The vanishing twin

Chris and I arrived at the clinic and waited for quite some time to be brought in for my ultrasound. I was a little annoyed, especially seeing that so many patients who came after me were getting called in sooner than I was. I asked the front desk what the hold up was, and they told me that they were a) waiting for a bigger room since Chris was with me, and b) the doctor would be doing my scan since I’m nearing the end of my time with the clinic, so it’s like a “farewell and good luck” parting. That made me feel sad, though, because I always look forward to seeing Mina during my scans; she has been my rock at this clinic since I first started coming, and seeing her is always a comfort to me.

When we got to the exam room, we waited for the doctor and his medical scribe to come in. They eventually came, and the scan began. But something just didn’t seem right. The doctor was silent for a much longer time than I thought he’d be as he examined one of the twins. I looked at his face, and he looked like he was wrinkling his brow and squinting. He kept zooming in close on one of the twins to get a closer look. I was getting worried.

After what felt like forever, he said quietly, “I’m so sorry. I do not see a heart beat.” He was referencing Twin A.

As soon as he said that, I felt like all the sound coming into my ears had just gotten sucked into a vacuum. I went numb. It was like nothing else mattered at all. In that moment, I just wanted to die.

“You don’t?” I managed to squeak out. He responded “no” quietly.

“What about the other twin? Is the other twin okay?” I asked. He took a look at Twin B, which was progressing well and had a heart beat in the target rate, at 169 beats per minute.

He suggested, for “peace of mind,” that he refer me to a maternal fetal medicine specialist to double check that the two twins were in separate sacs, as if they are in the same sac, that could pose some risk to Twin B. Unfortunately, the ultrasound machine at the clinic just isn’t high powered enough to confirm this to be true 100 percent. Chris started asking him questions about how common this was. He told us this was a fairly normal occurrence and tends to happen about 25 percent of the time; they call it “vanishing twin syndrome,” and they said it’s extremely common and “happens every day” with embryos that split into two. There is no concrete reason for why this happens. Twin A would either get absorbed into the uterus, placenta, or surviving twin, so it would not get expelled as with a regular miscarriage. He was trying to be empathetic, and said that it may take some time for us to digest this news, but he’d be available for a phone call if I had any questions at all or just wanted to talk this through. He then told us to take all the time we needed and left the room. His scribe went to get me some water. And as soon as they left, I just sobbed nonstop.

The doctor informed Mina right after he left our exam room, so she immediately came in to comfort me. I was so happy to see her despite the awful news. My clinic rock had shown up to take care of me.

I’d read at a cursory level what vanishing twin syndrome was after my 5-week scan, when Mina said she wasn’t 100 percent sure if she saw a second gestational sac or not. But at that time, I didn’t quite get the magnitude of how common it was… or that it could actually affect me. Of course, I worried a little about it, but I tried my best to hope for the best, to be cautiously optimistic, to be in the moment. “I’m going to be a twin mom,” I kept thinking, smiling to myself. I even started looking up how to raise twins and what the different twin stroller options would be, particularly for travel.

Every week since week 4, I would begin and end each day marveling at how lucky I was to have gotten this far, and to be doubly blessed with twins when I had only one healthy embryo. Every week, I just basked in gratitude that all my visits to the clinic had gone so well. I’m so lucky and blessed, I kept telling myself. How could I possibly be this lucky? I kept asking myself. I ended my first and only IVF cycle with only one viable, genetically normal embryo, and somehow that little embryo that could split into two; TWO POTENTIAL BABIES. I was just in disbelief that I could be this blessed. And I wasn’t sure when and if my luck would run out. And then when this devastating news hit me today, it was like all my joy just got sucked out of me. My attempt to live in the moment had just been shot to death. One of my babies had been taken away from me nearly as soon as it was given to me. The pain that took over my insides was just indescribable. One of my babies had died inside of me and I had no idea until that moment.

Just last week, I had two healthy, growing embryos the size of blueberries, both with their own gestational sacs, yolk sacs, fetal poles, and strong heart beats. What had happened to Twin A? How could it just have died just like that with no warning?

Vanishing twin syndrome is technically considered a miscarriage; it’s a pregnancy loss. While you still have one surviving twin, you have lost the second. I always knew academically that miscarriage would be devastating and could bring on depression. I just never had any idea exactly how awful it could be until it happened to me, even with one surviving twin. I want to be happy that I still have one little survivor, but I cannot help but mourn the loss of my second twin, who I cherished and grew attached to in the last three weeks. They were some of the happiest weeks of my life; I had never been more full of gratitude for my blessings than during that time.

This loss feels very real to me; I once had two strong heart beats inside my uterus, and now I have only one. I just don’t understand why this had to happen.

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