Candice Botha has a special story to tell, one of coincidences and special blessings. One of the first test-tube quintuplets in South Africa, she shares how many similarities between her mom and her have played out in her life now that she is the mother of twins.
Q. Your family made history in South Africa. Tell us about your and your siblings’ unique conception and birth.
My parents married in April 1986 and tried for more than four years to conceive a child. My mom couldn’t ovulate on her own naturally, so they started infertility treatment using the GIFT (gamete intrafallopian transfer) method of IVF. This is where the sperm and eggs are retrieved, fertilised in a test tube and transferred the following day – this is different from today, where the fertilised embryos are left for five days before they’re implanted.
They retrieved 15 eggs, 12 of which were fertilised. Out of those 12, eight were viable for transfer. My parents chose to implant four (or so they thought!) and freeze the other four. After 12 days, my mother felt ill and blood tests confirmed that she was pregnant with multiples.
At her first scan, they detected three heartbeats but during the C-section the doctor found a fourth baby. Even more incredible, just as he was closing her up after surgery, they noticed movement and found a tiny fifth baby!
We were kept in the NICU of Sandton Mediclinic (Sandton Clinic in those days), and were all very small. We ranged from 1.2kg to 770g. Calvin was born first, followed by myself, Brendan, Wesley and finally my sister, Kirsten.
The doctors didn’t know how to deal with such small babies in those days, so we were given far too much oxygen for our little bodies. Calvin was blinded, while Wesley and I each went blind in the right eye. My sister Kirsten was unaffected as they had kept her to the side, thinking she wouldn’t make it.
Eleven days after our birth, the doctors took Brendan off the ventilator believing he’ be able to breathe on his own. His lung collapsed, causing him to have a stroke and he passed away. I was taken home after three months, followed by my siblings a few weeks later. The amount of support we received nationwide was incredible (our story made the headlines for many years), as we were the first test-tube babies in South Africa using the GIFT method of IVF.
Q. What was life like growing up with your brothers and sisters?
I loved my childhood. We have always been such a close family and we did everything together as children. There was never a dull moment in our house, and the Botha bunch was always on the move. Even today we often have family get-togethers and have a family WhatsApp group where we talk all the time. We are known as the “Awesome Foursome”.
Q. How did you cope in mainstream schooling – and where did your brother Calvin go to school?
We all did very well at school. My parents made the choice to keep us in separate classes so that we each could develop individual personalities and have our own group of friends. We went to local primary and high schools, while Calvin was a weekly boarder at a school for the visually impaired in Pretoria, where he excelled.
Q. What careers do the four of you have as adults and would you consider yourselves successful?
I am a chemical engineer and Wesley is a mechanical engineer. Kirsten is a successful travel consultant and Calvin is in music production and an entrepreneur. I would definitely say that we are successful.
“The best way I can describe IVF is beautifully difficult.”
Q. Tell us how you and your husband met.
We are one of few Tinder success stories, which is awesome! At that stage, I lived in Secunda and was visiting my brother just for a night in Silver Lakes in Pretoria. Leon (my husband) used to stay in De Wilgers, which was not too far from my brother. I was on the app that night and came across his profile. He had no biography, and I usually never “swipe right” on those profiles, but for some reason I did.
As it turns out, we spoke for two weeks, had a nine-hour first date where he drove all the way to Secunda to meet me, and the rest is history. We got engaged on 19 December 2015, after starting to date in July that year. When you know it’s right, you know! Interestingly, he is an electronic engineer and he has the same name and surname as my late father, so I married a Leon and my surname remained Botha!
Q. You are the first in your family to marry and have children. Has this experience brought you even closer to your mom?
I got married in 2017 and we welcomed our twins in 2019. They are the first grandbabies on both sides of the family. The experience really has brought my mom and me closer. We both married Leon Bothas; we both went through IVF; we were both admitted to hospital for preterm labour; we both spent time in hospital before the birth and had our babies stay in NICU for a long time. I felt I could really relate to her and everything she went through to have us as well.
Q. Are there other multiples in your family and any in his?
My cousins are twins, but Leon has no natural multiples in his family. None of my siblings have children yet, so we’ll have to wait and see!
Q. Why did you start with infertility treatment so soon?
I had this feeling that I would have infertility problems like my mom and didn’t want to waste time and emotions trying to conceive unassisted. I always had very irregular periods and had been on the Pill from the age of 16 years, which masked my infertility issues. Every time I tried to get off it, I wouldn’t ovulate on my own for months. I’d managed to save quite a bit while working, believing I would need that money some day – I guess it was my intuition preparing me.
Q. Who did you approach to help with the treatment – and did you change doctors at any stage?
I started treatment on 27 April 2018 at Sandton Mediclinic. We did a medicated cycle, where I had to inject myself until I had enough follicles. I was then given Ovitrelle to ovulate and then we tried on our own. The first cycle failed. We then went on to try an IUI (intrauterine insemination), which again failed and I ended up with a 4.5cm cyst.
“Motherhood has made me realise that the small things that go wrong really don’t matter.”
When my doctor diagnosed me with PCOS (polycystic ovarian syndrome), I knew he’d been giving me the wrong hormones. This had resulted in my body producing too much FSH (follicle stimulating hormone), which masqueraded as PCOS. I knew we needed a second opinion, so we changed doctors in September 2018.
Q. What would you say to other couples about having the courage to change doctors?
Listen to your inner voice! If you feel something is not quite right, don’t be afraid to leave. You are more than entitled to get a second opinion.
Q. Explain the IVF process you went through. How many eggs were retrieved, fertilised and implanted?
The best way I can describe IVF is beautifully difficult. It is by far one of the hardest things I have ever gone through. It starts with a baseline scan, where they check your uterine lining to see how thick it is, as well as how many follicles you have. You are then given a specific protocol, where you need to inject yourself to get the follicles to grow. The follicles need to be at least 16mm in diameter for them to be mature enough to retrieve any eggs.
I started the full process on 7 January 2018 and the stimulation part started 14 February. My follicles were ready and I went in for egg retrieval on 27 February. I was under conscious sedation, so I didn’t feel or remember anything, and they retrieved 15 eggs. My husband then gave his sample and 10 eggs were fertilised. On the fifth day, I had seven blastocysts, which is the stage you want them to be at for implantation.
At that stage I became overstimulated and my ovaries were really big and full of fluid. It would have been dangerous to do the transfer then, so they put me into down-regulation to “turn off” my ovaries for a few weeks to normalise my hormones so we could do the embryo transfer.
Q. You chose to try again soon after losing your first pregnancy. Why and how did you work through the loss?
I decided to try again because I’d always dreamt of being a mom. It was very hard initially because my husband wasn’t home. I bought a bottle of wine and a nice meal and just had a “me” day. I’d spent time at my mom’s house before my last blood test confirming that it was a miscarriage. She made me chocolate pudding and I ate my feelings for a night. I then got up the next morning and decided that I wouldn’t let it define me and that I’d do whatever I needed to do to realise my dream.
Q. How did you react to the news that you were carrying twins? How did your hubby respond?
We transferred two embryos so we always knew it was a possibility and when we got our beta HcG results, we knew it was most likely more than one. We had our first scan at 5w5d and it was the most incredible feeling seeing two yolk sacs, two foetal poles and a faint flickering heartbeat in each. Our hearts simply melted!
Q. Did you attend antenatal classes to prepare?
I booked and paid for antenatal classes! Then, as luck would have it, I ended up in hospital for the last few weeks of my pregnancy so I missed them – I just had to rely on my instincts.
Q. How did your pregnancy play out?
I loved every second of it. The first 14 weeks I had crazy nausea, but otherwise it was incredible to watch my tummy grow and start to feel movements. I truly miss it! At 26w4d, however, I didn’t feel quite myself. I’d had a very busy day at work the day before, which may have been the cause. I called the doctor to squeeze in an appointment and it turned out I was in preterm labour. My cervix was 1cm dilated. It was terrifying and I’m very glad I went to see him.
Q. Towards the end of your pregnancy things became a bit difficult. Why were you hospitalised, and why were your babies delivered early?
The first time I was hospitalised was due to the preterm labour and I had to get a cerclage (cervical stitch) put in to keep the babies from coming early. I was there until 22 December 2018. I was hospitalised again on 10 January 2019 due to Braxton hicks becoming too frequent and my womb being really irritable.
They had to stop my contractions and I remained in hospital until the birth. In the two weeks prior to the birth, my blood pressure crept up to a dangerous 160/110 and they detected protein in my urine. I felt very unwell, so the doctor decided it was time for me to deliver. I made it to 34w1d and while I wish I could’ve kept them in longer, this was the only way to keep all of us safe.
Q. You have a baby boy and girl – did they respond well in NICU, and when did they first go home?
Yes, my little prince and princess! They both were on CPAP for a few hours, and on room air the day after they were born. They were really only in there to learn the suck-breath-swallow reflex. My little man, Luke, came home on 22 February, so he was there for 20 days. My little girl, Olivia-Grace, only came home 20 March. It was so hard when they were separated, but we had a good trial run as parents with Luke being home.
Q. How would you say your experience in NICU differed from your children’s?
Things are much more advanced than when they were then. For one, our babies were given surfactant to help with their breathing, whereas in 1990 they just gave babies more oxygen, which could be harmful. Our babies were in such good care and I never doubted the abilities of the doctors and nurses. Every possible test was done on them and we were always kept up to date. They even made sure their vision was perfect before they were discharged, just to give us peace of mind. Technology is just that much more advanced.
Q. What were your thoughts about breastfeeding, and how was this journey for you?
No one tells you how incredibly hard breastfeeding is! It was so important for me to hand express the colostrum while they were in NICU to help with their health and immune systems (never have I had so many people handle my boobs!).
When I was in the maternity ward, I expressed every three hours, which was very tiring. I’d then waddle to the NICU on the other side of the hospital to bring my breast milk to my babies. It was so rewarding watching them being fed my milk by syringe.
It was difficult to keep up with the schedule, especially at 2am. I ate so much chocolate to keep myself awake and my friends would keep me company. I really gave it my all, but once Olivia-Grace was at home it became too demanding and I suffered badly from postpartum depression (and still do to an extent).
“I wish they’d told me how hard the first three months would be, that sleep becomes a myth and eating is a rare occasion – also, how many wet wipes and nappies you really go through is insane!”
I was at home on my own during the day and didn’t know how to juggle everything at the start. I had to make the difficult choice between my mental health or breastfeeding. I miss breastfeeding but my babies needed a happy, healthy mom so we switched to formula (Nan Optipro) and they are thriving. Initially, Livvy was on Novalac AR for her severe reflux, but she is now on Nan and Nexium – although we’ll start weaning her off the Nexium soon. It will be so much easier having both babies on the same formula!
Q. Why did you choose to name your children Olivia-Grace and Luke – is there any special significance there?
I wrote in my wedding vows to my husband that he could name our son Luke as Leon is a Star Wars fanatic. I loved the name Olivia. She was initially named Olivia-Zoe but I wasn’t fully sold on that and then Kirsten suggested Olivia-Grace, which has such a dainty, beautiful flow to it. I also recently found out that my maternal grandmother’s name was Olive, which was serendipitous.
Q. It’s early days yet with your babies being only five months old. Have you thought about what you want to do with the frozen embryos you have left?
That is such a big decision and something we’ve been discussing a lot. For now, they will remain frozen and in a couple of years, we will decide what to do. We may want more children by then, or we may donate them to a couple who is struggling to have a child of their own.
Q. What kind of support system do you have?
My mom is close by if I need her, but I am very independent. I go out on my own to the doctor and to run errands. Leon’s family is in Pretoria, which is a bit far for day-to-day help, but otherwise they are very supportive.
Q. Tell us about your maternity leave and when you think you’ll return to work.
I was on paid maternity leave since 4 February 2019. I had saved all my leave from last year and took an extra month in June, and then took July as unpaid leave. By the time I go back to work, my little ones will be six months old (4.5 months corrected). I love being home with my angels, but I do look forward to getting back into a work routine.
Q. Each baby is unique. What can you tell us about Luke that differs from his sister, Olivia?
My Lukie is such a smiley, happy boy! He kicks and jives all the time and has started to suck on his hands so much. His sister is the apple of her daddy’s eye and smiles whenever she sees him. She has nice “chats” with us, and little cheeky smiles where she sticks her tongue out at us. She is more chilled than her brother and takes in everything.
Q. How hands-on is their father? What does he do to give you some time out – and what do you do when you get that me-time?
Leon is an incredible father! Most nights he gets up to check if the babies are okay, and if they’re crying, he gets up to check. He constantly messages me throughout the day to find out how they are and loves playing with them. They give him the biggest smiles when he gets home. When I have my own time, I usually like to go out for a run to clear my head. On the weekends I’ll pop into the shop on my own and get what I need, or just to wander around.
Q. How has becoming a mother changed you?
I have become less selfish and put their needs before anything else. Motherhood has made me realise that the small things that go wrong really don’t matter. What is most important in life is family and having a loving household. They have changed me for the better, without a doubt.
Q. What do you wish people had told you about having a baby – and having twins?
No one tells you how difficult it actually is! I wish people had told me that your time is not your own anymore. You won’t be able to go out as easily, or as quickly. You won’t have that freedom to go out on date nights anymore or to the movies. You always have two little people that really need all your love and attention. I wish they’d told me how hard the first three months would be, that sleep becomes a myth and eating is a rare occasion – also, how many wet wipes and nappies you really go through is insane!
We had to really think about everything we bought, so most of our baby stuff is second-hand. We also looked at the longevity of the items so that we wouldn’t have to replace things too often. We did our research and shopped around for the best buys. For example, we started stocking up on nappies from my fourth month of pregnancy, and we had a nappy braai for Leon. We also took advantage of the specials at baby expos.
Q. Is there anything you would like our community to know that we haven’t covered?
I just want to tell people that there is no shame in accepting that you need infertility treatment. IVF brought us our two miracles and I would do it all again in a heartbeat if we ever want more children. Also, having multiples is more fun than you may think. Yes, it’s difficult. Yes, my hands are full and yes, there are days when I have a good cry. But my heart is so full and I love being the best mom I can be for them. I love going out with our double pram and having strangers ask me questions. It makes life so interesting – they make life interesting.