Danielle Rogerson and Joe Smith are a thrilled pair of parents to hold their identical twin children. The twin boys are healthy but there is something peculiar about them. Ronnie was born twice the weight of his brother Teddy. This is due to a rare condition which they fell victim to - which they are lucky to have survived.
Danielle was diagnosed with twin-to-twin transfusion syndrome (TTTS) at only seven weeks of gestation after the difference in size between the boys' was noticed. Doctors warned the couple that their children were unlikely to make it because there was something wrong with how they were getting nutrients from a shared placenta.
Danielle, met Joe, an estate agent, in December 2014 on Tinder. Their love blossomed and soon enough, the couple was ready to start a family in 2016. But it was not going to be easy sailing for the pair. Danielle was diagnosed with polycystic ovaries as a teenager and was aware that her chances of conceiving naturally were slim.
Danielle told, “Doctors wanted to give me medication to help our chances but first they checked Joe’s fertility. After samples and tests it was confirmed that sadly, Joe’s semen didn’t contain any sperm at all.”
Understandable disheartened, the embryologist explained that it wasn't the quality of Joe’s sperm - it was brilliant - but it just wasn’t getting through to semen in the usual way. Danielle went on, "It meant we could have IVF and in October 2016 we were accepted for funding."
After a fertilized embryo was planted into Danielle’s womb in March 2017, she had to wait for a period of two weeks before taking a pregnancy test. She excitedly recalled, “When the day came I took the test at 5 am. Twice! Both results were positive!"
"We were so excited we could hardly contain ourselves. We called both our mums and said, ‘Good morning Nanny'’’, Danielle recounted. And then a scan at seven weeks picked up that the egg had split - Danielle was going to have twins. But there was an alarming development. There was a noticeable size difference between the twins, even though each fetus was no bigger than a blueberry.
Danielle explained, “The sonographer assured us it could just be a genetic size difference. She said something about a laser procedure if the difference continued but I gave it little thought. I imagined something quick and easy.”
But by 16 weeks, things were getting serious. Doctors had hinted at twin-to-twin transfusion syndrome earlier on, but when Teddy’s bladder became “absent” on scans, it was a sure sign of TTTS. Danielle said, “A disappearing bladder in the donor twin is a red flag. At 20 weeks we had the worst possible news.”
Twin to twin transfusion syndrome is when identical twins who share a placenta get an unequal distribution of nutrients from it. Only one of the twins receives the blood and nutrients in abundance. This can result in heart failure. The 'donor' twin receives insufficient blood and nutrients which slows down their growth. Their bladder begins to disappear and their chances of survival diminish.
TTTS is equally dangerous for both the twins. It's recorded in 15 percent of identical pregnancies and can occur to varying degrees throughout the pregnancy – the earlier the worse. The condition cannot be prevented. It is not hereditary or caused by parent behaviour.
A consultant told Danielle and Joe they had to make a difficult decision. “He told us if we did nothing we’d probably lose both twins but if we had a laser ablation procedure we’d possibly lose the smaller twin and might lose both twins. We were speechless. What a horrible choice. I broke down in tears. There seemed no hope", Danielle said.
Danielle’s mum Joanne, 46, recommended them to get a second opinion before taking such a drastic step. They got in touch with the country’s leading specialist in complicated multiple births, Professor Kypros Nicolaides at King’s College Hospital, London. With her twins’ lives hanging in balance, he agreed to meet Danielle the next day itself.
Danielle explained, “Prof Nicolaides explained the twins were not in a good condition. If we wanted to save one of the babies, I had to have the laser procedure.”So she had it there and then. She said: “It was so painful. An incision was made in my stomach. A laser and a camera were inserted. "
“I watched on the screen as the camera passed Ronnie. Then I looked away but I could hear the laser beam as it sliced through blood vessels”, Danielle recounted. The procedure arrested the nutrients and excess blood flow to Ronnie. It gave the family had some hope, however small it was. But the heartbreaking truth was it was, they still might lose Teddy because he was just so small.
The procedure was a success and bought Danielle some much needed time. She was able to carry out her term to 21 weeks, which meant the twins made it to 29 weeks. But at that point, Danielle’s consultant announced that the TTTS had returned and a emergency cesarean was required.
Teddy weighed less than a kilo at birth, which was dangerously small, but it was the only way to save Ronnie. Danielle said, “When the twins arrived at Portsmouth Hospital, Ronnie was small and Teddy even smaller.” Both siblings were put in incubators. They had to be provided oxygen and had phototherapy to combat jaundice.
Teddy had blood transfusions to supplement his health, and both had sight and hearing tests to check the result of their premature arrival. Incredibly, Ronnie was ready to join his parents in Bracknell, Berks, after six weeks. In December, Teddy followed after.
Danielle said: “Teddy has a hernia that’s just been operated on and they’ve both suffered from reflux. Teddy’s still on oxygen. But they’re starting to smile and are both strong. Ronnie is 10lb and so chilled. Teddy’s 7lb and very feisty."
“Some say Teddy will eventually catch Ronnie up but I think there will always be a size difference." They’re identical twins, but not quite. And that's what makes them pretty unique. “But they are both here, little and large, and that’s all that matters", the happy parents reported.
Danielle shares her story on Instagram to give hope to others in the same position.