Ashley Adams and her husband, Andy, were shocked to discover they were expecting quadruplets in March.
The couple have been married for four years and were looking to start a family. After trying unsuccessfully for some time to conceive, Ashley underwent infertility treatments and received a double dose of Clomid, which often results in a multiple-birth pregnancy.
"When the doctors told us we were having quads, we were extremely terrified and ridiculously excited all at the same time," Andy said. "It was just unimaginable."
Ashley added, "I didn't know how to process it initially, but it felt like a blessing."
But their surprise turned to fear when doctors diagnosed 24-year-old Ashley with thyroid cancer four months into her pregnancy.
"We were pretty overwhelmed when we found out," Andy said. "We were lost and scared and didn't know what to do."
Doctors had discovered an abnormality in Ashley's thyroid during an ultrasound, and a biopsy diagnosed it as stage 1 cancer. The cancer had spread to her lymph nodes.
"It was scary to find out about the cancer and thinking about what could happen, but if I stressed out about it, the babies would feel it, and I could possibly go into labor even earlier," Ashley said. "Dying was not an option, and our doctors were so reassuring that we just held on to that."
Multiple-birth pregnancies are often complicated, said Ashley's doctor, Julie Scott, a high-risk obstetrician at the University of Colorado Hospital in Aurora. As a result, Ashley wanted to wait until after the babies were born at 30 weeks to undergo cancer surgery. She delivered one boy and three girls, two of them identical twins, on Aug. 26.
Her surgery, a seven-hour procedure that included a thyroidectomy and lymph node removal, took place a few weeks later and was successful.
Scott has seen thousands of patients, many with higher-order (three or more fetuses) pregnancies. She said it is not uncommon to diagnose cancer in pregnant women because that's often when they have their first extensive health examinations. What's scary is that the cancer may have been lying untreated -- and spreading -- for years.
"Ashley has probably had that cancer for several years, and it went undiagnosed, probably because with her young age," Scott said. "The doctors missed the warning signs."
According to the National Cancer Institute, thyroid cancers are a highly curable form of cancer, with an overall survival rate of 97.5 percent over a five-year period.
"In cancer -- which is always unfortunate -- Ashley is fortunate that she had a form of cancer that was slow-growing and wasn't going to be altered by the course of pregnancy and could be managed," Scott said.
The Adamses are now waiting for Ashley's test results to come back to determine a treatment plan. She may require a combination of both chemotherapy and iodine radiation, or just iodine radiation.
Either way, she and her doctors would like to postpone treatment for as long as possible -- without putting her health at risk -- so that she can continue to breast-feed the quadruplets.
Six weeks after her cesarean section and nearly one month after cancer surgery, Ashley is recovering and the babies are growing.
Wyatt, her son, is expected to come home from the hospital this week. Identical twins Samantha and Braelynn each weigh five pounds, and Rylie is the smallest of their girls, weighing in at just under five pounds.
They will remain in the University of Colorado Hospital until they are full term to make sure they can breathe on their own and there aren't any complications. The girls are expected to return home before Thanksgiving.
Andy said he is excited about the babies coming home and not at all intimidated by thoughts of four babies crying simultaneously, or of all the diapers to change.
The only fear that lingers is "having something happen to them and their health when there aren't a thousand nurses around," he said.
The couple said they are optimistic about what lies ahead for their family, but do they see more babies in their future?
Andy laughs and says, "I will tell you no more; she will tell you maybe. But it's definitely no for me."