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.

Today, I came in for my fourth post-transfer appointment at the clinic. This time, Chris came with me because the nurse let me know that at this stage, it’s possible that we could see a heartbeat.

After having the usual bloodwork to check my HCG and progesterone levels, I was called into the exam room. Mina, my sonographer, came in and greeted us. She started the exam, and before I could even see anything on the screen, she gasped, “Ohmigod!”

Well, when you’re at a doctor’s appointment to monitor your pregnancy progression, “ohmigod!” coming out of your sonographer’s mouth can either be a really good thing… or a really, really bad thing.

“Mina!” I exclaimed. “Is that a good ‘ohmigod’ or a bad ‘ohmigod’?!”

She broke out into a huge smile. “Yvonne, you’re having twins! CONGRATULATIONS!”

Chris went completely silent. All I could say was, “OHMIGOD!” My mind went a little numb; we’re having twins???? OUR LITTLE EMBRYO THAT COULD…. SPLIT! It was a complete marvel to see so clearly on the screen. Mina didn’t even need to zoom in on the uterus for us to see it: two distinct gestational sacs with two distinct yolk sacs, each with their own fetal pole, which is where you can see the first little flickers of a heartbeat. And both little fetal poles were flickering; it was loud and clear.

I was in total awe. I just couldn’t believe it. Back in January, I was devastated at the end of our IVF cycle when the embryology lab informed us that we only had one embryo survive to the blastocyst stage to go on for PGT-A genetic screening; I wasn’t even sure if the evaluation would come back normal. And when the test did come back normal, I wondered if this little blastocyst would survive and result in our first and only baby. Was this our only shot? Was this a sign? I thought then.

Mina told us that the development of both looked really good and both heartbeats were very clear, and she’d see us back here in a week.

Walking back together, I was still in disbelief. I could not believe we could see two little heartbeats. Last week, we could see a semblance of two gestational sacs, with only one having a tiny developing yolk sac; the second one didn’t even have a yolk sac yet, which is why the sonographer wasn’t sure if it was even a gestational sac or not. Somehow, that second gestational sac has managed to catch up to the first one in just seven days, and both were so clear. At every stage of this process, I just cannot get over the wonders of the female human body. How does this even happen? A single embryo splitting is still a total mystery in the medical and reproductive communities. We still don’t understand fully how or why this happens.

“Well, at least the ROI on this is good,” Chris said, still in complete shock that this happened. “We get two for the price of one!!”

For the HCG level stats we’re tracking to ensure the pregnancy is going well:

9 Days Post Transfer: 45.91

11 Days Post Transfer: 127

16 Days Post Transfer: 1,695

23 Days Post Transfer: 16,059

The nurse called early in the afternoon to let me know that since the HCG levels have consistently looked good, this would be my last blood test, and moving forward until I “graduate” from the clinic, I would come in weekly just for the ultrasound for monitoring and no more bloodwork. This was also a relief to hear… especially since both of my arms are looking quite bruised from all the endless blood draws I’ve been required to get. She also congratulated me on twins: “They’re going to be identical because they split from one embryo! After you left, Mina came into the office and showed everyone your ultrasound picture, and it was endless squeals! We don’t see too many single embryos split!”

At home this evening, I kept staring at the picture of the embryos that Mina printed for us: TWIN A, TWIN B, both labeled on the sonogram. Are these going to be my miracle babies? Am I going to be able to get them to survive through the next 34 weeks? I need all the good wishes and prayers and hopes in the world now. I need to have my little babies survive. This feels like a sign to me that this was meant to happen, and I have to do everything in my power to do right by them.

Tonight is our last night with my friend staying with us, as she’s officially moving into her new place tomorrow. Today marks exactly four weeks since she started staying with us in an effort to separate from her partner, and while it’s definitely been a bit more crowded and dusty with three adults in this 1-bedroom apartment, it’s been really enjoyable. I have loved having her here with us, not only for extra company and socializing, but also for emotional support for me going through this crazy emotional embryo transfer process. Chris remarked that she arrived as a wreck and a shell of herself, but she’s left rejuvenated and fresh. She’s been adaptable in our routines, from watching food on TV while eating food, our “morning dinners” and “evening dinners” as Chris calls them, our random assortment of food on a plate ranging from Indian to Chinese to Thai and Yemeni and pesto pasta, and even our endless marital banter. It’s been comforting to have her hugs and embraces when I’ve felt anxious and uncertain. And I’ve also enjoyed being there for her to ensure she feels supported through this current life transition she’s going through. We’ve been friends now for over 24 years, and though I’ve always known she’s an amazing, warm, loving, affectionate person, I’ve never felt it as much or as immediately as I have than over the last four weeks.

In preparation for her departure, not only did she stock our fridge and pantry with all kinds of fresh food, produce, and snacks, but she even added pregnancy-symptom aiding items like ginger shots, fresh ginger, tamarind, and zinc. Sometimes, I’m in awe of how thoughtful she is. It really goes beyond me.

Well, she’s leaving the nest tomorrow. I will miss seeing her and getting her daily hugs, but it’s time for her to do her own thing. And it’s also time for me to survive without her here every day. I think I can handle it. One deep breath at a time.