Kotera Triplets

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I am pregnant with spontaneous triplets, consisting of monozygotic and dizygotic twins. How does that work? My one ovary released two eggs, which both got fertilized and created dizygotic twins. These traveled through my one fallopian tube to my uterus, and somewhere along the way one of them split into monozygotic twins, creating a total of three babies. You three Kotera triplets.

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This last month has been quite the roller coaster ride. We’ve always wanted two children, and we were very happy when my cycle returned 33 months after Babel was born. After five months of trying we fell pregnant with Berber, but he turned out to be an ovarian ectopic. So we lost him after 4 weeks, and I lost my left fallopian tube and left ovary and almost my own life. After I recovered from my emergency surgery, we had to wait a few cycles before trying to get pregnant again. We were lucky enough to fall pregnant on our first try. Obviously, we were nervous it could be another ectopic pregnancy, so we didn’t allow ourselves to get too excited.

Five days in a row I took a home pregnancy test, all in the morning, all the same kind of test. On December 8th, there was a faint line and it got darker the next two days, which was reassuring. After that it got fainter and fainter again, which was scary. At the same time I had little pain pangs left and right in my tummy and I started bleeding. So, I contacted the Early Pregnancy Unit at the hospital and they had me come in the same day for a scan and a blood test.

I was only pregnant for about 4 weeks so as expected there was no gestational sac visible in my uterus yet. The sonographer saw that my one ovary did release an egg and that the lining of my uterus was thick like it was preparing to receive a pregnancy. She couldn’t find anything growing outside of my uterus. So everything was looking as it ought to this early in a healthy pregnancy, but it was too early to rule anything out, it could still turn into an ectopic or a miscarriage.

The booked me in for another scan ten days later, hoping that by then we would be able to see something in the uterus. In the meantime, they checked the pregnancy hormones in my blood. On December 11th my hCG was 357 and 48 hours later it was 886. Which could be consistent with a regular early pregnancy, so that was reassuring.

Then a very long week of waiting for the second scan started. In this week I spotted and found little blood clots almost everyday, which was very worrisome. The nurse had said to go to A&E if the bleeding became severe and it was coupled with pain. The bleeding wasn’t filling pads and there was no excruciating pain (like when I had my ectopic) so I tried to keep myself calm.

Going over my discharge papers from my ectopic in July I discovered that mine was a ruptured ovarian ectopic. An ovarian ectopic is a rare form of non-tubal ectopic pregnancy. All this time I thought that Berber had tried to grow in my fallopian tube, but actually the egg had never left my ovary. It got fertilized in my ovary and Berber tried growing there. Ovarian ectopics typically end in ruptures around week 4 of pregnancy, which is earlier than when tubal ectopics typically rupture (between 6 and 8 weeks).

Knowing this made me bit calmer because at least the sonographer had seen that an egg had left the ovary, so this was not an ovarian ectopic. If this was a regular ectopic or a miscarriage at least I was not going to die this week and there was nothing I could do to save the pregnancy. So the best thing was to just wait for the scan on Dec 21st.

Because of the continued bleeding, I did spend the week worrying about this pregnancy and I was honestly expecting this to be a miscarriage. I knew if this turned out to be another devastating loss, that I was done trying to conceive. So I was basically preparing myself to be a mother of just one child, and I was focusing on the silver lining of that reality.

When I was pregnant with Babel I had also experienced some bleeding and they gave me an early scan at about 7 weeks pregnant to see what was happening. Back then, almost immediately the sonographer announced that there was definitely a baby in there. That was such a relief. But on December 21st, the sonographer was silent for a while and then started softly speaking to the student that was with her. My heart was sinking, because this couldn’t mean anything good.

Finally, she gently put her hand on my knee and said: “I don’t know how to tell you this…” I was momentarily devastated, because I assumed the worst. “…but there are two gestational sacs in your uterus.”

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My mind was blown! “Twins?! What?! Seriously?” I was shocked, I was laughing. Oh how many times have we joked about having twins? We even did so the morning before I left for the hospital to go have this scan. How funny is this, that this is now actually happening? “Hey, at least the baby, or rather babies, are in the right spot. How am I going to tell this to Yasu?”

The sonographer kept talking, but I was only listening half-heartedly trying to come to terms with this new reality. She said something about no fetal poles or heartbeats yet, so come back next week for another scan. But everything was looking as it ought to this early in pregnancy, so no bad news. The sonographer was very excited and printed me a photo of the two sacs free of charge. I was happy and numb and freaking out all at the same time.

While I was waiting for the debrief with the gynaecology specialist nurse, I sent messages to everyone that this was a uterine pregnancy. I didn’t say anything about twins yet because I had to tell your father first and I was not going to tell him over a text. So I was freaking out about twins all by myself for about 20-30 minutes.

Then the nurse called me in. She was amazed and excited. She had never had a suspected ectopic end up being this. We spoke in wonderment for a while how my body had done this with only one ovary and one tube. Then she wanted to go over the details. So she said: “gestational sac one is a little under 6 weeks old and has two yolk sacs.”

“WHAT?!” I interrupted her. “What do you mean?! TWO yolk sacs?! Is that identical twins?! Wait, HOW MANY are in there?!” She looked at me nervously: “I thought you knew it was… triplets…?” “WHAT? NO! TRIPLETS?!?! But I only have two boobs!” Suddenly, freaking out about twins seemed silly, twins seemed heavenly now. Triplets? Triplets?! OMG Triplets.

Naturally conceived triplets are extremely rare, but after only one try with only one ovary and one tube? The nurse said we should play the lottery after such a rare ectopic and now such a rare pregnancy, we keep beating the odds.

When I got home, your father opened the door and said something like: “So everything is okay?” I nodded and looked at him straight and said: “It’s triplets.” His face froze, eyes wide open. He was frozen for quite a long time, maybe a minute, and apparently he was trying to figure out whether I was serious or not. During this time I held his shoulder and kept saying: “I’m not kidding” and apparently I was laughing as well. Finally, he realized this was real and we both sank to the floor and just laughed out loud. Sometimes exclaiming “OMG triplets” and laughing some more. We were in shock, we were happy, but we were very much in shock. This is going to take a while to sink in.

Monozygotic twins and dizygotic twins making up three babies in total, in my uterus. I remember thinking it was a little too bad it wasn’t monozygotic twins when I thought I found out it was dizygotic twins. “Don’t worry” said the universe, “we’ll just split one of them for you!” Be careful what you ask for!

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On December 21st, the sonographer wasn’t 100% certain about the two yolk sacs yet, but she was pretty sure. And the scan on December 31st confirmed it all. Three fetal poles, three heart beats. The sonographer said that in her entire long career of scanning she had never had the honor of saying “there are three heartbeats” ever before. It felt incredibly good to see all your heartbeats pulsating on the screen. So far you are all doing okay, now it’s my job to keep you all cooking in my belly for as long as possible.

The people at the hospital are super excited about you three. They have never encountered triplets before. Everyone seems to know who I am, one nurse even came in to hug me and Yasu, she was so excited. They want me to come in to show my bump and you three in the future. I feel like a proper celebrity! Like your father said: “Our life is always interesting.”

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