Endometrium what?

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So today was the day of my big ERA test at the clinic. I was bracing myself for what would be 5 to 10 seconds of extreme pain. The clinical assistant had warned me that it would feel like “a very intense cramp for a few seconds, but then it would be over.” And so I knew that today was not going to be fun. They’re also taking a biopsy of my endometrium to check to ensure I do not have endometritis, which is an inflammation of the endometrium that can make an embryo transfer difficult. If I have it, the nurse said the fix would be easy — just a course of oral antibiotics.

The doctor came in with a nurse assistant and said that he was really excited about this menstural cycle for me because everything looked as good as it could possibly look: all my hormone levels were progressing as expected and hoped, plus the lining of my uterus was over the ideal level of thickness; he anticipates we’ll have a smooth transfer assuming this ERA test goes well.

“Excited,” huh? I’m not sure how “exciting” any of this is. That’s a funny word to use in the world of IVF.

So, he stuck the speculum into my vagina, and then took his instrument to remove a biopsy of my endometrium. He gave me a verbal head’s up when the “unpleasant” feeling would begin. It lasted less than 5-6 seconds, but it felt like a very, very intense menstrual cramp. And when he removed the speculum and said we were all set, I felt a combination of feverish hot flashes wash all over me. I could feel my face flushing. He suggested I lie down for a bit before getting dressed to leave. Even though he had removed the speculum already, it still felt like there was something down there, still inside of me, for at least a few minutes after.

The nurse stayed with me for about five minutes. They usually stay with you after this procedure for a bit to monitor you until you seem more composed… in the event that you may pass out and lose consciousness. She made some small talk with me and said that this ERA procedure went really well, as it was super quick; in some women’s cases, the doctor is not able to get to the right angle of the endometrium, so he actually has to go in a few more times after that, resulting in prolonged pain and even worse cramps for the woman. She also said that most women actually scream or moan or even cry when an ERA is done. “You handled this really well!” she said, smiling. My eyes widened. Thank GOD that was not me today!

After getting dressed, I still felt like I was having hot flashes and felt a bit dizzy and light-headed, but I thought that maybe walking in the cold would do me a little good. I walked for about four blocks to get some fresh air and then called an Uber to drive me home.

On the short 5-minute ride home, all I could think was…. “The shit I’ve had to do to just try and get pregnant. Please, God, make this all worth it…..”

Grocery shopping items – me vs. my husband

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While Chris does admit that he can be controlling when it comes to deciding on trips, even where we are going on our Saturdays exploring New York City, he is also quick to point out that he rarely decides what we are eating since I do 99 percent of the cooking, and thus I usually decide what we eat and let him know after I’ve started prepping. I mean, to be fair, if he says he feels like a certain type of food, I am happy to accommodate it, but he rarely does.

But the really funny thing that always happens whenever we go grocery shopping together is comparing what I put into our cart vs. what he puts into our cart. For the most part whenever I go grocery shopping, regardless of what store/market I am in, the bulk of my purchase is always fresh, perishable foods, which translates as primarily fruit and vegetables (if we’re at Costco, I’ll purchase meat to stock our freezer quarterly. Costco is the primary place I buy meat at, and occasionally at Whole Foods. I buy almost all my seafood at Whole Foods). Occasionally, I’ll pick up a whole grain or whole wheat bread, some tortillas, and of course oat and/or cow milk and juice when we are running low, but fruit and vegetables are my primary purchase. So when we are loading items into the cart, I’m mostly adding fruit and vegetables, or some pantry staple like dried beans or rice. But when Chris thinks about grocery shopping… he’s mainly thinking about a few categories:

  1. Juice (no orange, ever)
  2. Milk (cow or oat; he gets upset if he sees that I’ve purchased almond and/or soy)
  3. Chocolate (he prefers Aussie or British chocolate, but occasionally likes to try chocolates imported from Belgium or some other chocolate renowned country)
  4. Mixture or banana chips (if shopping at a South Asian grocery store, or some kind of ‘to tide you over’ snack pre-dinner time)

This is why I jokingly have told him many times that not only he is my baby, he’s a baby when it comes to grocery shopping: he likes to pick out the “non-essential” items that are more like snacks and treats rather than the “real food” for our diet. 😀 He’s like the kid who accompanies his mom during grocery runs, adding in the “extras” like random snacks and sweets covertly while mom is busy checking items like vegetables or fruit or grains on her shopping list.

Resistance training for fat loss

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I am not sure why, but in the last few YouTube videos I’ve been watching, the ads that I’ve been getting served have talked about the importance of resistance training, how running miles and miles on the treadmill will not result in weight loss and is simply a wasted effort (that last part is actually not always true for many of us, self included, but sure, you market you). Ever since I started regularly exercising in college and trying different workout regimens, I’ve always incorporated some sort of resistance training into my routine. This is no secret and is not up for debate: resistance training improves both strength and endurance. It also helps with losing excess body fat. And if you have a mesomorph body type like me, and if you use your own body weight (crunches, planks, lunges) vs. free weights, then you can build strength and definition without getting too bulky.

Oddly enough, while thinking about this annoying, recurring YouTube commercial, and while doing an interval run on the treadmill the other day, I thought about a former boyfriend who had once been, in his teens to early twenties, legitimately obese. When he showed me photos of how large he was, I was in complete disbelief. Granted, when I met him, he wasn’t the skinniest or most muscle defined guy, but he was FAR from obese. He lost a lot of that excess weight by running and working out on an elliptical (in addition to cutting his meal portions), but he had never really incorporated any resistance training into his workout routine. As a result of a lack of resistance training, he had a lot of flab around his stomach and love handles that … to put it bluntly, would literally just hang there. And it was NOT attractive.

I suggested to him several times that he try to do some form of resistance or strength training to lose it, that he needed to do more than pure cardio exercises as his 3-4x per week workout routine, but he insisted it wasn’t necessary. “It’s just excess skin,” he’d say defensively, and insist it wasn’t actually fat at all.

Well, that never worked — the polite suggestions or the relationship. He ended up gaining a lot of weight towards the end of our relationship. When I suggested that he try to lose it (this was mostly caused by stress and overeating as a result of stress from work), he said he didn’t feel like I was “accepting him for who he was” (no, that’s not the way I operate. It’s called tough love, idiots. We’re supposed to be striving to be the best version of ourselves, and that was NOT the best version of himself). And I found it completely unattractive and frustrating that he wouldn’t listen to me when I shared a very basic exercise fact that is known by pretty much ANYONE who does ANY form of exercise.

I’m not sure why I was reminded of him when reflecting on this commercial or while running on the treadmill. It was just a passing thought that came to mind. We all have different views and insecurities when it comes to diet and exercise, but to deny a basic fact about exercise seemed pretty ridiculous.

On the market for new knives

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So, I’m on the market for a new everyday knife. While washing dishes the other day, I dropped the santoku style knife I usually use for everyday cutting/chopping, and the blade detached from the handle. Clearly, this was a glue issue, and while I’m sure there is a way to fix it, Chris reminded me that he’s had these knives for nearly 11 years now. He got a crazy good deal on Amazon for them (A 4-knife set plus a block.. for $25???????!!!!!), and so maybe it is finally time to invest in a new knife set or at least one new all-purpose knife. I don’t have any love, attachment, or hate for any of these knives; they have served their purpose, and I use them because I am practical and will use what we have. I don’t consider them remarkable or incredible in any sense. But if I am going to buy a new knife, I want to make sure it’s a really, really good knife.

Since maybe five years ago, I started reading about different Japanese knives, and I knew I wanted Global knives since they would be light weight (hollow handled), super sharp, relatively easy to maintain (some Japanese knives are impossible to maintain without constant professional sharpening), and they weren’t insanely expensive. As an added bonus, I read an article where Anthony Bourdain lamented how insanely expensive (and thus stupid) so many knife brands on the market are, and that that’s why he appreciated and loved Global knives so much because the price point was just right, and they were excellent quality. I was sold.

So now, the debate is… do we invest in a whole new set of 4-5, or just get a Global santoku? But apparently, the debate has been made even more colorful because Chris doesn’t understand why I am stuck on Global brand knives and insists I should consider the Amazon basics line of knives or other Japanese knife brands he quickly glanced at on Amazon. My whole thing is… I am rarely, rarely brand-devoted to ANYTHING outside of airlines and hotels (and that’s because I benefit from loyalty). I even gave up my obsession with Le Creuset and Staub dutch ovens and enameled cast iron because I appreciate and get so much use out of my Amazon Basics dutch oven, which only cost $30 courtesy of his aunt and uncle. Can’t I just be allowed one thing to have brand love for, and if that one thing is KNIVES, then that seems pretty damn practical, right?

Chris’s “stress” rate

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For his birthday a few months ago, Chris’s brother got him a new Garmin device, so Chris has been using it daily, wearing it during his swims, and keeping it on pretty much day and night. He was looking at the Garmin app and noticing that for the most part, his stress level, as recorded by Garmin, seems to go up throughout the workday, and as soon as work starts winding down, it goes down gradually. Yet, on Thursday, it was a bit of an anomaly. The stress level pretty much stayed steady from about 9am through the time he went to bed. Why would that be the case?

Oh, that was easy, I said to him. We had our family chat that night! And thus, that added to Chris’s debate with me that Zoom/Google hangout/video chats do NOT relax him, and thus he doesn’t really look forward to them as he would socializing in person with people he cares about.

I’ve stopped wearing my Garmin regularly, but I wonder what my stress level is like when I do virtual hangouts with friends given what he said.

“Social calendar” this weekend

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I can’t even believe it. For the first time ever, I actually have three virtual social events to “attend” this weekend: a catch up with some female friends on Saturday night, a reiki launch session with a friend, and a friend’s baby shower. And then today, we had a Google Hangout with Chris’s parents and brother. It’s the “busiest” social period for me since the pandemic began.

I used to always feel so exhausted every time certain friends of mine would talk about how “back to back” all their friends outings and gatherings were every weekend, how they would literally go from event to event from Friday night through Sunday night. I wasn’t sure if it was a way to brag or show off that one had so many friends, or if it was meant to complain because they packed their schedules so much. But for me, just having three events on a single weekend is a LOT. But I’m looking forward to it. I do enjoy my alone time. I love reading and cooking and doing things by myself. But I also miss socializing in small groups and 1:1 with friends more regularly.

Progesterone in oil (PIO) shots vs. vaginal suppositories

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Before starting the IVF process, what I feared most were the injections. Little did I know that the daily stimulation injections leading up to egg retrieval were actually done with small, manageable needles administered on your abdomen, meaning, well, there’s a decent amount of fat on your stomach, so they won’t hurt very much beyond a tiny sting.

The “scary” injection is actually the progesterone in oil (PIO) shot, which is done to prepare your body (endometrium/uterus) to accept the embryo during an embryo transfer. The PIO is particularly ‘unpleasant’ as my doctor says because the liquid you are injecting yourself with is very very thick (hey, it’s called “oil” for a reason), which means you need to use a higher gauge needle, which… is not only thick, but it’s long… like SUPER LONG, 3-4 inches. And, as the added bonus, this needs to be administered on your butt. Yep, on your butt cheek.

You’re also expected to continue taking progesterone in various forms through the 9th to 12th week of pregnancy, assuming your transfer was successful. I asked my doctor about this during the IVF consult, and he said that this clinic actually had stopped using PIO because vaginal suppositories of progesterone were just as effective, if not more, than PIO (this is, of course, assuming that you as an individual do not have any known problems with an embryo “sticking,” so definitely take this statement with a grain of salt depending on your individual case and reason for going down the IVF route to try having a baby). So, I would not need to mentally prepare for PIO while at this clinic.

That was honestly like music to my ears. No butt shots. No big, fat, long needle. No butt icing. No butt heat applications. Phew.

But vaginal suppositories, at least the ones I am taking, are like vagina pills. Really. They come with an applicator similar to a tampon applicator, and you insert it through your vagina as far as it goes.Then pushing on the applicator, the pill pops out. That pill is then supposed to dissolve and be your body’s added progesterone to support your pregnancy. So lucky me, for this mock cycle, I get to insert this three times a day, as soon as I wake up, right before bed, and at some point in the middle of the day. As you can probably imagine, the middle of the day insert is not super convenient and would be even worse if it weren’t for this work-from-home/global pandemic situation.

No one told me this would be messy. I had quite a mess with some of the progesterone leaking out and had to clean my underwear twice. It really feels like a dissolved pill, mushy, white, and pasty. And so, I’ve learned my lesson and am wearing a panty liner from now on. Oh, the joys of IVF.

ERA test

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So after chatting with my reproductive endocrinologist and thinking about how I’d eventually like to STOP going to the clinic completely and actually have a child, I decided that even though the numbers weren’t that convincing that I’d suck it up and do an ERA test alongside a mock embryo transfer cycle. Most people, even those who have gone through IVF, may not even know what this test is. It’s become more common for IVF patients to do this in the last 20 years, particularly after failed embryo transfers, but it stands for endometrial receptivity analysis test. During this test, the doctor will take a biopsy of your endometrium, which is the lining of your uterus, and also the place where a woman’s body prepares for the arrival of an embryo each month. The endometrium, in that sense, is essentially a “home” where the embryo implants and resides during gestation. An embryo is able to implant during a specific receptive period of a time during a woman’s cycle, and this is called the “window of implantation.”

I’m not really that excited about having a ‘biopsy’ done of anything of mine, but I’ve figured… I’ve come so far in this whole terrible process that if there is just one more thing I need to do to give myself some level of reassurance that we’re doing what we can to ensure success, then I will just do it. I was reading about how this test feels, and it is supposed to be about 5 to 10 seconds of an intense menstrual cramp. The worst procedure I’ve had to do during this period that was like that feeling was the HSG exam, where they check to see if your fallopian tubes are open (and YES, both of mine are). It only lasted 10 seconds, but it hurt so badly that I felt faint and light-headed for a good 30 seconds after. The doctor even had to ask me if I wanted some water before getting onto my feet.

So now, this procedure is scheduled next Tuesday. I will be awake for it, so right after, I can just walk back home and go “back to work.” No one ever tells you before you start fertility clinic visits how LONG EVERYTHING SEEMS TO TAKE. There is so much waiting, so little definitive aspects, so much uncertainty.

A Series of Uneventful Dreams in the Last Week

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I think that my boring, mundane, “I have no idea what the meaning of this is, but I’m at least happy that nothing awful or terrifying or violent is happening” dreams seem to be continuing. If I had to try to identify when these vanilla dreams started, I’d say that it’s likely when I became more deliberate about my daily meditation time. Here are some dreams I’ve had in the last week:


Our friend and handyman was in Chris’s parents’ formal living room in Melbourne, delivering a lecture on dry rot, how to identify it, and how to solve it as a homeowner. He had a pointer and a big white board with all kinds of drawings and diagrams on it. I was sitting at the entrance of the living room watching. 


I opened one of our apartment closets to realize that there was actually a doorway into ANOTHER hidden compartment for storage. And in that storage area, I had a lot of beautiful carbon steel and cast iron pans waiting for me to use them. Oooooh, this was an amazing find.

I was at a banquet hall with my parents and my aunt. My aunt accompanies me to the bathroom, and as I’m entering a stall and closing it, she asks, “when are you going to have a baby?” Ughhhhhh.

My mom is sitting at some random table with me, and she asks if she can borrow my orchid porcelain tea pot because she is planning to host a tea tasting with my dad at their house for some friends. This is obviously a dream because a) my mom hates hosting anything or having anyone over at the house and b) my mom could truly care less about the nuances in flavor of one green or oolong tea to another.  

Moral/religious opposition to pre-genetic screening of embryos

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In the last two months, I joined a few IVF support groups on Facebook just to see what people were posting and if there was any information I could potentially benefit from. For the most part, over the last week or so, I’ve stopped reading any of the posts in depth, but I did notice a few annoying themes that I immediately ignore when scrolling.

I’m sure decades ago when IVF first became available, a lot of people were “morally” or “religiously” opposed, believing that this interfered with “God” or whatever higher power exists, and felt that pursuing IVF was wrong or “a sin.” I’m sure there are a lot of people who still believe this. Yet, as couples become desperate to start a family of their own, they slowly but surely begin to let their guard down, believing that “God intended for them to pursue this route,” or “God made people discover this possibility to benefit us,” so of course, it would be okay to pursue because God gives these options to people. In other words, when things are convenient for them, they allow what was previously against their beliefs to be acceptable.

The latest war seems to be against pre-genetic screening, which, for women who choose an IVF “freeze-all” cycle instead of a “fresh” cycle, they can also add on (with an additional expense if you are self-pay), as the embryos that make it to blastocyst/Day 5 are biopsied and sent off to a lab for genetic testing to make sure that the embryos are “chromosomal normal” (you cannot do PGS testing for a fresh cycle because the labs need at least 1.5-2 weeks to biopsy and get the result back to you, and fresh-cycle embryo transfers are usually 3-6 days after your egg retrieval). In addition to this, PGS testing also allows for you to know what the sex of the embryo is (it’s usually redacted, but you can request to have it un-redacted). You can also elect for other tests that can evaluate whether the embryo is a dominant carrier of certain diseases if you and your partner overlap for any recessive diseases. So funnily enough, there are many women and couples who think that although “God created IVF for a reason,” doing PGS testing is against God or “messing with God,” and choose “for moral/religious reasons” not to do PGS testing…. even though studies have shown time and time again that transferring a PGS-normal embryo results in a higher live-birth rate, a higher transfer success rate, and a far lower miscarriage rate.

And soon in the future, the people who were morally or religiously opposed to PGS-testing will ween themselves off this thought, and then be against some other new development in science and infertility medicine because it’s convenient for them. I hate it when people use religion or morals as a reason to be opposed to these decisions. You could use “God created X to benefit man/woman” with pretty much every argument!