MICHAEL MOSLEY: These two divers appear to move as one.
That's because the two were once one.
This woman is expecting three babies.
For them to survive,
her womb must stretch to almost 1,000 times its normal size.
And these brothers are remarkable...
conjoined identical twins,
their fate decided before their mother even knew she was pregnant.
Their stories are part of your story,
the story of what makes you human.
You are the most fascinating creature ever to have drawn breath on this planet...
...and the reason lies under your skin.
Hidden deep inside you is a wonderful, dynamic world...
...where vast forests of cells capture light...
...where tiny movements trigger fierce electrical storms...
...and raging torrents of blood feed your brain.
This is a fantastic voyage through the most complex organism on Earth.
the human BODY
It all begins with your creation...
...and the unlikely sequence of events that led to your birth.
how life begins
We've used sophisticated imaging technology
to illustrate the latest medical research...
...revealing some surprising things
about what it takes to produce a new life.
We'll journey with millions of sperm
on their long and dangerous race towards the egg...
...see how trillions of cells self-assemble into a human face...
...and show why being here at all is against the odds.
We start with Diane
and the story of her improbable pregnancy.
- WOMAN: Right... - MAN: Ooh.
MAN: That's it. Good. (CHUCKLES)
- WOMAN: That's quite nice, actually. - MAN: Is it?
If I do that, it stretches my legs more.
You've got to stay like that as long as you can.
I know.
Diane got pregnant three times and all at once.
She's carrying triplets.
If you can hold the back of my calves
and then push my legs forward for me.
Unusually, Diane's body produced three eggs at the same time.
DIANE: "This relieves strain in the lower back,
opens the shoulders and strengthens the legs. "
When it came to the end of the scan, she said:
"Well, just before I show you the screen,
just to let you know there's more than one. "
So me and Mike said: "Oh, twins? That's lovely! "
She went: "No, no, there's three. "
I even said to her:
- "Are you sure? " - Yeah.
''Of course I'm sure, they're on the screen!''
DIANE: Just read it to me again.
The prospect of three babies came as a big shock.
- You burst out crying. - I started crying
for about 30 seconds solidly, hysterical crying.
And then it turned to laughter, hysterical laughter.
Mike had his head in his hands.
- Head in his hands! - He was like this.
It's incredibly rare for a multiple pregnancy like this one
to happen naturally.
All three babies are growing inside Diane
completely independently of each other.
Apparently, I released three eggs
and Mike, he had three separate sperm that fertilised all three eggs.
They've all got their own placentas and they're all in separate sacs,
so they've all got their own little bedroom. (CHUCKLES)
Producing three eggs in one go naturally is rare,
but it's even more surprising that all three were fertilised.
When a man ejaculates, he produces on average over 250 million sperm.
Enough, at least in theory,
to populate the UK, France, Germany and most of Spain.
There needs to be so many because getting sperm to egg
is fiendishly difficult.
The first hurdle comes immediately after sex.
Unless the time is right, the sperm will be trapped and die.
That's because, for most of every month,
the entrance to her womb is blocked by mucus.
For the sperm to progress,
they have to arrive when the woman is ready to get pregnant.
Timing is everything.
Once a month, the woman's body offers them a helping hand.
Hormones soften the mucus blocking the sperm's progress...
...ingeniously transforming it from a barrier into a chemical rope ladder.
Even so, it's tough going.
To make the climb, the sperm need to be fit and strong.
The deformed, the lazy and the dead are left behind.
Men produce an awful lot of sperm,
but they also produce an awful lot of duds.
Take this group of rugby players.
They're all fit,
healthy,
virile,
the perfect age for breeding.
They've each supplied us with a sperm sample.
Now they've a chance to see its quality up on the big screen.
- Sample 1. - Let's see it, let's see it!
- That one's going crazy! - (LAUGHS) That's a massive sperm!
- That is massive. - That's huge!
- Oh, it's got two tails! - Oh, it has got two tails.
Nice! Two tails!
Massive nose, they've all got big noses!
They're right.
Many of James's sperm are very strange-looking.
He has lots with two tails that can't swim at all.
As well as being deformed,
the majority of James's sperm seem reluctant to move.
Ooh, sample 1.2!
- Oh, ooh, hello! - Not many there.
That one in the middle, what's he doing?!
- Whose do you reckon that is? - I reckon that's...
Despite first appearances, Adam's sperm aren't much better.
Many of his are lifeless, lazy or directionless.
Adam! Who'd have thought?
That's surprising.
Hello! Here we go!
- This is a good one. - Good speed, good speed.
- I think this is yours. - They're very good.
- They're really going for it. - They're going for it.
Look at those lads go! Come on, boys!
- Good swimmers. - Pleased with that.
They are good swimmers,
but, sadly, many of them don't seem to know where they're going.
In fact, none of these guys has anything to worry about.
They are all perfectly normal.
Around 85% of the sperm that men produce are useless,
one reason we produce so many.
Though some men produce far more than others.
Oh, what? Monumental?!
- What does that mean? - Oh, my God!
Oh, my God! Oh, my God!
- It's pretty crowded. - I'm pretty all right with that.
Oli's sample, it has to be said, is impressive.
But however many you produce,
only 1% will make it from the vagina to the next stage, the cervix.
And there's no guarantee that any of them will survive for long.
Sperm are foreign to a woman's body and are treated as unwanted invaders.
Her immune system is triggered to kill them.
Once they enter the cervix,
they are in a labyrinth of dead ends.
Perfect for an ambush.
White blood cells attack the sperm from all directions.
By the time any survivors reach the safety of a Fallopian tube,
of the original 250 million, there could be as few as 20 left.
It might seem odd,
but it's actually an incredibly effective selection process.
And it clearly works
because humans can be extremely successful breeders.
I'm Christi Cason and I'm 39,
and I'm about to have a baby 14 months after my last one.
Christi's body had barely recovered from childbirth
when she got pregnant again.
Are you nervous, excited about this one?
DAVE: Yeah, I'm confident.
But, yeah, nervous too.
Christi has been getting pregnant almost yearly for the past 20 years.
CHRISTI: We also have Laura - two,
Morgan - three, Walker - five, Trevor - six,
Rebekah - seven, Emma - eight, Harper - ten,
Kaylee -11, Gage -13, Bailey -14.
Oh, my gosh!
Austin who's 16, Dalton - 18, Chad -19,
and Jessica who is 21.
MICHAEL: This will be Christi's 16th baby.
She's spent the majority of her adult life pregnant.
If you tot it all up,
Christi has been continuously pregnant for over 12 years.
It would seem that the only time Christi can't get pregnant
is when she is pregnant.
I mean, the furthest spacing is 22 months,
and our closest spacing is 13.
So you guys can go back and do the math.
Christi and Dave clearly love having children,
and for them, the more the merrier.
You try and...
when you're actually trying, you practise.
Right. He's all about practise.
Although Christi is currently pregnant with their 16th child,
she is already planning another.
I guess our family's just not complete yet.
In a little while, will I go, "I want to have another," you know?
Do the whole experience again.
And Christi might be surprised to learn just how much she's in control.
We have recently discovered a neat trick.
Women take charge of those few sperm who have survived the selection process.
One by one, they are lured into the soft walls of the Fallopian tube...
...and powered down.
They're alive, safe, but fast asleep.
The woman now has up to five days to supply an egg from her ovaries.
It's a clever system and it has to be
because, unlike sperm, eggs are in limited supply.
A woman is born with all the eggs she will ever have.
It's a strange thought,
but the egg that led to you started life inside your grandmother.
That's because the egg you came from
was first formed inside your mother's embryo
when she was developing as an embryo inside her mom.
When your mother was born, she had all her eggs already in place.
And one of them became you.
The precious egg that became you
was stored inside your mother's ovaries for decades.
Then, when its time came, it rose to the surface and ripened.
As soon as an egg is ripe it's released from the ovary...
...and gently wafted into the opening of the Fallopian tube.
Once the egg is ready and waiting,
it's time to wake up the sleeping sperm.
Sending out a powerful chemical beacon,
the egg guides the sperm towards it.
The sperm are now in a race to the finish.
They have come a long way, but there can only be one winner.
The competing sperm break off the cloud of cells that surround the egg.
They struggle to burrow in
until, finally, one pushes through the soft shell underneath.
This is a critical moment for the egg.
If a second sperm gets in,
the egg won't survive.
It must quickly protect itself.
Under the shell, tiny granules detonate,
hardening and making the egg impenetrable.
A new life is under way,
but the road ahead is long and treacherous.
Hello.
Diane is now 21 weeks into her pregnancy.
Oh, thank you for ringing. Things are going very well, thank you.
Today she's come with her partner, Mike, for a state-of-the-art 4-D scan.
All right, if you'd like to come through this way.
Afternoon to you. We're going to do a scan for your three babies, I believe.
It's a chance for them to see their babies clearly for the very first time.
There's quite a mixture of arms and legs to try and work out here.
Diane is having two boys and a girl.
- Oh, look. - Brilliant.
That's amazing.
SONOGRAPHER: So we can see baby...
Each of the triplets is in their own amniotic sac,
developing completely independently of each other.
SONOGRAPHER: A little ear coming round there.
They're all very close. (LAUGHS)
They are very, very close.
To get to this point,
the triplets already had to overcome some significant hurdles,
not least of which was going from one cell to two.
Within hours of fertilisation, the cell inside the egg divides in two.
Both of these then divide, making four cells.
Then eight,
16 and so on.
Except it's not that straightforward.
70% fail within the first six days,
before the woman even knows she's pregnant.
You made it against the odds.
Your cells managed to stay alive
and went on to create your body.
In some cases, on rare occasions,
one embryo becomes two humans.
Around one in every 250 early embryos will split...
...growing into near replicas of each other.
Identical twins.
- Ready? - Yeah.
Go!
This quirk of nature has given synchronised divers,
Helen and Carol Galashan, a distinct advantage.
Being an identical twin definitely helps with synchronised diving.
We don't really have to try with the synchronised part.
That part comes quite naturally to us.
The twins started out life as just one fertilised egg.
But some time in the first 12 days, their single embryo split in two.
Although they are identical twins, they aren't completely identical.
We actually think we're mirror-image twins.
Like we fold our arms the opposite ways.
Our hair parts the opposite way.
Even like when we're diving,
the first foot I put on is my right foot, Carol's is the left foot.
Identical twins actually come from one egg...
- That's split, isn't it? - ...and that splits into two
and non-identical twins from two eggs.
So the way we see it is like we were actually one person and then we split.
So we're like one person in two bodies!
Being an identical twin certainly has its perks,
but becoming one also has its risks.
Occasionally, the dividing embryo fails to separate completely.
Who the heck is that now?
Hello.
Brothers Ronnie and Donnie Galyon are a stark example of what can go wrong.
That guy's got heat!
The baseball-loving Galyon brothers
are the world's oldest living conjoined twins.
We're the Galyon Siamese twins.
My name is Ronnie.
Donnie.
Ronnie and Donnie grew from an embryo that started to split
but never separated entirely.
The brothers have been joined ever since.
Theirs is a condition that scientists are only now beginning to understand.
The dividing embryo must complete its split within two weeks of conception,
or it never will.
It's not a genetic condition.
What happened to Ronnie and Donnie could have happened to anyone.
- That's another hit! - Come on!
This is Jim, Ronnie and Donnie's younger brother.
The twins come from a large and otherwise physically unremarkable family.
This hospital here was called St Elizabeth back in the day.
It was actually St Anne's maternity ward on this far end here.
That's where Donnie and Ronnie and the other seven of us siblings were born.
Back in 1951, their mother didn't even know she was having twins.
JIM: Donnie came out head first and being pliable as newborn babies,
they were very flexible.
Ronnie was actually twisted and came out breech, feet first.
And it wasn't till they were halfway birthed that Dr Cord realised that...
RONNIE: He delivered twins.
He was delivering not only twins, of course, but...
Siamese twins.
We was born the shape of a 'U'...
Donnie was born head first. I was born feet first.
So he's 2 minutes older than I am.
The places where Ronnie and Donnie are joined together
were determined by which cells of their early embryo remained in contact.
That's better. That's better than going to Coney Island!
Ronnie and Donnie are joined from the chest to the groin.
They each have a heart, liver, stomach and their own arms and legs.
But they have to share a rectum, bladder and penis.
Their whole life depends on teamwork.
- Excuse me. - Go ahead, head in there. Do your thing.
This is my foot, this is my brother's foot.
It's called a leg, silly.
And this is his hand, this is my hand.
- Arm. Arm. - Same the other side.
And our bellybutton's on this side.
There's only one.
At 59 years old, Ronnie and Donnie are biological marvels.
Right now, they are the oldest known living set of twins in the world
and they're proud of that fact.
But they're going for the top record of the longest ever living.
Ronnie and Donnie are clearly extraordinary.
But when you realise what goes into building a human body,
it's remarkable that things go right as often as they do.
When your cells first began to multiply, they clustered randomly together,
but after the second week they began an astonishing transformation.
Every living creature on Earth goes through this.
It's called gastrulation.
It's easily seen in frog embryos.
The cells begin to self-assemble into a body.
This is the key moment when those individual little cells decide,
if you like, to become heart, brain, guts, or muscle.
It's a wonderfully elegant way of constructing life.
After three weeks of constant growth, you had a tiny beating heart.
Though you still looked very similar
to the embryo of any other mammal, bird or amphibian.
But by ten weeks, you looked unmistakably human.
You had developed your face.
It tells the world what you're feeling,
who you are and where you come from.
We've taken data from scans of a developing embryo
so we are able to show you for the very first time
how our faces don't just grow,
but fit together like a puzzle.
The three main sections of the puzzle meet in the middle of your top lip.
Sometimes, permanent gaps are left behind.
Around the world, one in 700 babies are born with what are called "clefts".
Here in India, they are all too common.
Plastic surgeon Per Hall is a volunteer, part of an international medical team
who have come to north-east India with the charity Operation Smile.
The team are here to put right where nature went wrong.
Can we have a look inside your mouth? Can you open up? Good girl.
Oh, that's really good. So the palate's normal.
OK, so it is just the cleft lip, and if you look at that,
the muscles just need bringing together.
You see how they bunch up there, waiting to come across into here?
The gap in Kamana's lip was left when the two sections of her face
failed to fuse in the womb.
And the condition can be much more severe.
All right, so she's got a cleft palate
that goes all the way through right to the back.
Eight-year-old Majoni has a cleft lip and palate.
This is more than just a cosmetic problem.
This is a functional problem for speech and swallowing.
She'll be able to say ''m'' and ''n'' and maybe ''g'' sounds,
but none of the sounds that you need your tongue to come forward
or to stop air coming out of your nose, will she be able to make.
So when she tries to talk, people will probably think she's a bit stupid.
But actually, she's not. She's completely normal intelligence.
Clefts are so common because, for the sections of the face to fuse correctly,
they must meet at precisely the right time in the womb.
For the palate, the time window is only a matter of hours.
See you tomorrow.
It's OK. It's OK...
In the next ten days, Operation Smile hope to perform 250 cleft operations,
and put right the numerous mistakes that nature has made.
Here's an example of how the face forms.
It's quite easy to kind of see the maxillary segments
or the ones that come in from the side.
And they're supposed to meet tissue that comes down from the nose,
the frontonasal process,
and this seam has just failed to happen.
Now, this tissue it's a bit like the keystone of an arch,
that should be locked into that, should be locked into this.
The way your face comes together
only really makes sense when you understand that,
strange though it may sound, we are actually descended from fish.
The side of your top lip, jaw and palate
started life as gill-like structures on your neck.
Your nostrils and the middle part of your lip
came down from the top of your head
as your eyes moved in from the side.
It is absolutely extraordinary that this all happens in the womb
some time between when we're the size of a grain of rice
or the size of a small chilli bean.
To repair a cleft,
Per will try to replicate what should have happened in the womb.
When the face comes together in an unborn foetus
there is no trace of a scar.
The plates of tissue and muscle fuse seamlessly.
Of course, it would have been a lot more sophisticated in the womb.
We're just kind of making a scar to join them together.
So that's that one done.
Per will return to check on Kamana's progress.
- She has the palate too? - She has a cleft palate, yeah.
It's OK, it's OK.
Majoni has lived with her clefts for eight years.
Today is the first step towards a new life.
PER: I can see the beauty there,
despite the fact that perhaps others can't see that,
because I know what she could look like.
They're always a bit bewildered the day after surgery.
There's all this kind of kerfuffle going on on the ward.
They've had a sort of... a night of soreness,
and then, you know, it's all a bit too much.
Hi, how are you?
Do you want to have a look at yourself in here? Can you see?
Who's that?
It's been a chance of a lifetime for Kamana.
Majoni had even worse problems.
Have you seen your face? Do you want to have a look?
Look! That's you.
Per has given her the prospect of a far better future.
Your time in the womb was an extraordinary partnership
between mother and child.
A partnership that was extremely one-sided.
When you were just a tiny cluster of cells,
you attached to your mother's womb.
Within weeks, you had tapped into her blood supply.
As you extracted nutrients,
you quickly grew into a recognisably human foetus.
From then on, it was all about growing bigger and bigger.
You took, your mother gave.
It's all gone mushy.
Diane is eating for four.
She's not finding it easy.
DIANE: Although I'm supposed to be eating a lot more,
especially in the third trimester,
I physically can't, because there isn't enough room.
At the moment I've got a real, big craving for milk
and I can easily get through two pints a day.
Spinach as well.
I'm loving anything vegetable at all. Spinach is my favourite.
MICHAEL: Diane's uterus has stretched to almost 1,000 times its normal size.
She feels fit to burst.
The funniest bit for me is watching them move.
It's mesmerising.
I think, at the moment,
triplet two and triplet three are aware of each other,
because they are head to head. They're literally there.
Triplet number one, I think he thinks he's an only child.
I don't think he thinks he's got brothers or sisters,
but he'll soon find out when they're all born and sharing a cot bed.
We humans nurture our babies inside the womb for nine long months.
This is a very risky thing to do.
As you approached birth, your mother's life was in great danger.
Humans die more frequently in childbirth than any other creature on Earth.
Having children is particularly dangerous here in Rwanda.
One in every 260 births results in a woman's death.
Come e take your photo...
26-year-old Nkosi' and husband Samuel are expecting their first child.
I'm about 4 monts pregnant.
I'm very happy, we are ready.
Like all humans, when the time comes,
Nkosi will find it difficult to give birth on her own,
but her closest maternity clinic is a two-hour walk away.
Today, she's making that journey to meet a visiting medical team.
They are bringing a form of technology that's never been seen here before.
It could save many lives.
Excited mothers-to-be have come from miles around
to be scanned and find out vital information.
Nkosi thinks she is four months pregnant.
But there's a surprise for her.
The head... the head circumference is 21 weeks, five days.
The measurements show that Nkosi is a month-and-a-half closer to giving birth
than she had guessed.
It's critical information.
Now she can make sure she's near help when her time comes.
By the time you were ready to be born,
your head had grown almost as big as your mother's pelvis.
A big head to house a big brain.
A brain that needs all the time it can get to mature.
But Diane's triplets will never reach full term.
They've now stretched her uterus as far as it will go.
Diane has gone into labour...
nine weeks early.
Over the last 12 hours she started to contract regularly,
and despite analgesics, we can't control those contractions,
and the cervix is now opening, so she's going into labour.
- D-day... C-day! - Yeah.
Having triplets greatly increases the dangers of childbirth,
and Diane's doctors have decided
to perform an emergency Caesarean operation.
There'll be quite a crowd in here,
so there's going to be three teams of neonatologists.
The babies will then go on an incubator round to the special care baby unit.
Diane and her triplets
will have the best care that modern medicine can provide.
It was a rough night.
I coudn't sleep.
Nkosi's labour started in the middle of the night.
It's about 5 in the morning.
We're ready to go to the clinic,
where my wife will have the baby.
Medical help is a two-hour walk away,
and Nkosi has no real idea how close she is to giving birth.
Relax your shoulders, so they're really floppy. Really slide your shoulders down.
She's got a spinal anaesthetic in, but they're also going to put an epidural in as well,
which will give her pain relief afterwards.
Are you all right? Comfortable enough? Not too cold?
- You're not cold? - No. I'm just shivering a bit.
Just cos of nerves, that's all.
- Here she is, the lady of the moment! - Sorry I'm a bit late!
Nkosi's only pain relief comes from the hormones her body is now producing.
But these hormones also bring on stronger contractions.
We've gone through 1/3 of way.
She must be exhausted.
We need to take a motorbike.
The race is now on to get Nkosi to the clinic before she gives birth.
There'll just be a bit of pulling and pushing now, OK?
- Yeah... - That's fine.
Lovely.
Thank you.
The final moments of childbirth are the conclusion of a nine-month journey.
It started with the coming together of an egg and a sperm.
There were many potential pitfalls on that long journey...
...but you beat the odds when many didn't.
Now, finally, it's time to come out and face the world.
Hello!
She's gonna bring him around to show you quickly.
Here we go, you two. Here he is. Isn't he beautiful?
He's another breech baby.
Yes?
Hello... Isn't he lovely?
This is the skinny minny.
Here she is. She's lovely. She's beautiful.
It's like I've won the lottery.
Born two months premature,
the triplets needed round-the-clock intensive care.
Baby Emma Iridikunda arrived home just two days after his birth.
Little Nathaniel is now the 16th Cason baby.
He will probably not be the last.
Now out of hospital, the triplets have made great progress.
It's astonishing that despite all the challenges
that go into creating a new human,
a third-of-a-million babies are born every single day.
- And you think she'll be the boss? - I think she will, yeah.
- Bossing those two around? - Yeah.
I think she'll be...
corrected for this release by: Tio Beto from Brazil
tiobetonh@gmail. com ... =Peace Through Anarchy=...