Elizabeth Holmes has started her 11-year prison sentence. Here's what to know

Disgraced Silicon Valley superstar Elizabeth Holmes has surrendered to federal prison in Texas to begin serving a 11-year term for defrauding investors with her once high-flying blood-testing company Theranos.

Holmes, a 39-year-old mother of two, reported Tuesday to the prison camp in Bryan, Texas, an all-female facility about 100 miles outside of Houston, where some family members of Holmes reside.

Lawyers for Holmes attempted to delay the start of her prison sentence by asking that she remain free while she appeals her conviction, but the 9th Circuit Court of Appeals denied her request, ruling that Holmes has not raised a "substantial question" of law or fact about her case.

Here's what to know about the incarceration of Holmes, the most high-profile tech executive to be sentenced to prison time.

Why is Holmes going to prison?

In January 2022, a jury in San Jose, Calif., convicted Holmes of fraud and conspiracy over false claims she made to investors about medical devices she said could detect hundreds of diseases with just a few drops of blood.

Months later, the federal judge who oversaw the case, Edward Davila, handed down an 11-year sentence for Holmes. She was also ordered to pay $452 million in restitution to investors including media mogul Rupert Murdoch and former Education Secretary Betsy DeVos.

One factor that weighed heavily in Holmes' lengthy prison sentence was the hundreds of thousands of dollars she defrauded from investors, which, under federal sentencing guidelines, put her recommended range between 11 and 14 years behind bars.

Can she still appeal?

Holmes can try. She has not yet exhausted her appeals process, though she will now have to fight her conviction from prison.

She could appeal her case all the way to the U.S. Supreme Court, but it would be highly unusual for the high court to intervene in such a case.

Will she serve the entire 11 years in prison?

It is unclear how long Holmes will be at the prison camp in Bryan, Texas, but The Wall Street Journal reports that many inmates are released early from the facility for good conduct and participation in prison programs, including training Labrador puppies for work as service dogs, or working in the facility's kitchen, which pays 12 cents an hour.

Will Holmes' children be able to visit her?

Holmes became pregnant with her first child, William, before her fraud trial started, and she became pregnant again, with her daughter, Invicta (Latin for invincible) before her sentencing date. The father of both children is Billy Evans, whose San Diego family runs a hotel company.

Holmes' family will be able to visit her every weekend and her children will be able to sit on her lap. Bureau of Prisons policies allow women who breast feed to do so in visitation areas.

Most interactions with family, however, are carefully regulated at the facility.

"A brief kiss, embrace and/or handshake are allowed only upon arrival and departure," according to BOP rules for the facility.

Holmes will not have any access to the internet while incarcerated, according to BOP rules, but inmates can have a radio, MP3 player, or watch purchased through the prison's commissary.

Prison guidelines stipulate that all music listened to must be "non-explicit."

Holmes will be able to watch television at designated hours and at the discretion of staff, according to the prison's handbook.

Among recreational activities offered to inmates: "beading, knitting, ceramics, paper art, fimo, crocheting, quilling, plastic canvas, and beading," according to the handbook.

What led to Holmes' downfall?

Holmes, who made public appearances in black turtlenecks and spoke in her signature baritone voice, amazed the business world with her promises of revolutionizing the health care industry. She drew comparisons to Steve Jobs and landed on the cover of magazines for being a once-in-generation innovator.

But it turned out that her blood-testing machines, which she named the Edison, was only being used to analyze a fraction of the blood samples the company was processing, and when it was used, results were riddled with inaccuracies.

Much of the scrutiny was set in motion by journalist John Carreyrou, who wrote a series of stories for The Wall Street Journal on Theranos beginning in 2015 that shed light on the company' misleading claims. He later wrote a best-selling book on Holmes' hoax called "Bad Blood."

Then, in June 2018, federal prosecutors charged Holmes, and her ex-partner and No. 2 at Theranos, Ramesh "Sunny" Balwani with fraud, kicking off a long-running legal battle that resulted in prison sentences five years later.

Balwani was also convicted, in a separate trial, and he was sentenced to 13 years in federal prison.

Why did she do it?

This is one of the biggest mysteries of Elizabeth Holmes.

She has long argued that she did not start the company as a get-rich-quick scam — saying she never cashed out her Theranos stock when the company was at its height.

Instead, she has said that she was a hard-driving young CEO who devoted her life to Theranos and quickly got in over her head in the face of expectations from investors, who poured some $945 million into the company.

Yet during the trial, prosecutors pointed to the lavish lifestyle Holmes led while she ran Theranos, from traveling by private jet to staying in luxury hotels to sending out assistants to do shopping for jewelry and expensive clothing for Holmes.

At the same time, prosecutors called on witnesses and presented evidence that Holmes repeatedly lied about the capabilities of her technology and went to extraordinary lengths to cover it up, including forging company documents to make it look like pharma giants Pfizer and Schering-Plough were endorsing the company's devices.

Holmes also wrongly claimed to investors that her technology had been used on battlefields in Afghanistan. U.S. Secretary of Defense James Mattis took the stand during the trial and said he had been personally misled by Holmes, and he even joined the board of Theranos based Holmes' misrepresentations.

Still, Holmes has maintained her innocence.

Even after being convicted and sentenced for fraud, Holmes appears to believe that Theranos could have delivered on its lofty promises had the company not garnered so much attention.

"We would've seen through our vision," Holmes told the New York Times earlier this month.

Defenders of Holmes say she was under unique pressure for being a high-profile woman in the male-dominated tech world.

Holmes' supporters also say that many male CEOs in Silicon Valley have hyped up products, or made exaggerations about a tech service, but have never faced federal charges.

Yet prosecutors have countered that selling a product with puffery is not illegal, but knowingly and intentionally lying about a product in order to drum up investment money is a crime.

Edward Davila, the judge who presided over Holmes' 15-week trial, mused before sentencing her to 11 years in prison that Holmes' true motivations are not at all clear or easily understood.

"This is a fraud case where an exciting venture went forward with great expectations and hope, only to be dashed by untruth, misrepresentations, hubris, and plain lies," Davila said. "I suppose we step back and we look at this, and we think, what is the pathology of fraud? Is it the inability or the refusal to accept responsibility or express contrition in any way? Now, perhaps that is the cautionary tale that will go forward from this case."