Given the fertility journey I have been on, every appointment I’ve had after learning I’ve been pregnant has been beyond nerve wracking. I have to try my best to fight off anxiety while going to all of these appointments, whether they’ve just been for blood draws to check my HCG level, or scans to check on the growth of the embryo and its heartbeat. I’ve also had to start seeing an endocrinologist to ensure my thyroid levels are within healthy range, and each visit there, they also take my weight and blood pressure. I’ve always had normal blood pressure, but at this first OB visit, which is strange to even call it that since prior to getting pregnant, I would usually just refer to my OB-GYN as my “gynecologist,” when the nurse took my blood pressure, I noticed that it was a little elevated. Great, I thought. I’m getting off to an awesome start with this visit.

Then, I undressed from the waist down as instructed and waited for my doctor of the last nine years to come in. And I felt nervous. What if the embryo isn’t growing? Or what if its heart beat can no longer be detected? These worries keep plaguing me each visit, and they’ve only gotten worse since Twin A’s heartbeat stopped.

I knew she was coming when I heard the clicking of her heels. She loves heels.

She opened the door with a huge grin on her face (yes, I could even see it with her mask on): “YVONNE!” She shouted in a sing-songy tone. “You’re PREGNANT!!!! CONGRATULATIONS!”

I smiled. “Yep. I”m excited… and absolutely terrified,” I responded, laughing. “Every visit, I’m scared I’m going to find out something bad.”

She reassured me that at this stage of pregnancy, now that we’re at week 10, the miscarriage risk was extremely low. “Now, you should really just focus on your health and the future,” she insisted.

I hope she’s right, I thought. I mean, based on the statistics, what she is says is true, but I cannot help but have some lingering doubt in the back of my mind. I cannot get too comfortable.

She proceeded to perform my very first transabdominal ultrasound; I couldn’t believe it. “We don’t have to do it vaginally?” I asked to be sure. She said that at this stage, we should be able to see clearly enough over the stomach (thank God; I’m so over having foreign objects stuck in my vagina all the time). So she pressed the wand over my stomach and we started looking at the outline of what is now, as of this week, transitioning from an embryo into a fetus. We saw the outside of the baby’s head, butt, hands, and feet. And she also measured the heart beat: 179 beats per minute, which is on track for this stage. And the little peanut is measuring at exactly 10 weeks. Thank goodness. A major sigh of relief came out.

She had me do some routine prenatal tests, including both blood and urine samples, and gave me a referral for a formal 12-week scan that would provide better imaging for nuchal translucency and growth at the hospital in two weeks. I will see her again in five weeks.

I just need to get through these weeks and not worry about the growth and progression. I’m not used to not having weekly scans, and I just need to trust in the process. I need to trust in the process. I am going to get through this. My baby is going to get through this, too, and be healthy and happy. Please, please.

I was surprised to get a message from Maria, Raj’s wife, yesterday morning, asking if we’d be free to catch up over a video chat this week. Obviously, we’d been wanting to chat with her since we found out about Raj’s passing, but we figured she was overwhelmed with being a new mom and all the new responsibilities around that, not to mention grieving her husband, and so we just let her know we’d be free to chat whenever she was ready.

We ended up chatting with her this evening, and I just couldn’t help but get emotional. I don’t think it takes any difficult guessing to figure out that life has been really hard for her since he got sick and died so suddenly. And it’s only been made worse by the fact that no one, not the doctors or anyone at the hospital, have any idea what brought on these seizures out of nowhere… they know nothing until this day. One by one, his organs just started shutting down, and the end finally came. And he was hospitalized just days after bringing their baby home.

Maria expressed a lot of confusion and anger at the world that something like this could happen to Raj, and it was easy to understand. “Why Raj? Why him?” she said through tears. “He’s such a good person… Why did he have to get taken away, and like this?”

The world isn’t a fair place. It’s no wonder I get angry at life and the world so often; it’s when things like this happen. Maria has been so strong, partly because she has no choice given she’s responsible for an entirely new human being now. I just can’t believe how strong and fierce she’s been; it was so admirable to see.

It just felt so strange, though, to be on that Zoom chat with just her. It’s almost like I still don’t believe Raj is gone, like all this is some awful joke being played on us, and that out nowhere any second, he will pop into the Zoom frame and say hi to us. I can’t believe she’s actually a “widow” now. That is just too strange to me to think about. My heart just hurts.

This afternoon in the suburb of Folsom, family and friends gathered at a beautiful winery to celebrate the life of our dear friend Raj. For those of us who are not local, a live stream of the event was provided on YouTube, so Chris and I tuned in to participate from home. As we can imagine would have been what Raj wanted, this was no somber affair; the food and wine overfloweth, and the family requested guests to not wear funeral attire and instead to wear business casual.

One after another, we heard friends and family members of Raj talk about memories they had with him. All of them were relatable, and none were surprising given the big heart that Raj had. Some were actually pretty funny (I had no idea he converted Maria’s parents into wine lovers. These are people who barely even knew what wine was before!). Even his manager and the head of his team came to share thoughts and memories of their colleague and friend, a side that we never got to see of Raj since we never worked professionally with him.

The tear jerker moment for me was seeing his dad speak. Given the timing, it was unlikely he got to see Raj this year before his son’s untimely death given he was stuck in Nepal, and it just broke my heart to see how strong he was being. Raj was so close to his parents; he frequently called his dad his best friend. And regardless of being in a totally different time zone, he called his dad every single day, even if it was just to talk for five minutes. He was an open book to his dad. I cannot even begin to imagine the pain and anguish his parents must have felt upon learning their eldest son had suddenly passed. It must have felt like death for themselves.

This morning, Chris and I went to the clinic for what was supposed to be my last visit before “graduating.” When you are getting fertility treatments at a clinic, they consider “graduation day” to be the day when you have finished all your treatments and have been given the green light that your pregnancy is healthy and progressing, and so you are allowed to transition back to your OB-GYN. In the elevator going up, Chris asked, “Is this really going to be your last visit?”

I gave him a tired look. “I HOPE SO!!!!” Because if this isn’t my last visit, it either means a) something is wrong with the growth of Emmie that would require closer monitoring, or b) she isn’t going to make it, and I’ll need to start from square 1 all over again. Please don’t be the case…

As I sat on the exam table waiting for the doctor to come in for my last scan, I suddenly felt nervous. Is everything going to be okay? Is my little remaining Twin B going to be growing appropriately with a good heart rate? Am I REALLY going to graduate today and have this be my last visit here?

The doctor and sonographer finally came in, and the doctor got started with the scan right away. As though reading my mind, as soon as he stuck the probe in me, he immediately said, “Wanted to confirm right away that yes, we do see a heart beat! And it’s looking on track!”

Thank God.

Hey, little Twin B, you can do it! You can do it! And she certainly is doing quite a bit with her heart beating at 186 beats per minute, which is within healthy, normal range of what she should be at given we’re now at the 9-week mark. He also confirmed that Twin B’s growth rate is on target for where it should be. “This is exactly what I was hoping to see today!” the doctor exclaimed, smiling, with relief.

He answered some of our questions and talked through transitioning back to my OB. I thanked him for everything before he wished us well and left the room. I also gave a parting gift and thank you card to my sonographer, who has been my rock at this clinic for as long as I’ve been going. It was definitely a bittersweet day. I’ve been treated very well at this clinic; they’ve taken very good care of me, especially when I read all the horror stories in other fertility support groups online, or hear my friend’s stories about her clinic. Transitioning over to my OB-GYN will be like I never got fertility treatments at all; it will seem and feel like a “normal” pregnancy.” But that also means less checking, less reassurance that things are progressing well. I just have to trust in the process. No more weekly scans. Now, it’ll be every four weeks until week 32 from what I’ve read, then weekly until delivery.

Unfortunately, Twin A is still there with no heart beat. You can even see her on the sonogram the doctor printed out for me. It’s a sad reminder of a little potential life that unfortunately did not work out, but it only makes me hope even harder for Twin B to survive and thrive.

I am just hoping, praying, hoping endlessly that nothing goes wrong and that my little Emmie the embryo continues to progress and become a little human I can hold in my arms. If I ever come back to this clinic, I want it to be as a guest, not as a patient.

It’s always been said that pregnant women should not share their pregnancies openly until they are out of their first trimester. The main reason for this is during the first trimester, that’s when there’s the most concern about whether your pregnancy could end in a miscarriage. And who wants to tell friends that they are pregnant, to then retract that statement just a couple weeks later? It’s devastating and tragic, and well, society doesn’t know how to respond to miscarriages in a tasteful way that doesn’t blame the woman who had the miscarriage. Miscarriage is the result of at least 30 percent of all pregnancies, and that’s only what is reported; the actual number is likely much higher. That’s very much fear inducing in itself.

But maybe we’re actually part of the problem in continuing this. Maybe by not sharing, we’re actually increasing the stigma around pregnancy loss. We’re making it “not normal” to share before you clear the 13th week mark of pregnancy. Maybe we should all be openly sharing when we are pregnant during our first trimester because that will increase awareness and communication around pregnancy, the highs AND the lows, and the very real fear and worry of miscarriage. Miscarriage doesn’t just affect people you don’t know; it actually has likely affected MOST people you know whether you are aware of it or not.

The only downside of this idea is that when you are the pregnant person hoping to share, to lead the way in being progressive and forward thinking, is that the burden will ultimately fall on you if your pregnancy does end in a loss. And that’s quite a heavy load to carry on top of the loss itself. It’s a complicated matter about a complicated topic. There’s really no winning in this. I just wish more people had more empathy when it came to pregnancy, pregnancy loss, and the real burdens that pregnant women, and women hoping to become pregnant, face. There is so much anxiety that is not openly acknowledged. It’s not really a fun and exciting time in the first thirteen weeks because you’re plagued by fear of the unknown.

I couldn’t deal with work or the rest of the world the rest of this week, so I took Wednesday through Friday off and told work I was feeling unwell…. and told my manager I had a family situation emerge. When one of your growing embryos that had a strong heart beat suddenly just dies and starts shriveling up in a matter of days with zero warning, nothing else in the world really matters.

I had a long Zoom session with two of my close friends tonight, two of the three people outside of Chris and me and the medical professionals I’ve worked with who knew that I was pregnant with twins. Even if just for three short glorious weeks, I thought I was going to be a twin mom. And they knew, too, and they were so excited and happy for me. Yet even after detecting strong heart beats in two, one of them just vanished… literally into thin air. And when telling them about what happened, it was like my pain was their pain; we all cried, grieving the loss of this little embryo that had split off from its sibling… who I thought could both survive. This is when you know that your friends are really your close friends for life; when they mourn when you mourn, even when you are mourning something you only had for a few weeks.

I had two babies… and now I have one. Chris doesn’t quite get it; he said it wasn’t real. He insists that they are not babies. He said they are “two potentials” and one “went away.” I told him he’s wrong; they both had strong, detectable heart beats that I heard. I heard them with my own ears. There’s documented proof in my flow chart that they REALLY existed. How dare he tell me they never were “real.” Of course, it’s not easy for any man to understand this, my friend said. They don’t have the burden of carrying the child. They don’t have the physical feeling of being pregnant, the pelvic tension, the weird food aversions, the bloating, the intense breast soreness that is a constant reminder that your body is growing a living thing. They never had to go through the countless clinic visits, all the endless transvaginal ultrasounds, all the blood draws that have left bruises and scars on my arms that I’ve gotten questioned about during physical therapy visits. Yes, it might be a loss to him, but the loss will never be the same. He thinks rationally with his head, and I’m thinking with literally everything I’ve mustered up in this fight with the world and my body and the forces out there working against me just to fucking get pregnant. He has not invested as much into this as I have. He has not fought as hard as I have. It’s just not the same at all. This is where men just truly cannot empathize AT ALL.

They don’t call women who have to go through IVF “IVF warriors” for nothing; it really feels like you are fighting a war just for the chance of being a mother. Their partners are just spectators reading news in newspapers of the results of that war, attempting to sympathize but not quite getting close enough to really feel the pain and the loss and the suffering.

We got the first and only available appointment today at the Maternal Fetal Medicine specialist that my reproductive endocrinologist referred me to; given his referral, they were able to squeeze me in this last minute, which I was grateful for. Chris and I went together; I wasn’t sure I could stomach any more bad news this week, and I absolutely did not want to be by myself if I had to hear more crappy news.

Typically, if you are having any complications during pregnancy, whether it’s preeclampsia, gestational diabetes, or abnormal growth with your fetus, that’s when you’d see a maternal fetal medicine specialist for more careful monitoring and direction. Otherwise, you’d just go to your OB-GYN for routine visits and scans. Sitting in the waiting room here was a bit unnerving; it was very clear I was the only patient in the waiting room who was so early on in her pregnancy; everyone else looked at least six months or more along.

We were invited in, and after undressing waist down, a sonographer came in and performed the longest transvaginal ultrasound I’d ever had, ever. She took so many pictures at so many angles, zoomed in and zoomed out; it was certainly an extremely thorough ultrasound. She confirmed that Twin A no longer had a heart beat, and well, even worse: it had already started shrinking in size even just from yesterday. She also confirmed that Twin B was progressing well, with 171 beats per minute. She took a very close up shot of Twin B and printed it for us. She identified where the brain, head, and tush was. Twin B is currently the size of a kidney bean, and it certainly looked like a little shrimp at this point. She then completed the scan and said the doctor would review the results and come in to discuss with us.

When the doctor came in, she seemed confused as to why we were even here. “Did your fertiilty doctor want to confirm that it was twins….?” she asked, confused. “Yes, it was definitely twins.”

No, I told her. We knew it was twins all along, but the doctor wanted to confirm they were in their own sacs. She said they were, in fact, in their own sacs, so Twin A not progressing would not affect Twin B; Twin B would basically progress as though it was a singleton pregnancy all along. She did say that the two twins did originally share the same placenta, so I had a moni-di pregnancy: this means I had a monochorionic, diamniotic twin pregnancy: one embryo that split into two, which would have been genetically identical offspring. These twins share a single placenta (blood supply) but have separate amniotic sacs.

So thankfully, since they are in separate sacs, Twin B would be unaffected. And I hope for the best for Twin B’s progression. And while I have calmed down since yesterday and feel relief that Twin B will be unaffected by Twin A’s death, I still feel heavy in my heart for A. I was also annoyed that the doctor today seemed pretty un-empathetic and so matter-of-fact. She also just stood in the doorway and made it clear that this would be a quick, couple-of-minutes long conversation. It felt very rushed. While I get that vanishing twin syndrome is very common, she really doesn’t have to be so robotic at sharing this and completely disregard my feelings as the person who was carrying these two embryos. Some doctors are truly just assholes. Given there appeared to be no other complications, she said, I didn’t need to follow up with her and could just go back to my clinic doctor. Thank god, I thought. I did NOT want to continue working with this doctor again. She kind of epitomized everything I hate about the worst New York doctors.

Now, I just have to hope for the best and pray for Twin B; my little embryo that could. You can do this. We got this.

I was on the treadmill this morning, doing my usual morning jog to start my workout, thinking about all the times when Chris and I had spent time with Raj and his wife Maria. We’d had so many conversations, serious, fun, jokey, hypothetical, about the past and future; everything. I was thinking about all the things we’d talked about. Raj was so openly vulnerable and admitted how much he depended on and needed Maria; it was so sweet and adorable. We talked about our future hypothetical deaths once.

“No, I definitely need to go first,” Raj admitted, squeezing and bear-hugging Maria. “I can’t live without Maria. I just don’t know what I’d do! I need her for everything! I don’t care how that sounds; it’s just true.”

Chris insisted the same in different words, saying he’d definitely go before me. I gave them both annoyed but comical looks; I hated discussing our future deaths. This kind of topic always made me feel so sad. I wanted to focus on the now and the positive.

What none of us realized at that time was how soon Raj’s “going” would happen. Usually, when we think of our deaths, we think it will happen decades and decades later, not in the prime of our lives in our 30s.

Even if Raj did live as full of a life as he possibly could, it’s still robbery that his life was taken this soon. It just hurts to know that we’ll never see his huge smile or feel his big, nearly crushing bear hug ever again.

Raj’s untimely passing reminded me of Ed’s passing. In my adult life, they are the two people I’ve lost that I have genuinely cared deeply for. They both lived such different lives, yet passed away at similar ages. Ed passed away just a few weeks shy of his 34th birthday. Raj was only 36 (I think?). Raj had traveled the world and truly lived life to its fullest. Ed had never left the country and was just asking me months before he passed about the passport application process. Raj had friends pretty much everywhere and was a true extrovert. My brother was socially awkward just like our dad and had no real friends… just like our dad. Raj had a loving and close relationship with both his parents, to the point where he even called his dad his “best friend.” My brother had a tumultuous relationship with our parents, always with endless conditions, lots of judgments, and our dad barely acknowledged him until after he died.

When I look back at Raj’s life, or at least, what I know of it, he truly did “live life to its fullest “as trite as that sounds. He made the most of every single day. He did as much as he could wherever he was. He hated wasting a moment and was always just so damn positive. When I reflect back on Ed’s life, something held him back quite a bit. Part of it, I’m sure, was the fear my mom instilled in him of the world, always believing something bad was going to happen when you turn the next corner. The other part of it was that he just didn’t have the parental love and support system he needed to be secure in himself to go out and explore the world and really be independent in the way that Raj was. Ed had a lot of potential that just never got seen or recognized. Raj had all the potential that was seen, recognized, and appreciated. And then life had a different plan for him than to continue on with us. Their deaths were a tragedy, but more, as sad as it is, will look at Raj’s life and truly feel it was tragic, whereas with Ed, he has likely already been forgotten by most people who knew him. The world is a cruel place, during life, and even in life after death.

I wonder… if there truly is an after life, a heaven, will Raj meet Ed? Will they have a conversation? Will they have some sort of connection because of me? One day, when it’s my time, will they open up the gates for me?

My mind has been racing since it was confirmed yesterday that I am, in fact, pregnant with identical twins. Of course, I showed my therapist a picture of the sonogram this morning during our session and told her. I told her I’ve been having anxiety before each appointment, wondering if my HCG levels would drop or if they’d find something abnormal on the ultrasound.

“Yvonne, today, you are pregnant with twins,” my therapist said. “You are pregnant with twins. Be in the present. We have no idea and no control what will happen tomorrow, so focus on this moment right here and right now.”

I’ve been practicing my breathing exercises and continuing with my meditation to center myself more. But aside from that, I’ve also thought a lot recently about Ed and how he would react to know that his sister was pregnant with identical twins. He would be so excited at the idea of twins. I always knew that once I were to have kids, he’d likely spoil them rotten, give them candy behind my back, and give them all the latest toys on the market. That’s just how generous and loving he was. He had no clue how to be otherwise. He’d also likely never help with diapers or anything dirty, but, well, at least he’d be consistent. No, none of this is being present, but it’s grieving the past and what should be here now that is not.

“It’s really fucking unfair that he cannot be here,” I told my therapist, tearing up. “He should be able to be here to experience this joy with me.”

I told her that when I first made the appointment for the consultation at this clinic, I originally requested the appointment with another doctor that my OB-GYN recommended to me. Because her schedule was backed up for another month, the clinical assistant scheduling me suggested that I meet with the second doctor (there were only two doctors here given this is a boutique clinic), who had availability that was sooner. Given I just wanted a consult, I agreed. And when I saw his first name was Edward, I thought… well, maybe it’s a sign. He has the same name as my brother, so maybe he will be successful at helping us get pregnant.

The second sign was when the night before my egg retrieval, I dreamt that Ed took me to my egg retrieval procedure. It felt like he was watching over me, hoping for the best for us.

I shared this with my therapist, and she said it’s all likely true: I’ve found a way to incorporate him into my life even though he’s not physically here, and he is watching over us, trying to do what he can to help us.

The world is a really unfair, unequal place. There are so many people who have died for reasons that should never have happened. So many people face injustices completely out of their control or line of sight. So many couples and women face sub- and infertility for years and years longer than we ever did and have yet to see a positive pregnancy test. I am still waking up each morning, thankful that we have gotten even this far and hoping for the best for our two miracle survivor embryos to continue growing and becoming eventual little humans on this earth.