When a US mum was told she was carrying two babies again, she asked her fiance to pinch her in case it was a dream.
Danesha Couch had already given birth to two sets of twins in the past two years, and was amazed to hear it was happening again.
"I was surprised on my second time because me and their dad were discussing it, jokingly," Couch told US ABC News.
"I said, 'This is not happening right now. Pinch me.' [My fiance] pinched me, and it was reality."
Couch, 20, had given birth to her first twins, Danarius and Desmond, in April 2014. Sadly, Desmond died soon after birth because of complications during delivery.
She then welcomed twin daughters Delilah and Davina in May last year, and another set of twin girls, Darla and Dalanie, on June 17.
Couch, from Kansas, is engaged to the father of her second two sets of twins, Jeffrey Pressler. She told ABC that although twins don't run in their families, they each have lots of siblings.
"His mum had nine kids. My mum had 12 kids," she said.
Although Couch falls pregnant easily, she said the couple don't plan on having any more children in the near future.
"I feel blessed that I can even have babies," said Couch, who conceived her babies naturally. "When I talk to women that can't have kids, I consider donating my eggs. I would just have to speak with my spouse about it. I would be 100 per cent okay with it."
According to the stats, the odds of having three sets of twins is one in 88,000. However, obstetrics chief at University Hospitals Case Medical Centre, Marjorie Greenfield, said some women are more likely to have twins than others.
"It's partly statistical and it's partly genetic," Dr Greenfield told ABC.
"She probably doesn't release two eggs every single month, but there are people that are genetically prone to releasing two eggs. The way you get fraternal twins is by releasing two eggs. Identicals are not formed by releasing two eggs.
"If you release more eggs, therefore, you have a greater chance of having twins."
The family churns through 35 nappies a day, and Couch breastfeeds her newborns as well as spending $100 per week on formula for her 1-year-old daughters,