Photo of both mothers with the quadruplets. Headshot of Dr. Craig Sweet on file from May 2011. Susan…any chance we have a graphic of twin babies that can then be mirrored? x
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Florida reproductive endocrinologist delivers quadruplets to same-sex couple
FORT MYERS – Last spring, reproductive endocrinologist Craig Sweet, MD, made history when he delivered two sets of twins – quadruplets from the same set of eggs and anonymous donor sperm through in vitro fertilization (IVF) – each set carried separately by a same-sex couple who had yearned for children.
With the exception of a same-sex couple from Riverside, Calif., who delivered two sets of twins – quadruplets – in 2008, the Florida case is arguably only the second such delivery nationwide, perhaps worldwide.
“The idea that the womb is protected from the body’s immune system where one can carry an embryo that’s created by two other people and is then carried by a totally different person remains an interesting concept for medical and non-medical people alike,” said Sweet , founder of Specialists In Reproductive Medicine & Surgery, PA, private reproductive endocrinology and infertility practice located in Fort Myers. “Why the pregnancy isn't rejected, to me, remains an amazing mystery.”
The delivery of four healthy babies was a happy ending for the women whose journey to motherhood had been fraught with obstacles. Laura Cavin and Sheri Green had initially sought Sweet’s medical assistance several years ago, when Cavin was 24 and Green was nearly 35. After much discussion, it made sense for Green to provide her eggs with an anonymous sperm donor through IVF, and for Cavin to experience the pregnancy. On the first try, Cavin conceived identical twin boys from the transfer of a single embryo that split. However, she lost the babies at 24 weeks’ gestation because of the extremely rare condition of twin-to-twin transfusion.
Devastated, Cavin and Green, with guidance from Sweet, decided not only to try again, but also to increase the likelihood of giving birth to a healthy baby by transferring two embryos into each woman.
“With the loss of the past twin pregnancy, I was very reluctant to transfer more than one embryo,” said Sweet. “Then, recalling Laura’s age and the likelihood that they would all take to be so low, we all started thinking about two embryos for each of them. The national guidelines for transfer would have been one or two but with her age, two per patient was entirely acceptable. We were also simply hoping just to make it to the finish line. Eventually, we were all in agreement. I remember the ladies texting each other while I performed the embryo transfer since they were in two separate rooms on two separate exam tables and couldn't experience the transfer together at that moment in time.”
Another factor: “Sheri produced an abundance of eggs and high quality embryos,” said Sweet. “However, the chance that all four transferred embryos would implant and grow was less than 2 percent, so we were all amazed when the improbable occurred.”
Fees for egg donation cycle evaluation and recipient studies, mandatory FDA testing, embryo transfer, and pregnancy monitoring may top $30,000, excluding genetic testing, that insurance doesn’t cover. Sweet pointed out that this estimate is for a patient who is new to the IVF process, and may need to pay $4,000 or more for the egg donor. Long-term frozen embryo storage fees are additional.
“As I recall, we reduced our fees because of all that they’d been through and how much we really wanted to help them,” said Sweet.
The first five months of both pregnancies went well, but at 31 weeks, Cavin delivered Briana and Derek on May 9, 2011, after her placenta partially ruptured. Fourteen days later, Green gave birth to Anthony and Cason. All four babies, celebrating their first birthday this month, are doing well.
“The idea that I would transfer embryos into same-sex partners is novel, but not impossible to imagine,” said Sweet. “The probability that all four embryos would take is about 1 in 81. That all four would carry and not have at least one lost to miscarriage makes the overall likelihood less than 1 percent that all four would be delivered and thrive.”
The unique circumstances have also presented other challenges. For example, even though Cavin and Green consider themselves mothers of the four children conceived on the same day instead of two children each born two weeks apart, the state considers them mothers of only the children they bore. They’re working with a family lawyer for each mother to adopt each other’s children.
“They’re a family connected through genetics, reproductive medicine and the love these two women share with each other,” said Sweet. “It’s an amazing modern family.”
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