IVF and Twins
We underwent IVF for this pregnancy as well. Previously, we attempted a transfer with two embryos, but it didn’t succeed. This time, during the embryo transfer, the doctor confidently remarked something like, “See you later, this worked.” The embryologist later returned to the room and expressed his belief that this time we had a strong chance of success, possibly with one or even two embryos. Looking at the ultrasound photo, it appeared that both had taken.
This time, I didn’t experience many pregnancy symptoms before my blood test, which left me feeling a bit discouraged, especially after the last month’s failure. Our BETA #1 was 874, and BETA #2 soared to 2522. After seeing these numbers, especially the significant increase in the second test, we felt reassured about being pregnant, and potentially with twins, as the numbers were much higher than during my first pregnancy. The nurses and front desk staff were all speculating about twins.
During the ultrasound, the doctor discovered two sacs and confirmed that we were indeed having twins. We were over the moon with excitement!
Pregnancy
This pregnancy had been far more intense than with just one baby. The nausea was overwhelming; I experienced vomiting both early on and during the third trimester, often waking up with a sick feeling. I had to take it easy initially due to the IVF and some mild spotting. In the beginning, I could only tolerate soup and chips, as chicken was especially hard to keep down. Even Mexican food made me nauseous; I craved anything except chicken, particularly rotisserie. I focused on foods that wouldn’t trigger nausea or vomiting. By the third trimester, the discomfort intensified, affecting my entire abdomen, lower stomach, back, and ribs. I often woke up feeling sick, experienced tightness that felt like contractions (though I suspect I have an incompetent cervix), along with lower back pain, pressure on my cervix, and persistent headaches that over-the-counter medication couldn’t alleviate. Dark chocolate almonds became my go-to remedy for those headaches. Walking to the bathroom was painful, and I struggled to sit up to eat without experiencing significant discomfort. I dealt with sciatic nerve pain, itchy skin, and trouble sleeping.
From Bliss to the Most Challenging Moments
Since I was expecting twins, I was under the care of both a regular OB and a high-risk OB. My regular doctor was exceptionally cautious, and I believe that without him, I wouldn’t have my twins today. He recommended regular ultrasounds due to the twin pregnancy. Once, when he was out of town, the substitute doctor didn’t think an ultrasound was necessary, but I insisted on following my regular doctor’s advice and had them schedule one. Thankfully, I did, because that appointment changed everything.
No Cervix
Just when I thought I was in the clear with no more spotting and could start walking normally at 18 weeks, my doctor informed me that my cervix was measuring only 1.5 cm. He advised me to see the high-risk doctor the following day to begin progesterone suppositories. For twin pregnancies, they avoid cerclage since research indicates it could cause contractions, early labor, and doesn’t yield the same results as with singleton pregnancies.
I managed to reschedule my appointment with her from Monday to Friday (the next day). She agreed with my regular doctor’s recommendation, prescribed the suppositories, and advised strict bed rest, planning to check on me in a week and a half. My bed rest was so strict that I could barely shower.
At my 19-week appointment, I hoped to hear that my cervix had lengthened and that I could finally stop bed rest. Unfortunately, the opposite was true. The doctor informed me that I had no cervix left and was 1 cm dilated. She revealed that the baby’s membranes were visible and the gestational sac was protruding. I faced an urgent decision that night for an emergency cerclage, as Baby A’s sac was bulging out of my cervix. She cautioned that placing the cerclage could accidentally rupture the sac, potentially leading to the loss of Baby A, while maybe saving Baby B. She mentioned that if the cerclage was successful, they might make it to 24 weeks, but both babies could face developmental issues. She didn’t seem optimistic that I would reach 24 weeks. I left the appointment in tears, and my husband was overseas at the time.
I reached out to my regular doctor, who encouraged me to take the risk, stating that the worst-case scenario of doing nothing would be the loss of the babies. He later explained that if I dilated to 4 cm, they would have likely been lost due to my pregnancy being at 19 weeks.
Emergency Cerclage
We chose to proceed with the cerclage procedure. That evening, I was admitted to the hospital for monitoring and to begin antibiotics, ahead of the cerclage placement scheduled for the following morning at 7:30. Since my husband was working overseas, my mom stayed by my side in the hospital while my sister looked after my eldest daughter.
Overnight, between the doctor’s appointment and the placement of the cerclage, I had progressed from 1 cm to 2 cm dilated. The procedure itself was daunting, with numerous negative outcomes and only one positive possibility. I tried my best to hold back tears to avoid causing stress. The spinal anesthesia made me feel incredibly nauseous, and despite my repeated requests for relief, the anesthesiologist continued administering medication through the IV. I could sense them repositioning me, but thankfully, I felt no pain.
(A cerclage is a stitch that is placed in the cervix to prevent it from opening, which is particularly useful for individuals with an incompetent cervix. We suspected this might be the case for me, as I had dilated without contractions during my first pregnancy.)
After the procedure, the doctor shared that everything went better than she had anticipated and decided to keep me in the hospital for two nights for observation. She successfully avoided puncturing the sack. The next morning, an ultrasound revealed that my cervix was now 2.5 cm long with the cerclage in place.
Following the cerclage, I eventually managed to have lunch (broth, jello, popsicles), but I felt extremely nauseous afterward. None of the anti-nausea medications were effective, and they were trying to get one approved by my insurance, which took hours. I spent those hours in agony, battling nausea and trying to avoid vomiting, as it could strain my cervix. Eventually, I received the medication and felt somewhat better, although my stomach was still in pain. Unfortunately, I ended up getting sick.
Bed Rest for the Last 18 Weeks
About two weeks after the cerclage was placed, my cervical length decreased to 1.5 cm and then fluctuated between 0.7 and 1.5 cm for the remainder of the pregnancy.
From 18 weeks to 36 weeks pregnant (the day of birth), I was on bed rest the entire time.
At around 28 weeks, I tested positive on a test that predicts potential delivery within the next two weeks, which led to a two-night hospital stay for steroid injections (two shots, 24 hours apart) and magnesium (which makes you feel extremely warm). However, since the test is known for false positives, I didn’t feel overly concerned.
Despite my calmness, all the doctors and nurses expressed concern for me, as statistically, I was not expected to be doing well. Throughout the remainder of my pregnancy, I had weekly appointments with my OBGYN and bi-weekly visits with my high-risk OB, eventually transitioning to weekly visits with the high-risk team as well. Each time I attended an appointment, they were pleasantly surprised to see me, as they did not expect me to make it to each visit.