Hello

Hi everyone,

I was referred here by some kind ladies I know at another forum.

My situation is a bit odd, but that's the story of my life. I guess it truly is not in my nature, literally, to do things the normal way.

My husband and I have been ttc for nearly 5 years but with some medically forced breaks. We tried many methods but what worked for us was IVF in January. I had my first u/s at 6w4d and they told me they saw 2 sacs (or blobs as I saw them) but only 1 yolk sac and 1 heartbeat. Our IVF doctor declared the pregnancy a singleton and told me the 2nd baby never developed. At 8w4d they had me see a Nurse Practitioner who did the u/s and found Baby A right off the bat and focused on getting lots of shots of our cute little gummy bear. I followed a hunch and asked her to look further, lo and behold we had Baby B in there, but Baby B was in a small sac and hadn't much room. Both babies measured at 8w5d and had a clear heartbeat. The NP said that it was likely we were going to lose Baby B within a couple of weeks. At that point I don't know if they were in 2 gestational sacs, but there was definitely 2 blobs of water, so maybe. It's tough to say. So, at 10w3d we went back and saw our IVF doctor again. She saw both babies right away - one on top of the other. Baby A had lots of room in his blob to swim and wave at us, but Baby B was stuck in a small blob but was still alive.

We are delighted that we still have both babies and we continue to pray that they both continue to grow and flourish, but we are extremely concerned about Baby B. It was at this last visit that our doctor shocked us and told us that she suspected that they were identicals with TTTS. All this time we just assumed that they were fraternal. I assumed that they saw 2 gestational sacs in the beginning, but after discussing this with my friend on another forum, I may be mistaken because I recall that my doctor never specifically said there were 2 gestational sacs, and I know for sure that they only ever mentioned seeing one yolk sac.

So, with the data they collected in the beginning with assumptions being made, it is tough to say at this point whether or not they are identical or fraternal.

We have the NT ultrasound on Wednesday. Do you think they'll be able to tell the chorionicity at that point? I'll be 11w5d at that point.

 

Hi and welcome to Twinstuff! Congrats on your twins.

I would encourage you to join our Big Sister Program. You will be matched up with another Mom with older twins and she will support you throughout your pregnancy. Click on the link in my signature for more information, it's a great program.

QUOTE
We have the NT ultrasound on Wednesday. Do you think they'll be able to tell the chorionicity at that point? I'll be 11w5d at that point.

Sorry I don't know anything about this, hopefully someone else will have some answers for you.

 

Hopefully your next scan will give you a lot more info. We went through something similar where they told us Baby A's sac was measuring too small and then that the baby was measuring a week behind the other. These scans were all done vaginally. When I went to see the Peri and they did the scan abdominally the babies looked fine. They measured the same and the sacs were fine. They said the vaginal wand had given us a weird angle because Baby A was far back in the uterus. It was a huge relief. I hope you get good news too!

 

Thank you, both of you!

I'll look into the Big Sister program.

I sure hope that my next ultrasound shows just that - that the sacs were different due to being transvaginal vs. abdominal.

 

This sounds interesting... It kind of sounds like if you saw two "sacs" - meaning dark blobs on the u/s, they you would have di/di twins and you couldn't have TTTS (although they may still be identical). If both babies are in one big dark blob, then they would be mo/di or mo/mo and they are identical, and you could be at risk for TTTS. It kind of sounds like the second "sac" was smaller than the other sac though. Then that would be a different issue.

The farther you get, the harder it is to see if it's one placenta or not, because two placentas can be close together and "look" like one placenta even though they're not. They may be able to see a "lambda" sign between babies, which would mean di/di, though.

However, keep us posted, and if you do have TTTS, do not hesistate to PM me! also check the ttts foundation website and forums!

jenny

 

QUOTE(ferfischer @ Mar 23 2008, 08:20 PM) [snapback]683740[/snapback]
This sounds interesting... It kind of sounds like if you saw two "sacs" - meaning dark blobs on the u/s, they you would have di/di twins and you couldn't have TTTS (although they may still be identical). If both babies are in one big dark blob, then they would be mo/di or mo/mo and they are identical, and you could be at risk for TTTS. It kind of sounds like the second "sac" was smaller than the other sac though. Then that would be a different issue.

The farther you get, the harder it is to see if it's one placenta or not, because two placentas can be close together and "look" like one placenta even though they're not. They may be able to see a "lambda" sign between babies, which would mean di/di, though.

However, keep us posted, and if you do have TTTS, do not hesistate to PM me! also check the ttts foundation website and forums!

jenny


That's what we thought at first. I assumed that each blob was its own gestational sac, but I never had a very early ultrasound to check the fetal pole or anything. It was close to 7 weeks before the first u/s and at that time there was only 1 yolk sac, which is why my doctor assumed the other baby didn't make it - with IVF they always assume fraternal twins from the get-go. Also, it wasn't until just the last few days that I knew anything about what any of this meant. We thought we just had one baby until nearly 9 weeks along, and even then we assumed fraternal twins. At the first and second u/s, Baby B was difficult to see past Baby A. Baby A seemed to be in front or on top of Baby B and it was difficult even at the last u/s to get to see Baby B. Also, all of my ultrasounds were done at the infertility clinic and not by someone who specializes in prenatal u/s. I didn't know the right questions to ask, and they were just checking to make sure my pregnancy was viable.

Since I did IVF we know the embryo status up until day 3 so if they are identical, the embryo would have split on or after day 3.

I'm really hoping they can tell me chorionicity on Wednesday and put these fears to rest - or at least give us a better idea of what we are dealing with. If it's not TTTS, then I have no idea why our babies are in such different sized amniotic sacs.

 

I'll be very interested to see what the next scan says. I was just like you, all my first confusing scans were done at the fertility doc's office. We also did IVF, putting 2 embryos back.

 

Not got much advice here but just wanted say congratulations and :sign0016: to twinstuff! x

 

What a nervewracking situation for you. I know that at my NT screen we were able to visualize the membrane between the sacs, which my OB had seen previously but was at that point confirmed with the higher resolution they used. I hope you have similar findings and both your babies will be OK.

 

We were in a similar situation. At my third sono at 12 weeks we discovered twins and I was sent to high risk where the head sonographer was concerned about the differences in sac and fluid. I was 12 weeks exactly and after alot of searching they found the superthin membrane. She suspected ttts and I was immediately referred to a different specialist who had experience with ttts.He said this early in id twins there is some difference to be expected and they would monitor me. So maybe that is what is going on and it will even out in a few weeks. In our case 2 weeks later we were in full blown stage 2/3 ttts and referred to another hospital with more specialists but we had a very positive outcome. I was monitored at 3 different hospitals a few times a week stayed in stage 2 and made it to 36 weeks when they induced me and we brought two healthy girls home with us. So (hoping it's not) but if it is ttts positive situations occur and you will scare yourself to death reading up on it on the internet- I sure did. If you have questions or need to talk pm me. Wishing you the best!

 

Thanks everyone.

I was really frightened at the beginning when I started researching, but I found a lot of good information in the end and that helps me to feel much more empowered!

I also sent an e-mail to the TTTS Foundation requesting information, and they replied quite quickly offering great advice. I also e-mailed Dr. De Lia (the hot shot doctor of TTTS) and explained the whole situation to him. He called me and says he believes that the babies are monochorionic based on what has happened with the ultrasounds and on my own symptoms (malnutrition, cramps, and severe water retention). I asked about the possible 2 gestational sac issue and he said that based on the baby sizes, the sac sizes, and the timing, he thinks they simply missed the twin entirely on the 1st ultrasound. He gave me some very good advice at combatting the malnutrition and the water retention and he gave me a list of questions to get answered at the NT ultrasound.

So yes, at the NT ultrasound they can tell me:

-chorionicity
-measure the membrane between the babies
-measure my cervix to make sure there is enough support there

He also said that just based on the issue we currently have with the lack of fluid around baby B we need to get them to do another u/s at 16 weeks.

He was sooooo helpful!

 

Congrats and welcome to TS!
If it does turn out to be TTTS, be comforted knowing there are lots of success stories on this board. Our girls are thought to have had TTTS which led to their IUGR (Growth restriciton), but it was never 100% determined. In any case, they are perfect.

We look forward to your update!

 

I'm updating the first post but thought I'd say that the news is good!

 

Okay, I lost the edit option on the first post. :lol:

It's a very good day today!

First of all, the doctor said that he's 80-90% sure the babies are di-di, meaning that they could still be identical, but there isn't much likelihood that they are monochorionic. They can only have TTTS if they are monochorionic. He based this on the thickness of the membrane between the 2 babies. So, while we are not 100% sure because they couldn't see the placenta, it is looking very hopeful.

Second, thanks to the TTTS scare, I found a lot of information and excellent resources for really good advice. I learned that I was quite malnourished and dehydrated, I guess due to the runs I've had through the pregnancy. The malnourishment and dehydration were causing my body to well, give me those really bad cramps and retain a lot of water. Drinking those protien drinks and resting a lot on my left side really helped a lot!! I feel much better, don't have the runs so much, don't have as bad of cramping anymore, and best of all... (drumroll please).... the amniotic sac differences are starting to balance out!!

Third, my screening came back great! Bloodwork is usually elevated with twins - the twin issue often causes false positive screens. Even so, the blood work compiled with the results of the ultrasound I still have a very low chance of the babies having DS or one of the Trisomies. The chance of either baby having DS is 1 in 1793 (both babies measured about the same!) and the chance of Trisomy 13/18 is 1 in 5,781. My chances of these issues are that of a 20-year-old!!

More woohooo!!!

So, it's all good news. I have a few concerns, but they are mild. One is that we still may have mono-di twins because they couldn't rule that out, but it's a very low concern for me now that the amniotic sacs are looking better.

So, the upshot is, everything is looking much better and I'm so glad I had this scare because it got me on the right track of what I needed to do to provide better nutrition for these babies and myself through all the m/s.

 

That is great news! I hope everything continues to go well for you.

 

congratulations!! thats wonderful news!!

 

That is great to hear!

 

I am THRILLED FOR YOU! I have been through the early diagnosis of TTTS and it is scary. CONGRATULATIONS!