Danesha Couch, from Kansas City, gave birth to twin daughters Delanie and Darla on June 17, two years and two months after she gave birth to her first set of twins.
Ms Couch had previously given birth to twin boys Danarius and Desmond on April 13, 2014 and twin girls Delilah and Davina on May 29, 2015.
Baby Desmond died only minutes after being born because of a placental abruption.
“It’s been pretty tough,” Ms Couch said of the loss of her child. “I tend to cry about it one minute, and then I am happy again. I do hope one day [Danarius] doesn’t tell me he feels empty and alone (without his brother).”
A few months later Ms Couch met her current partner and fiancee, Jeffrey Pressler, who fathered Danarius’ four younger siblings.
“It was a blessing,” she said, “my mum started calling me double trouble.”
All three sets of twins are fraternal and were conceived without fertility drugs and delivered by caesarean section, the mother said.
Dr Marjorie Greenfield, the obstetrics and gynecology chief at University Hospitals Case Medical Centre in Cleveland, Ohio, told ABC News that although Ms Couch’s situation was rare, having multiple sets of twins occurs partly for genetic reasons.
“It’s partly statistical and it’s partly genetic,” Dr Greenfield said. “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.”
“Having that hit three times gets unusual,” but not impossible, Dr Greenfield said.
“I was surprised on my second time because me and their dad were discussing it, jokingly,” Ms Couch told ABC News recalling when she discovered that she was carrying a second set of twins.
“When I got the news, I pretty much knew that we had to step up,” the Kansas mother said.
“I knew that I had to buck up and put on my big girl panties.
“It’s tough sometimes, but Jeff and I try my best,”Ms Couch told BBC.
“They are my top priority. They keep both of us awake all through the night.
“It’s tough enough to wake up and smile in the world at the moment. But as long as I know that my children are safe, I’m happy,”she said.