Birth Story: ‘One twin was conceived naturally, the other via IVF’

Posted in All, Labour & Delivery, Pregnancy and tagged .

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Sheridan’s path to motherhood was strewn with heartbreak. Miscarriages, months of invasive treatments, and IVF left her dejected and praying for a miracle.

What happened was beyond anything Sheridan and her husband Andrew could have ever dreamt of. They were finally pregnant – with twins. But with only one embryo implanted, how was it possible they were expecting twins? Incredibly, Sheridan had fallen pregnant naturally, while she was already pregnant through IVF.

Heartbreak and healing

Andrew and Sheridan had always known they’d try for a baby as soon as they married, so when the NSW couple tied the knot in November 2018, they didn’t waste any time. In March 2019, they were ecstatic to discover that they were expecting.

“I remember standing in the kitchen not exactly sure how to tell Andrew, when the words came out I think we were both a little shocked but overjoyed, we couldn’t believe our luck at being able to fall pregnant naturally quite quickly after we decided to start trying,” Sheridan told Mum’s Grapevine. “We entered the stage of excitement and anticipation, eagerly awaiting the first ultrasound and already talking about how we would manage a baby into our busy lifestyles and work schedules.

“Andrew works away weekends in Narrabri so is away from Thursday to Monday every week. My first ultrasound appointment at 10 weeks gestation was booked when Andrew was away so I attended the appointment by myself.
I lay on the table, bladder full, watching the screen, the technician went quiet and asked me how many weeks I thought I was. I knew at that moment that it was not good news, the embryo had stopped developing at around the 6-week mark. I left the appointment in a daze, and somehow managed to make it home before I fell into a heap on the floor in tears.”

‘We decided to look at other alternatives’

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A devastated Sheridan opted to have a D&C procedure, wanting to have some control over the situation. “After the procedure, I was informed that it would take some time to start menstruating again. I waited for four months and nothing had happened. I went back to my doctor and following an ultrasound, it was determined that I had retained product left in my uterus so I would need another procedure.

“I was frustrated and angry, I felt like time had been wasted just waiting when there was a problem that should have been fixed with the first procedure. It was now October 2019 and I was feeling very anxious about how soon I would be able to fall pregnant again. My OB prescribed letrozole to assist with ovulation which I took for four months however it seemed that whenever I was ovulating my husband was away at work. The timing was becoming a barrier so we decided to look at other alternatives.

“It was at this stage we decided to engage the services of Genea to assist. It was recommended by their doctor to try the process of tubal flushing and ovulation tracking with blood tests for a couple of months to see if we could still fall pregnant naturally.”

Sheridan and Andrew embarked on the journey full of hope but had no success. So the next step was to proceed to IVF. But with Covid impacting elective surgeries and procedures, it was another two-month wait before they could start the process.

“In June 2020 we began with the daily hormone injections in preparation for the egg collection. Each morning I did the injection and counted down the days until the ultrasound where the nurse would examine my follicles. The follicles were growing and I had a good amount to harvest, on the day of egg collection I had eight mature eggs collected and six were able to be fertilised.

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“The technology Genea has for tracking is incredible, every two days I was provided with an update and images of how my eggs were progressing. On the day of transfer, I had one egg transplanted and two were able to be frozen for use at a later stage. I had the IVF process explained very thoroughly and had done extensive research however you don’t expect the egg numbers to drop so significantly, out of eight eggs collected only three embryos were created, and once the embryos are frozen there is no guarantee they will still be ok at the stage of transfer. I prepared myself mentally that we may need another round of IVF so that we had a good store of fertilised eggs if the first transfer wasn’t successful.

“I was 37 at this point and was mindful that even though I still had a good amount of eggs left in my ovaries (confirmed with a blood test) the quality of eggs might not be great. On the day of transfer, I lay there watching my embryo in its dish and said a prayer when it was inserted, now all I had to do was wait. It was about 10 days after until I had my blood test and the results came back, the process had worked and I was pregnant.”

The waiting game

Sheridan kept busy working 14 hours days, and overtime on weekends, but in the end, her busy schedule played havoc with her mental health. “I was sleepwalking, having anxiety attacks, losing weight as well as losing hair. I thought if I could just keep it up for another eight months until my baby arrived I would then be on maternity leave and be able to take a professional break.

“At my eight-week ultrasound, the technician informed me that I had a blighted ovum and unfortunately the pregnancy was not viable – my second miscarriage. I immediately launched into self-preservation mode, I wanted the D&C done ASAP. I contacted my OB at the time who couldn’t see me for another week let alone give me an indicative date as to when the procedure could take place. I felt like I couldn’t wait for what could be another week so confided in my friend who is a nurse at Gosford Private Hospital and she recommended the services of Dr Jini Mandapati.

“Within two hours I was sitting in Dr Jini’s rooms having a consult and confirming the date for the procedure. After my procedure testing on the taken product was performed to see whether there were genetic reasons as to why the embryo didn’t develop, everything came back as normal, and there was no medical explanation as to why I had miscarried again. I blamed myself and my work schedule, I wasn’t taking care of myself physically or mentally and I felt like I had caused this to happen through stress.

“I decided to make some drastic changes to my lifestyle to gain some sense of peace and composure, I resigned from my job, focused on healthy eating, I started seeing a naturopath, and went for acupuncture. I now had time to catch up with friends and family and was enjoying having my weekends back, I also changed my career and was employed in a job I loved. After all this, I finally felt ready to start trying again and proceed with the transfer of my stored frozen embryo.”

An unexpected surprise

In January 2021, Sheridan and Andrew started the process to transfer their stored, frozen embryo. Ten days later, they were thrilled to discover they were pregnant and due in October. Sheridan booked in with Dr Jini for her first scan, but two days before started to bleed.

“I had passed a decent-sized clot and there was a significant amount of blood so I sat in the waiting room leading into the appointment holding back tears fully expecting the ultrasound to show I had miscarried again. When conducting the scan I couldn’t bear to look at the screen so when Dr Jini firstly told me that there was a heartbeat and secondly asked, ‘Are you sure they only implanted one embryo as there is a second sac’. I couldn’t believe what I was hearing let alone seeing on the screen.

“One embryo was showing a fetal pole and heartbeat whilst the second embryo was showing a fetal pole however it was much smaller and too early to see a heartbeat. I was told that I had to come back for a second scan in a week’s time to see whether the second embryo had continued to develop and was put on strict bed rest in the interim. The bleed I experienced had been a subchorionic hematoma which is quite common in IVF pregnancies and a condition that increases the risk of a miscarriage occurring in the first trimester.

“On my follow-up appointment with Dr Jini the second heartbeat was detected and we were confirmed to be pregnant with twins! We were thrilled, these were our double rainbow babies and I could not believe how blessed we were. The embryos had separate placentas so were classified as DCDA twins and since there was a significant size and dating difference between the two embryos. The explanation for this was best to be established through NIPT testing and an amniocentesis procedure. The amniocentesis procedure was not something my husband and I readily agreed to.

“I had done extensive research and even though the risks were low there was still a risk. We knew that the procedure would 100 per cent provide us and our doctors with the information they needed to determine whether there was actually something genetically wrong with the smaller embryo to explain the size or whether it was just conceived at a later date. Plus with this information, they would obtain they could better manage the pregnancy moving forward.

“The results showed that they were two separate eggs and that the smaller embryo was a spontaneous pregnancy, or a natural pregnancy, as the larger embryo was in line with the dating Genea had provided. It was possible that we had fallen pregnant naturally as intercourse had taken place within a week of the embryo transfer. We were ecstatic to learn that we were going to have a boy (IVF) and a little girl (natural). I had never heard of births similar to our situation with an IVF and spontaneous pregnancy occurring before, I personally didn’t think it was possible however it had happened and was discovered to be quite rare.”

A double rainbow

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After realising their twin pregnancy was even more miraculous, the couple hoped for a complication-free few months. But the pregnancy threw up plenty of challenges.

“I had another serious subchorionic hemorrhage at around week nine, this time worse than the first, I bled for weeks. I was seeing Dr Jini on a weekly basis for monitoring and was to remain on bed rest until I had reached the second trimester. The risks associated with twins is much higher and throughout the pregnancy continued monitoring and ultrasounds conducted by a specialist from Royal North Shore Hospital was necessary to ensure both babies were continuing to develop and grow.

“It was predicted early on that the growth trajectory might plateau which it did. At week 28 the smaller baby’s placenta was showing signs of inadequate blood flow. I was given two injections of steroids to assist with the baby’s lung development in case I had to be induced soon. Moving forward twice-weekly ultrasounds were booked, plus the weekly appointment with Dr Jini along with CTG scans. We were told that if the blood flow decreased further we needed to prepare ourselves to give birth at Royal North Shore as opposed to our hospital, Gosford Private, as RNS was better equipped to handle premature babies under 34 weeks.

“Each week that we progressed further along we celebrated, our goal was 35 weeks. On the 2nd of September, the observations from my ultrasound were not great, the smaller baby’s blood flow was concerning so I was admitted to the hospital and the c-section was booked for the following Monday. I was to give birth at Gosford Private at 34w5d gestation. The hospital was expecting the babies to need assisted breathing so the equipment was made ready and extra staff on board, instead, both babies came out crying and in perfect health.

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“Darcy Russell was delivered first at 8.25 am on the 6th September weighing 2090g, Fleur Eloise was delivered at 8.29 am weighing 1190g. Fleur’s birth was also a rare event as it was an en caul birth where she was born in an intact amniotic sac, this little girl just kept amazing us.

“During our stay at the hospital, the twins have gone from strength the strength. Both twins require feeding tubes however we are slowly introducing more suck feeds. In the first week, Darcy had the onset of jaundice which was rectified in 24 hours under the blue light and Fleur had to have a drip inserted after a bad reaction to some breastmilk fortifier, besides that there have been no other complications. The twins are both steadily gaining weight and we are hopeful to bring them home in three weeks bringing the total time in hospital for the twins to six weeks.”

“I do find a lot of my day is spent either staring at them in their cribs or giving them cuddles, I can’t help myself, I’m absolutely besotted.”


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