs, and that she had less than a 10% chance of ever conceiving.

While it was heart wrenching to watch this and see her mental health go through a complete downward spiral, and while many of her moments have been relatable as I go through my own road of reproductive challenges, I will say that at times, she probably was a little too extreme in the way she was with her loved ones. To tell Miranda “How could you do this to me?” seemed pretty extreme, when Miranda accidentally got pregnant after having sex just once with Steve. One person’s pregnancy or success (and it definitely was NOT perceived as happy news to Miranda at that time) is not at the expense of another person’s; all our journeys are completely unrelated to each other. There’s also just the fact that we need to better compartmentalize our feelings and struggles from that of others.

Also, I will say that given the few times when she was with Trey and they showed the injections that were done during their IVF cycle, it was completely inaccurate to show butt shots. Butt shots are progesterone in oil injections that are done to prepare the lining of your uterus to receive and fingers crossed, successfully implant an embryo. That is WAY after stimulation cycle and egg retrieval. If they were at the beginning of their IVF stimulation cycle, the only injections needed (haha, “the only”) would be subcutaneously in the stomach region.

Because if they really had gone through egg retrieval and fertilization and were preparing for an embryo transfer… my next question, given that they eventually separated and divorced, would be… what happened to those potentially surviving embryos….?!

Embryo updates – the pain is in the waiting

After your egg retrieval, depending on the clinic you are working with, you will receive updates the day after egg retrieval. The day after egg retrieval is considered Day 1, about 24 hours after the eggs and sperm have been examined, and after they have, fingers crossed, done their dance with each other and fertilized. So, Day 1 update is also called “Day 1: Fertilization Update.” Some labs will call you. Others will email. Some may do some combination of both of the above. My lab sends a secure email message, likely because they probably cannot deal with an emotional, hysterical post-oocyte retrieval woman hearing what could potentially be bad news and then balling her eyes out.

Day 3 Update is next: that is considered “Day 3: Embryo Update.” Three days later, these fertilized… things will become actual embryos. The development here matters because if they are not multiplying into at least 6+ cells by day 3, they are very unlikely to survive to become blastocysts, which is the stage they need to reach by day 5 or 6 in order to be potentially successful candidates for implantation.

It’s Day 3, and I already feel like it will be a miracle if we even have one single embryo that reaches blastocyst. On Day 1, we were told that of the 12 eggs retrieved, three were far too infant (read: JUST DEVELOPING!) to be fertilized; these were discarded immediately. Of the remaining nine, only 5 were mature oocytes that fertilized normally. Four were one level below mature (so …. immature), but they fertilized anyway. Two of these fertilized normally, while two fertilized abnormally. They warned us that immature oocytes were highly unlikely to progress through the stages, but they would still keep them in culture to see how they’d progress.

My takeaway from the above Day 1 update: I took nearly three weeks of daily injections and that only yielded FIVE MATURE EGGS???????

Why didn’t my RE just have me continue with the daily injections and push the retrieval out by a few more days to allow those immature oocytes to… MATURE MORE?


Day 3 update: only three have progressed well with 6-7+ cells. That is three out of a total of nine embryos. And I believe I read that only about 20-30% of all embryos make it to Day 5/6, or blastocyst.

I feel defeated and like my body has completely failed me. And maybe, I have committed great sins at some point in this life to deserve this type of mental and emotional torture.

In full honesty, the stimulation period of daily injections, of nearly every other day doctor’s visits, was the calm of this whole period in my mind. I managed it well, and so did my body given my lack of side effects. It was the easiest part to endure because all I had to do was do exactly what I was told at the times I had to do it. I was completely focused during my daily meditations. I was focused at work. I was able to compartmentalize everything. I was so full of hope every single day during that period that this would work out for us.

But this period of receiving the updates of what seems like my dwindling chances of becoming a mother every other day — this is the most brutal and excruciating. In some ways, I wished they just would forgo the day 1 and 3 updates and just provide a final update on day 5/6 of how many made it to the blastocyst stage, just to spare me of the anguish of this every-other-day waiting game.

In the recovery room after egg retrieval

Two days ago, I had my egg retrieval.

Well, that’s not really a sentence I ever thought I’d ever write.

After the nurses walked me out of the operating room, I was led into a recovery room where, unlike the operating room, it is a shared space. There are about four beds for patients who will eventually be recovering from their own procedures, and you are separated from the rest of them by a curtain. After the procedure, I was predictably groggy and sleepy from the IV sedation. I could feel mild cramping and bloating from the procedure (as is considered normal), and the nurse immediately gave me two Tylenol and water before allowing me to sleep and gain back energy to go back home. Chris would be in the waiting room downstairs, waiting for me to wake up and be discharged.

The RE came over and tapped on my foot to get my attention. He provided the update that they retrieved 12 eggs, but we wouldn’t know until the following day how many of them would be mature (immature eggs are highly unlikely to fertilize and reach blastocyst stage, meaning they have extremely low chances of “sticking” after an embryo transfer). That number sounded higher than what the sonographer had estimated with me a few days ago during my last ultrasound, so I felt pretty decent about it and thanked him as he left.

What was the most disturbing thing that happened was what I overheard next to me about ten minutes later. A woman whose procedure had also completed was distraught. A nurse came over to say to her in a lowered voice that she was so sorry about what happened, but the doctor and embryologist would examine the results in more detail to better understand. From what I could hear through the curtain, her egg retrieval… resulted in zero eggs retrieved. While the aspirating needles were able to remove liquid from her follicles, there hadn’t been adequate “cellular development” resulting in eggs.

I was only half conscious listening to this, but I could already feel myself getting choked up. Why and how could this have happened to her, this poor woman? Like me, she had to go through countless injections, endless ultrasounds and bloodwork, too many doctor’s appointments nearly 3-4 times every week for 2-3 weeks…. all to retrieve zero eggs? I felt so horrible for her, and I don’t even know who this person was, nor was I able to see her face.

A woman’s fertility journey can be an extreme life struggle. And when defeats like this happen, it really does feel like your body has failed you… and that part of you is just broken.

Fertility evaluations

I don’t really know why, but despite the thousands of years that human beings have been in existence, there seems to have been so little progress made specifically in understanding fertility from both the man’s side and the woman’s. For a long time in society, people only expected to live until their thirties, and then, well, they’d die. Therefore, their prime time to have a child was in their teens. In modern day society, even in more conservative societies, teens giving birth is… no longer really a thing. The earliest you tend to hear of people giving birth is in their early 20s. But when you live in western society where the goal is for men and women to at minimum finish high school, perhaps college or even graduate school, the age to have a first child gets pushed off further and further. I think a few years ago, I read a stat that said that in Silicon Valley, the average woman has her first child at age 37. Wow.

I guess what I am struggling the most with is… why would a process like IVF pretty much be exactly the same today as it was in the 90s and early 2000s, when Michelle Obama conceived both her daughters via this process? That means 20-30 years have passed, and the process is exactly the same. Why is it like this? Have people just stopped prioritizing research on infertility/subfertility… because of the fact that the main onus is on the woman, with endless hormonal injections, transvaginal ultrasounds, and bloodwork, not to mention surgery at the end, plus progesterone supplementation via butt shots, vaginal suppositories, and oral pills? Men don’t have to be inconvenienced (well, financially, but not physically or emotionally) as much as woman do, so let’s just stop research on this…?

The scariest thing to me about all of the lack of progress in this area is not even the above, but rather the complete inability to evaluate oocyte (egg) quality until after an egg retrieval. Science has long made it possible to evaluate sperm count, motility, and morphology (and thus overall sperm quality), a woman’s estrogen, luteinizing hormone, AMH (ovarian reserve) level… but NOT the actual quality of the eggs. Why is this? …You just have to go through a $15-20K IVF procedure to then find out that your egg quality just sucks? Then, what are you supposed to do with this information — Go home and cry your eyes out?

I was researching the interactions of eggs and sperm earlier today, and read a likely bullshit but nevertheless devastating article that puts even more pressure on women (because, as you can tell, ALL the pressure is on women when there are fertility problems, and even without fertility problems, women have the sole responsibility of carrying a baby to full term!): some random study was done that was trying to evaluate how male factor infertility can be solved for during IVF via “healthy eggs.” The study somehow came to the conclusion that if you have a very healthy, high quality egg, and you inject it with a single sub-par sperm (that’s the ICSI process, minus the sub par status), the healthy egg will be able to “heal” the subpar sperm and develop into a healthy embryo that would be ripe for future implantation.

I read this and immediately closed out the tab. You’ve got to be ****ing kidding me, I thought. The woman even has the responsibility of having healthier eggs than her partner’s sperm and has to HEAL ITS DEFICIENCIES….??!!

Well, if that’s the case, why don’t we all just kill ourselves now and be done with it because we, as women, will always have to do all the work in society, and then some, just to make up for men’s laziness, idiocies, and complete deficiencies. This is just a great analogy.