Couple's girls were conceived naturally — not through in vitro fertilization.
INDIANAPOLIS — Amanda and Chad Doss wanted a child. But Chad had had a vasectomy after having two children, now 12 and 9. So in February, the Franklin, Ind., couple decided Chad would undergo surgery to reverse the vasectomy.
Four months later, to their surprise and delight, they found out Amanda was pregnant.
"We were just going to let it happen as it was intended to happen," Amanda Doss said.
But the real surprise came 19 weeks later when Amanda underwent a routine ultrasound.
As Chad's two older children watched, the ultrasound technician took measurements. At one point, the Dosses asked why one measurement had "baby a" written next to it and another "baby b." The technician did not answer.
Finally, when she was done, Amanda cracked a joke: "At least there's not four in there."
The technician answered, "You're not having four. You're having triplets."
Amanda and Chad had suspected Amanda, 27, might be carrying twins, but three babies, all girls, all identical?
"Never in a million years we would have thought that," said Amanda, now 28 weeks into her first pregnancy.
No wonder. The odds of giving birth to identical triplets, who were conceived naturally, is difficult to calculate.
The event is rare enough that when it occurs it can make international news. Since the Dosses learned that they were expecting, they have heard of two instances of identical triplets. One trio was born in Great Britain this summer and the other in California last month.
When the California family hit headlines last week, their doctor estimated the odds of conceiving identical triplets naturally at somewhere between 1 in 1 million to 1 in 100 million. Other experts place the odds at closer to 1 in 2 million.
Dr. James Sumners, a maternal-fetal specialist at St. Vincent Women's Hospital who became Amanda's doctor when she learned she was expecting triplets, said in his years of practice, he has taken care of about 200 sets of triplets.
While it's fairly common to see triplets where two are identical, it's much rarer to find a family in which all three come from the same fertilized egg.
The ultrasound revealed that the Doss girls share one placenta, one chorionic sac and three amniotic sacs, Sumners said, suggesting that the fertilized egg split in three soon after conception. DNA testing was not necessary to determine they're identical; the presence of a single placenta is the cue.
Often triplets or other multiples result from in vitro fertilization as doctors transfer more than one fertilized egg into a woman's uterus to increase the chances of a successful pregnancy. If that results in triplets, however, the three fetuses are not identical.
From the time Amanda was a child, her grandmother and mother had told her they thought she would have twins. Amanda's great-grandmother had three sets of twins, and her own grandmother was a twin whose sibling died in infancy.
Amanda noticed her belly was growing faster than those of other pregnant women. She and Chad thought they heard two heartbeats on the home Doppler monitor he purchased, but the doctor said there was no way to know until the ultrasound.
"Chad and I had joked about it. We almost prepared ourselves for twins," she said.
On Oct. 2, the ultrasound confirmed that Amanda's pregnancy was not a singleton.
But Amanda's multiples probably have nothing to do with genetics, Sumners said. Fraternal twins that result from a woman releasing two eggs in the same cycle can run in families. Identical twins, when one egg splits in two after conception — or in three, as happened with the Dosses — does not appear in generation after generation. Most twins are not identical.
Fraternal multiples can be mixed sexes, but identical twins share the same DNA, meaning they will be the same sex.
The Dosses learned their babies' sex before they learned they were identical.
Now the Dosses are girding themselves to care for three bundles of joy: Avery, Bentley and Cassidy. Amanda has had two baby showers, and Chad's brother threw him a beer and diaper party to help the family stock up on necessities. Family and friends have been chipping in to help the family, which includes Chad's two children, Caleb, 12, and Kaitly, 9.
Amanda Doss has stopped working and is on bed rest.
Pregnancy with triplets requires extra attention. They have an increased incidence of birth defects, Sumners said. Identical triplets, who share a placenta, can run into trouble if there's an imbalance in blood to one fetus.
The biggest risk with triplet pregnancies, however, is extreme prematurity, Sumners said. On average, triplets are delivered at 32 to 33 weeks of gestational age, as compared with the 40-week norm. About 13% of mothers of triplets deliver before 28 weeks, compared with less than 1% of the mothers of singletons, Sumners said.
So far, Amanda and her babies are doing well. At her last appointment, all three babies weighed in at about 2 pounds, 4 ounces. She had gained about 42 pounds, shy of the recommended 60 or so.
She said she feels pretty good and never fails to amaze those who see her at the doctor's office.
"Every time I go, someone tells me, 'Man, you're just meant to have triplets,' " she said.