A couple shares their journey through multiple IVF cycles, hard conversations, and controversial decisions to build their family.
April 25th, 2024 | 8 min. read
When you have to pay for fertility treatment out of pocket, it's natural to want to give yourself the best possible chances of success. Hear from one uninsured couple who had two sets of fraternal twins as a result of their choices during IVF treatment.
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Editor's Note: We are so grateful to Dionicio and Ruddy for being willing to share their story with us in honor of National Infertility Awareness Week. To learn what RESOLVE and other organizations are doing to protect access to fertility and family-building care across the United States, please visit their website.
Meet Dionicio & Ruddy
In 2013, Dionicio and Ruddy met online, and an immediate spark was lit. Both Ecuadorian, their shared cultural background and dreams for the future made them realize that they wanted to spend the rest of their lives together.
The couple married in 2014 and moved to the United States soon after. "We always wanted to be parents," Dionicio says. They began trying to conceive, eager to expand their family. After having no luck on their own, they quickly realized that things might not be as simple as they'd planned.
Taking the First Step
A friend of the couple recommended Illume Fertility, and Dionicio and Ruddy decided to make an appointment to see one of Illume's reproductive endocrinologists. They were paired with Dr. Shaun Williams, one of Illume's Spanish-speaking doctors, and a Spanish-speaking Care Team, who were able to communicate with the couple directly.
"We still remember our first consultation with Dr. Williams," Dionicio says. "He was always very positive with us, and we felt we had his support (as well as the support of the entire Illume team) on our arduous yet beautiful path to fertility."
Starting IVF Treatment
After undergoing initial diagnostic testing to rule out certain issues that might be impeding their fertility, the couple discovered that they were going to have some big obstacles to overcome. In vitro fertilization (IVF) was their next step.
"Going into that first IVF cycle was very hard for us," Dionicio remembers. "We started out with a lot of optimism, but also felt fearful that it wouldn't work due to a complicated fertility issue my husband had."
Dionicio and Ruddy underwent additional fertility testing and Dr. Williams and his team used the information gathered to create the perfect treatment plan.
Making a Controversial Decision
Due to the couple's unfortunate lack of fertility coverage, they wanted to transfer two embryos at once instead of proceeding with the recommended single embryo transfer.
"Currently, most IVF cycles now involve the transfer of just a single embryo, and the risk of having fraternal twins is extremely low," says Dr. Williams. "At Illume Fertility, a single embryo is transferred in over 90% of IVF cycles."
Note: Elective single embryo transfer (eSET) offers a higher chance of a single, healthy baby and greatly reduces the risk of pregnancy complications, including preterm labor, preeclampsia, and gestational diabetes.
Dr. Williams explained why Illume Fertility's guidelines strongly advise against transferring multiple embryos at once, and urged the couple to reconsider their decision. He outlined the additional risks of a multiple pregnancy (twins, triplets, etc.) for both mother and babies.
Despite these conversations, Dionicio and Ruddy still wanted to move forward with a double embryo transfer, holding out hope that it would increase their odds of success with the limited amount of "tries" they had while paying for treatment out of pocket.
A Dream Come True
After their double embryo transfer, the couple were elated to find out that they were finally pregnant - not just with one baby, but two. Luckily, Dionicio's pregnancy progressed smoothly, and their fraternal twin girls, Victoria and Valentina, were born August 14, 2020.
In November 2022, after their daughters turned two years old, the couple returned to Illume Fertility, hoping to give Victoria and Valentina a sibling. This time, they transferred a single embryo and waited to hear what they hoped would be more happy news.
Sadly, that embryo transfer (which would have been a boy, says Dionicio) did not lead to a successful pregnancy. The couple were devastated, but determined to continue.
After the Storm Comes a Rainbow (or Two)
"After this very hard blow, the loss of our baby boy, we wanted to try again," she says. "We were actually hoping for another set of twins." They discussed their desire to transfer two embryos again with Dr. Williams, who strongly advised against it, knowing that the risk of complications would be high.
Dionicio and Ruddy considered his advice but ultimately decided to move forward with another double embryo transfer. And again, their transfer resulted in multiples - this time, boy/girl fraternal twins.
While the couple were thrilled to be pregnant with a second set of twins, "this is not the ideal outcome [with IVF]," emphasizes Dr. Williams. "We never actually try to end up with twins."
Dionicio was lucky enough to experience another smooth pregnancy, and against all odds, twins Nickolays and Esmeralda entered the world on February 21, 2023. "It was wonderful," recalls Dionicio. "It was the happiest day of our lives."
What the Experts Say
According to the Centers for Disease Control and Prevention (CDC), "Obstetric risks to the mothers from a multiple-birth pregnancy include higher rates of caesarean delivery, maternal hemorrhage, pregnancy-related hypertension, and gestational diabetes. Risks to the infants include preterm birth, low birthweight, birth defects, developmental disability, and death."
Some fertility patients feel these risks are acceptable, while others follow the CDC's guidelines to transfer one embryo at a time. While each case is unique, it is important to keep all of this information in mind as you proceed with IVF treatment.
The Shock of a Lifetime
Christa and Aland share their journey through infertility, IVF treatment, and a complicated identical twin pregnancy.
Fraternal Twins vs. Identical Twins
"Identical twins are associated with greater risks, compared to fraternal twins," says Dr. Williams. "Fraternal twins are completely separate embryos, usually with two separate placentas and pregnancy sacs, while identical twins often share a placenta and may be developing within the same pregnancy sac."
Because of this, there are blood flow abnormalities that can occur when identical twins share a placenta, creating a higher risk for poor fetal growth and loss of the pregnancy.
"Additionally, since the embryos share a common placenta, when one embryo/fetus fails to grow, the other embryo/fetus will also be affected," adds Dr. Williams. "The risk of pre-term labor with fetal loss is also elevated, similar to the risk associated with fraternal twins."
Note: More than half of twin pregnancies result in preterm delivery, which is before 37 weeks. The average pregnancy lasts 40 weeks, but most twins are born around 36 weeks, with a range of 32–38 weeks. Monochorionic twins have a higher risk of preterm delivery than dichorionic twins, according to Johns Hopkins Medicine.
Why They Share Their Journey
Like most couples, Dionicio and Ruddy never expected to need the help of an entire team to build their family, and have learned a lot from their experience as fertility patients.
"We share our story so that other couples like us know that it is possible, and it's worth trying," says Dionicio. "Be encouraged that nothing is impossible with the help of God and a great team of professionals."
These days, the couple say their lives and hearts are full as they navigate the daily chaos and joy of parenting two sets of twins. "A beautiful, long adventure awaits us together, and we have so many dreams to fulfill," she adds.
Everyone Deserves the Chance to Build a Family
While the couple's twin pregnancies both had a happy ending, many others do not. "Fortunately Dionicio did well, despite having twins," says Dr. Williams.
Dionicio and Ruddy's story is one of hope, love, and perseverance. The dilemma they faced while trying to build their family through IVF is an example of why increasing access to fertility care and expanding insurance benefits for family building is so critical.
Want to make a difference? Learn how to get involved in advocacy efforts!
Advocacy organizations such as RESOLVE: The National Infertility Association and Fertility Within Reach are working tirelessly to ensure that no one has to choose between the safety of their future child and achieving their dream of becoming a parent.
No coverage for IVF treatment?
For those without fertility coverage, the cost of IVF can be out of reach. Learn how to get financial assistance through IVF grants, scholarships and more.
