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.

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.

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….?!

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?

THOSE FIVE MATURE EGGS NEED TO HOLD DOWN THE FORT FOR US ALL!

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.

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.

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.

After the last two U.S. Senate seats were won by two Democrats, and while Biden was supposed to be declared the winner of the U.S. presidential election by the Senate, a bunch of deranged Trump supporters decided to rage into the Capitol building and stage an insurrection. Filled with delusional thoughts of fake news and a fradulent election simply because their side lost, they refused to accept the outcome of this election. And the worst part, aside from the fact that these idiots did this? The Capitol police did absolutely nothing to prevent them from coming in and storming through the entire building. If you have even a remote idea of how strictly security works at government buildings, you would know that the only way something this intense and big would’ve been allowed to happen would be if they were literally invited in with welcome, open arms. The number of photos I saw of police officers taking selfies with these morons was disgusting. I thought about the many protests around Black Lives Matter over the last 6+ years and thought… wait, so protesters peacefully protesting in honor of the rights of people of color were tear gassed and arrested, yet the White Trump supporters barely face any consequences for an actual insurrection? And don’t even get me started about how Trump has been encouraging and inciting violence since even before Biden officially won. It’s truly amazing to me exactly how much you can get away with in this country when you are white, and even moreso, a white male.

Anyone who doesn’t believe that this has anything to do with race — well, I want nothing to do with you and the delusional world you live in. If there is just one reason and one reason alone that the Republican Party of today is evil, it is that they are the one party of this country that is pro voter suppression, and that is ALL ABOUT RACE when you actually take a look at the data.

When I think about the way that we live our lives, I think that one thing we are never really prepared for is health issues. No one really anticipates what their life will be like if they encounter chronic pain, fall ill with an ongoing illness, or fracture their hip, requiring surgery and recovery time. When I was young, my mom used to scold me for lying in certain positions on the couch with my neck awkwardly positioned, saying that I may not know it at that moment, but that position for my neck would cause major issues for me when I was older, and she didn’t want me to have issues with my neck later on. The issue is: you don’t know you will have pain … until you are in pain. You don’t know how susceptible you are to anything until you are unlucky enough to fall ill for whatever reason.

With cubital tunnel syndrome, previously, it was only known to affect people who were affected by direct trauma to the elbows. There’s really not enough data to understand why some people are more susceptible to it than others, even when they exhibit all the same behaviors every single day; it’s unclear if genetics play a role here.

My PT said that as long as I do not experience sharp, burning pain in my elbows, arms, or hands, at this point, it’s really about continuing to do nerve gliding/flossing exercises, icing 2-3x a day, and trying my best to not perform actions that will exacerbate potential pain or cause flare-ups. Now, it’s about pain and condition management. So in other words… what does this mean? Am I supposed to have these pains, random flare-ups, hand tightness, and dull elbow pains forever…?! I thought I came to PT to get cured?! I’m not really sure what my next step is supposed to be. I’ve been told that cubital tunnel could take weeks to months to go away. After speaking with people who have suffered from carpal tunnel, which is closely related, some took over a year to fully heal and feel “normal” again, with PT exercises, stretching, splinting, and thankfully no surgery.

This just feels pretty hopeless right now, and I feel sad and frustrated.

My good friend is due to give birth any day now. She’s actually supposed to be overdue, as the baby’s due date was this past Saturday, but hey, maybe the baby wanted to wait to come out after the Biden transition was officially approved. Who knows.

Last night, I dreamt that my friend was in labor, and I went to the hospital to go meet the new baby and see how my friend was doing post-birth. Instead of arriving at the hospital and greeting my friend with her baby, I was greeted by my friend in the hospital lobby without the baby anywhere in sight. It appeared as though she had already given birth. I asked her where the baby was, and she said she already came out, and that she was fine. But she wanted to tell me that when she got admitted into the hospital to give birth, at the same time, she saw my brother get admitted into the hospital. Apparently, he had gotten into a serious car accident, and the doctors said that he remained in critical condition.

I was in such shock from this news that I didn’t say anything. I think I tried to open my mouth to say something, but no words came out. I immediately broke down crying, silently sobbing while my friend held me in her arms. In the back of my mind, I was thinking, “Where’s the baby? How is Ed in critical condition from a car accident when he’s supposed to be dead? Is he going to survive this time? What the heck is going on?!”

Back in 2013 when I finally forced myself to switch to morning workouts vs. after-work/early evening workouts, I had a memorable fitness instructor who taught my 7am spin/strength training course. She was a fitness fanatic obviously and loved running, having participated in a number of marathons and fitness competitions. She oftentimes talked about injuries, whether they were on her back, feet, but especially her “IT band.” Some days, she just instructed and couldn’t exercise with us because of her injuries.

If you are not familiar with what an “IT band” is, don’t worry. I didn’t really know what this connective tissue was called until she kept mentioning it. The IT band, or the iliotibial band, is a long piece of connective tissue that runs along the outside of your leg from the hip down to the knee and shinbone. If you do a lot of squats, barre, or running, you will notice that this tissue can get very tight and sore and will oftentimes need to be punched down or massaged out, likely with a long foam roller.

Well, seven years after learning about my own body and parts I didn’t know the names of, I finally injured mine. Since returning to the gym early September, I’ve also started running again. But I don’t think the running is really what set it off. It was likely the running plus some new barre exercises I started. I felt sore after the workout and sore throughout the day, but I thought it was just normal ‘new exercise’ soreness and fatigue. I realized it was far worse than that when in the middle of the night last night, I woke up to a burning sensation on my right IT band. It was so bad that I needed to put an ice pack on it.

Welp. These are the joys of getting older and taking care of that aging body.