Twins?

Anonymous
OP, I understand what you are feeling. We were in our mid-40s when we were having children. My wife had medical issues that required signficant care during her 30's and early 40's and we could not attempt to have children until we were in our mid-40's. Due to her medical conditions we had to go with a surrogate for both her health and safety and the children.

We started at SG, but had 3 failed transfers. We switched to VCRM in Reston and Dr. Sharara was very helpful. Both facilities tried to discourage us from transferring two, but we did. We wanted to have two and were willing to handle twins. I think the only reason that we were not discouraged much more actively than we were, is because we had a surrogate around 30 years old. Had my wife been carrying, they would have been much more adamant. There are a LOT more dangers to both mother and child for an AMA mother and an AMA mother pregnant with twins increases the risks exponentially. While there are many healthy babies born to women in their 40's, the dangers are significantly higher; same for multiples. Our children were born at 34 weeks and spent 16 days in the NICU including Respiratory Distress Syndrome for one. The IVF cycles including a fresh cycle plus two frozen transfers from SGIF then switching to VCRM for another fresh cycle was expensive. Then the hospital expenses rolled in. All told, it cost around $170K for those 16 days in the NICU. Our insurance fought us about many of the charges. It wasn't until my twins' first birthday that I finally finished battling with the insurance company about the costs. We ended up with about $13-14K out of pocket only because the hospital ended up forgiving about another $15K in expenses that the insurance refused to cover.

Then there is the are. The NICU helped us get the twins on a 3 hour cycle. We woke both twins up at the same time for diaper, feeding, playing and then back to sleep. It was exhausting. The onoly way we ended up making it work is that we both took off a lot of work. My wife had 6 weeks of leave. I had 2. We then both too unpaid FMLA leave part-time for 12 weeks. I worked M/W/F and my wife worked T/Th for those 12 weeks. And we started sleeping in shifts. My wife slept 8pm-3am. I slept from 2am-7am. We didn't spend much time together outside of work for those 4 months. And even still, it was exhausting. The twins did not both sleep more than 3 hours until they were 8.5 months old. These were little peeing machines. At the height (around 10 months old), we were going through 28-30 diapers a day. A case of 224-252 diapers typically lasted a week.

While it is now less work (they are 7 now), for the first 18 months, it was more than double the work. And those first 18 months are still somewhat of a blur. The only thing that helped is that I am a very healthy active person, even though I am 15-20 years older than my peers (parents of my children's friends) that requires relatively little sleep. I am normally more active than most 30 somethings. But I have to say that having twins has taxed even my stamina. If you are in your 40's now, unless you are very healthy and can operate for extended periods of time on little sleep and are high functioning and organized, you want to be careful with twins. That first year or two is going to be very, very hard on you physically (and my wife didn't even go through pregnancy and she was still exhausted from the twins) and also emotionally on your marriage. If your marriage is not solid, twins will strain it to its limits.

Through our multiples club, I have met many other twin families including ones that have older singleton children and they have all said that having twins was much harder than having two at separate times. Most all of the women we know who had twins after singletons ended up leaving the workforce to be SAHM. Even with a nanny, it's still very hard.

Good luck, but I would caution as most of the other PPs have against implanting two unless you are very, very sure about all aspects of this decision.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:I can say from very recent experience that Shady Grove is now advising against transferring two embryos (I’m mid-thirties, though, so cannot speak for the 40+ patients).


I wonder if it’s really about the risks, or if they are realizing that their two for one promotion wasn’t as profitable

Seriously though, I do wonder if it’s economically driven vs risk aversion. I know PPs have mentioned the risks and anecdotal experience, but I will add that my anecdotal experience is that I know many, many twins via IVF (elementary age through high school) and they are mostly all fine.


If there is an entity that is anti-twin for profit reasons its insurance companies. NICU charges and complications for the mother get pricey fast and they cannot create plans without coverage, like they have with IVF. I think the insurance companies bring pressure to bear on professional associations and in turn doctors to avoid twins at all costs. The ranking of outcome look like this:

Singleton birth
.
.
No birth
.
.
.
.
.
.
.
.
.
.
.
Twins


I hadn’t thought about that. You’re right that insurance companies have motivation to avoid twins before the pregnancy. They can’t deny coverage for the complications that can arise even if the twin pregnancy was by “choice”.


This is why Massachusetts now mandates infertility coverage. Insurance companies figured out it was way cheaper to fund infertility cycles and disincentivize multiples instead of subsidizing NICU stays that can run into the millions.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:I can say from very recent experience that Shady Grove is now advising against transferring two embryos (I’m mid-thirties, though, so cannot speak for the 40+ patients).


I wonder if it’s really about the risks, or if they are realizing that their two for one promotion wasn’t as profitable

Seriously though, I do wonder if it’s economically driven vs risk aversion. I know PPs have mentioned the risks and anecdotal experience, but I will add that my anecdotal experience is that I know many, many twins via IVF (elementary age through high school) and they are mostly all fine.


If there is an entity that is anti-twin for profit reasons its insurance companies. NICU charges and complications for the mother get pricey fast and they cannot create plans without coverage, like they have with IVF. I think the insurance companies bring pressure to bear on professional associations and in turn doctors to avoid twins at all costs. The ranking of outcome look like this:

Singleton birth
.
.
No birth
.
.
.
.
.
.
.
.
.
.
.
Twins


I hadn’t thought about that. You’re right that insurance companies have motivation to avoid twins before the pregnancy. They can’t deny coverage for the complications that can arise even if the twin pregnancy was by “choice”.


This is why Massachusetts now mandates infertility coverage. Insurance companies figured out it was way cheaper to fund infertility cycles and disincentivize multiples instead of subsidizing NICU stays that can run into the millions.


You are insane! Babies stay in NICUs because they are at a real risk of dying or long term issues. Yes there are many success stories but also many tragedies. What loving, responsible parent would intentionally try to make this trade off of risk for a second baby on the cheap??
Anonymous
Another twin mother here. At the end, I was so very lucky. But, I did not realized just how lucky I was until I got exposed to the world of parents of multiples. So many heartbreaks, so many complications.
Anonymous
THere was a great "this american life" episode where a twin parent said "it's not 'twins' it's two f*ing babies at the same time". Don't do it.
Anonymous
Wow this thread has been soooo eye opening.

I am a twin and I didn't realize how lucky my twin and I were! We were born in the 80s in a small village not in America. We were 8.5lbs and 7.5lbs and never had any health issues. Based on this thread this seems like a miracle given that there was very little health interventions for our mother back then. I don't even think she gave birth in a hospital. I think it was a small birthing center and if something went wrong most likely we would have just died.

I have always loved being a twin. My sister is my closest friend and we are very very close. I wouldn't trade it for anything in the world but I would prefer not to have twins.
Anonymous
Anonymous wrote:Wow this thread has been soooo eye opening.

I am a twin and I didn't realize how lucky my twin and I were! We were born in the 80s in a small village not in America. We were 8.5lbs and 7.5lbs and never had any health issues. Based on this thread this seems like a miracle given that there was very little health interventions for our mother back then. I don't even think she gave birth in a hospital. I think it was a small birthing center and if something went wrong most likely we would have just died.

I have always loved being a twin. My sister is my closest friend and we are very very close. I wouldn't trade it for anything in the world but I would prefer not to have twins.


I think more so that this thread has been hijacked by a few super anti-twin people. I bet they work for the health care industry.
Anonymous
Anonymous wrote:Wow this thread has been soooo eye opening.

I am a twin and I didn't realize how lucky my twin and I were! We were born in the 80s in a small village not in America. We were 8.5lbs and 7.5lbs and never had any health issues. Based on this thread this seems like a miracle given that there was very little health interventions for our mother back then. I don't even think she gave birth in a hospital. I think it was a small birthing center and if something went wrong most likely we would have just died.

I have always loved being a twin. My sister is my closest friend and we are very very close. I wouldn't trade it for anything in the world but I would prefer not to have twins.


You are lucky in the way that twins that were never carried to term or born with significant mental handicaps aren't here to contradict you.

It's like saying I smoked for 50 years and never get lung cancer, therefore smoking is safe. It's called anecdotal evidence, and is not very helpful.
Anonymous
Anonymous wrote:
Anonymous wrote:Wow this thread has been soooo eye opening.

I am a twin and I didn't realize how lucky my twin and I were! We were born in the 80s in a small village not in America. We were 8.5lbs and 7.5lbs and never had any health issues. Based on this thread this seems like a miracle given that there was very little health interventions for our mother back then. I don't even think she gave birth in a hospital. I think it was a small birthing center and if something went wrong most likely we would have just died.

I have always loved being a twin. My sister is my closest friend and we are very very close. I wouldn't trade it for anything in the world but I would prefer not to have twins.


You are lucky in the way that twins that were never carried to term or born with significant mental handicaps aren't here to contradict you.

It's like saying I smoked for 50 years and never get lung cancer, therefore smoking is safe. It's called anecdotal evidence, and is not very helpful.


I don't think PP was being sarcastic - i think most people do think twin pregnancies all go well because you see so many twins everywhere and you have to be in the world of loss etc to really learn how much more risky they can be than a regular pregnancy
Anonymous
Anonymous wrote:
Anonymous wrote:Wow this thread has been soooo eye opening.

I am a twin and I didn't realize how lucky my twin and I were! We were born in the 80s in a small village not in America. We were 8.5lbs and 7.5lbs and never had any health issues. Based on this thread this seems like a miracle given that there was very little health interventions for our mother back then. I don't even think she gave birth in a hospital. I think it was a small birthing center and if something went wrong most likely we would have just died.

I have always loved being a twin. My sister is my closest friend and we are very very close. I wouldn't trade it for anything in the world but I would prefer not to have twins.


You are lucky in the way that twins that were never carried to term or born with significant mental handicaps aren't here to contradict you[u].

It's like saying I smoked for 50 years and never get lung cancer, therefore smoking is safe. It's called anecdotal evidence, and is not very helpful.


People with intellectual disabilities are here. What a strange comment.
Anonymous
Anonymous wrote:
Anonymous wrote:Wow this thread has been soooo eye opening.

I am a twin and I didn't realize how lucky my twin and I were! We were born in the 80s in a small village not in America. We were 8.5lbs and 7.5lbs and never had any health issues. Based on this thread this seems like a miracle given that there was very little health interventions for our mother back then. I don't even think she gave birth in a hospital. I think it was a small birthing center and if something went wrong most likely we would have just died.

I have always loved being a twin. My sister is my closest friend and we are very very close. I wouldn't trade it for anything in the world but I would prefer not to have twins.


I think more so that this thread has been hijacked by a few super anti-twin people. I bet they work for the health care industry.


Yes, the twin parents on here, including the ones who work extensively with multiples support groups are just raging anti-twin people with a health care industry agenda...give me a break.

Heck, even if health care industry folks were commenting, YOUR comment is stupid because presumable 1) they want more multiples born so they can nefariously increase their profit margins (insert evil laugh), or 2) they have professional experience and science, SCIENCE, on their side (clutch your pearls!) when speaking of why twins are not an outcome to be pursued for convenience or because “I always wanted twins.”

But do give us your expert opinion.
Anonymous
Ivf twins are very risky. Natural twins are less risky but having a baby is all a gamble really.
Anonymous
FYI: the goal of IVF doctors is a single take home baby. Doctors do not want you to carry multiples intentionally.
Anonymous
Anonymous wrote:Huh...I am a twin mom and surprised that there seems to be such a strongly negative consensus about the experience.

My pregnancy was fine. The babies arrived four weeks early, but were healthy and spent no time in the NICU.

They are about 1.5 years old now, and are absolute angels. It hasn't been that hard to take care of them. And I already had two older kids.

All that said, we've been particularly lucky in some ways that have helped out a lot:
1. We have a nanny (our older kids are in school, so the nanny watches just the twins)
2. The twins have been sleeping through the night since three months
3. The twins are very easygoing
4. The twins are both healthy, aside from the occasional cold

I'm not writing this to suggest that having twins is a breeze. It's certainly more work and can come with more complications than a singleton. But I do want to point out that it's certainly possible to have a wonderful experience.

FWIW...When I first found out that I was pregnant with twins, I was so scared and sad. Now that they are here, it's amazing.




The fact that you had premature twins and no NICU time is an exception.

The fact that you have a full time nanny is an exception - many families, even two-income families, cannot afford a nanny (like mine). Daycare cost $3400 a month for our twins, though still cheaper than a nanny. That plus before and after care for our oldest child totaled $4,300 a month. That's a lot of money

Sleeping through the night at three months; easy going temperaments, totally healthy - all great for you; NOT the norm for every baby, let alone twins.

In sum, you are a fortunate exception not the rule.

Anonymous
Anonymous wrote:From what I know of SGF recently, they are pretty laissez faire about twins. My three friends who recently went there all had twins and said their doctors were like, great!


Totally contrary to my experience. On my first visit with Widra he made clear he was not interested in promoting twin pregnancies due to the risks and because the loss rate is higher. That was for DD1. Came back two years later with hopes of a second and he was still just as firmly against twins.
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