How to Have Twins: Tips for When You’re TTC

Whether you’re hoping for twins or are just curious, you may wonder about the likelihood of getting pregnant with multiple babies. The idea of having two babies at the same time is of interest to many people. This excitement can come from expanding families, the special bond between twins, or cultural reasons.

But did you know that having twins is relatively rare? They account for approximately 3% of live births in the United States. However, twin births have increased over the past 3 decades, likely due to people having children later in life and advancements in fertility. In fact, after 1980, the rate of twin pregnancies increased by over 75%!

It's essential to understand from the outset that while certain biological and medical factors can increase the likelihood of twins, there is no guaranteed method to achieve a twin pregnancy. It is sometimes a surprise of nature. This article aims to provide a clear, realistic, compassionate, yet science-backed overview of the factors that can influence the chances of having twins. So, what is the cause of twin pregnancy?

How Does a Twin Pregnancy Happen?

A twin pregnancy occurs when two fetuses develop in the womb simultaneously. This phenomenon is primarily categorized into two types based on their development: identical twins and fraternal twins. Understanding the difference is key to grasping the factors that might increase the chances of twins. 

• Identical Twins (Monozygotic): Formed when a single fertilized egg splits into two embryos, sharing virtually similar DNA. This occurrence is random and not influenced by external factors. This is why, when people ask “how rare are twins?” the answer is: it's an entirely random and uncommon event.

• Fraternal Twins (Dizygotic): Developed from two separate eggs fertilized by different sperm. They share about 50% of their DNA, similar to typical siblings, and their occurrence can be influenced by genetics, age, and fertility treatments. The odds of having fraternal twins are significantly higher if these influencing factors are present. 

Here's a comparison of identical and fraternal twins:

How to Have Twins? The Ethical and Medical Reality

When considering the possibility of having twins, it's essential to approach the topic with a clear understanding of the ethical and medical realities involved. While some fertility treatments can increase the chances of having twins, modern medical practices should prioritize the health and safety of both the aspiring parent and the potential children above all else.

In vitro fertilization (IVF) is a fertility treatment that involves fertilizing eggs with sperm in a lab and transferring the embryos into the uterus. Historically, multiple embryos were often transferred to increase pregnancy chances, leading to twin or higher-order multiples, which carry higher risks. About 40% of twin births are due to the use of fertility treatments such as IVF.

Most reputable fertility clinics now follow "single-embryo transfer" (SET) protocols. This shift addresses the risks of multiple pregnancies, such as preterm birth and maternal complications. It is generally considered unethical and inadvisable to aim for a twin pregnancy unless medically necessary for specific infertility cases, making it less likely that your doctor will transfer multiple embryos during the procedure. However, certain natural factors could increase the likelihood of having twins.

Natural Factors That May Increase Your Chances of Having Twins

What factors increase the chance of twins, or what makes it easier to have twins? Twin birth can be influenced by factors that encourage the release of multiple eggs during ovulation, a process known as hyperovulation.

Other natural factors can increase the likelihood of conceiving twins. These factors include genetics, age, ethnicity, weight, and a history of previous pregnancies. Understanding these biological tendencies can provide hope and guidance for individuals seeking to ethically increase their chances of having twins.

Family History of Fraternal Twins

Are twins hereditary? It depends, as genetics plays a significant role in the likelihood of having twins, particularly fraternal twins. If there's a history of fraternal twins on the mother's side of the family, her odds of having twins are notably increased. For instance, a 2016 study found that two particular genes are strongly linked to increased odds of conceiving twins, with having one copy of each gene increasing a mother's chances by 29%. While a family history on the father's side doesn't directly increase his partner's likelihood of twins, a father who is a fraternal twin himself may be able to pass on the gene for hyperovulation to his daughters, potentially increasing their future chances of twins.

Being a Fraternal Twin Yourself

If you are a fraternal twin yourself, your chances of having twins are significantly higher than those of the general population. For women who are fraternal twins, the odds of having twins naturally can be as high as 1 in 60, compared to the average woman's 1 in 250. This strong correlation further underscores the genetic component of fraternal twinning.

Maternal Age Over 30

A woman's age has a significant impact on her chances of conceiving twins. Women over 30, especially those in their late 30s and early 40s, are more likely to have twins due to hormonal changes, particularly fluctuations in follicle-stimulating hormone (FSH) that can lead to the release of multiple eggs. 

By age 35, white women are three times more likely and African-American women four times more likely to conceive twins than younger women. While there is no guaranteed method to induce the release of two eggs, increasing maternal age and a genetic predisposition to hyperovulation can enhance the likelihood.

Higher Body Weight or Height 

Research indicates that taller and heavier women, particularly those with a BMI over 30, are more likely to have non-identical twins. While the exact reasons are unclear, it is believed that better nutrition or increased bodily resources may support hyperovulation, contributing to the chances of twins. However, intentionally gaining weight to increase the likelihood of having twins is not advised due to health risks.

Race and Ethnicity 

Ethnicity influences the likelihood of having twins, with varying twin birth rates among different racial and ethnic groups. Research shows that African populations have the highest twin birth rates in the world. In the U.S., Black women have a higher twin birth rate of 32.2 per 1,000 live births compared to White women at 31.0. Hispanic women have the lowest rate at 23.6. This highlights apparent differences among these groups.

Having Multiple Previous Pregnancies

Women who have had multiple previous pregnancies may also experience a slightly increased likelihood of twins. The more times a woman has been pregnant, the higher her chances of having twins with each subsequent pregnancy. 

Fertility Treatments That Can Lead to Twins 

Natural factors contribute to some twin births, but fertility treatments significantly increase the likelihood, with Assisted Reproductive Technologies (ART) accounting for about 40% of twin births. It's important to note that practices are evolving to prioritize single pregnancies due to safety concerns. If you want to increase your chances of having twins, fertility treatments are the most effective method, though current trends aim to limit this for health reasons.

Ovulation-Stimulating Medications

Fertility treatments often increase the chances of having twins, primarily through ovulation-stimulating medications like Clomid, Letrozole, and Gonadotropins. These drugs stimulate the ovaries to produce multiple mature eggs during a single cycle. If two or more eggs are fertilized, a twin pregnancy can occur. 

The chances of having twins range from 5-12% with Clomid and Letrozole to 20-30% with Gonadotropins, depending on dosage and individual response. For those trying to conceive, understanding and timing hormonal fluctuations is key, as releasing multiple eggs during ovulation can boost the odds of twin pregnancies.

The Mira Hormone Monitor, along with its Wands and App, is designed to track changes in hormone levels in urine, which is key to recognizing these hormonal patterns. By analyzing hormones such as the progesterone metabolite (PdG), follicle-stimulating hormone (FSH), estradiol metabolite (E3G), and luteinizing hormone (LH), women can gain a clearer understanding of their reproductive health.

Disclaimer: The Mira Hormone Monitor, Wands, Mira App, and BBT tracking tools are intended for fertility awareness and cycle tracking purposes only. These products are not intended to diagnose, treat, cure, prevent any disease, to diagnose or track pregnancy, or serve as a form of contraception. The information provided through these tools should not be used as a substitute for professional medical advice, diagnosis, or treatment. Individual results and cycle patterns may vary. Users should always consult with qualified healthcare providers regarding fertility, conception, and reproductive health matters.

IVF and Embryo Transfer Practices

IVF increases the chances of having twins, as multiple embryos are often transferred to boost pregnancy rates. If two implanted embryos develop, a twin pregnancy occurs. However, recent guidelines from the American Society for Reproductive Medicine (ASRM) have shifted the focus toward SET to reduce the risks of multiple births.

Clinics now assess patients to determine the optimal number of embryos to transfer, prioritizing SET for low-risk cases, which slightly reduces the likelihood of twins but improves overall outcomes for both mothers and babies.

Twin Rates and Risks With ART

About 40% of twin births in the US are due to ART, mainly from multiple egg stimulation or embryo transfers. However, with a shift towards single embryo transfer for safety, twin birth rates from ART are gradually declining. While ART can result in twin pregnancies, it is not the primary goal of fertility specialists.

If you're concerned about your fertility journey, the Mira Hormone Health Clinic can help. Specializing in fertility, our data-driven practitioners offer personalized coaching and guidance to help you optimize your reproductive health. Whether you're seeking to enhance your chances of having twins or navigating assisted reproductive technology safely and ethically, our team is here for you.

We offer support through hormone analysis, recommended lifestyle and nutrition changes, and strategies to optimize men’s fertility. Remember, there are no wrong questions, as our practitioners are dedicated to helping you understand your journey. While we provide valuable support, please consult your healthcare provider for medical advice, as we do not diagnose or prescribe treatment.

Unproven or Inconclusive Methods — What Doesn’t Really Work

Can you encourage your body to have twins? Amidst the scientifically supported factors that may increase the possibility of twins, there are numerous anecdotal beliefs and myths about how to have twins that lack robust scientific evidence. While these methods are generally harmless, it's essential to approach them with a critical perspective and understand why they are not scientifically reliable.

Folic Acid Supplements

Folic acid is essential for women of childbearing age to prevent neural tube defects. While it's vital for a healthy pregnancy, there is limited evidence linking folic acid to an increased likelihood of having twins.

Dairy-Heavy Diets

The belief that a high dairy intake increases the chances of having twins is popular but unproven. Research has not consistently supported a link between dairy consumption and twin births.

Breastfeeding at the Time Of Conception

Some anecdotal reports suggest that breastfeeding at conception may increase the chances of conceiving twins. However, a 2017 study and other research lack sufficient evidence to support this claim. While breastfeeding can delay ovulation, its effect on twin conception remains largely unproven.

Yams, Pineapple, or Other “Twin Superfoods”

What foods increase your chances of conceiving twins? There are no scientifically proven "twin superfoods" that increase your chances of conceiving twins. Foods like milk, yams, and pineapple are often cited as being beneficial for twin pregnancies, but there is no scientific evidence to support these claims. A balanced diet is crucial for fertility, but no specific foods can reliably induce a twin pregnancy.

Is a Twin Pregnancy Right for You? Medical Risks to Consider

While the prospect of a twin pregnancy can be exciting, it’s essential to recognize that it is generally a high-risk pregnancy requiring intensive monitoring and specialized care. Understanding the increased medical risks is vital before pursuing or hoping for twins.

Key risks include:

• Preterm labor and birth: Over 50% of twin pregnancies result in preterm birth (before 37 weeks), which can lead to various health issues due to underdeveloped organs.

• Low birth weight and NICU admission: Twins are more likely to weigh under 5.5 pounds, often necessitating NICU care ranging from a few days to several months.

• Increased maternal complications: Carrying twins raises the risk of complications like preeclampsia, gestational diabetes, anemia, excessive bleeding, and potential C-sections.

• Emotional and financial considerations: The challenges of raising two infants can lead to significant emotional stress and economic demands, including higher childcare costs and potential medical bills. 

Conclusion

Having twins involves a mix of biological factors and fertility treatments while prioritizing health and safety. Family history, age, and assisted reproductive technology can increase the chances of twins. Still, it's essential to understand that a twin pregnancy cannot be guaranteed. Due to the risks associated with multiple gestations, fertility and family planning should always involve consultation with healthcare professionals for the well-being of both the parent and child.

Frequently Asked Questions

How hard is it having twins? 

Having twins is often more challenging than raising a single child due to the increased demands on time, energy, and finances, as well as the need for more intensive care and planning.

How common are twins? 

Conceiving twins naturally is uncommon, with about 1 in 250 pregnancies resulting in twins. However, the overall rate has increased significantly to about 31.2 twin births per 1,000 live births in the US in 2022, mainly due to fertility treatments and women having children later in life.

Can you be pregnant with twins and not know? 

Yes, especially in the very early stages, as initial pregnancy symptoms for twins can often mimic those of a singleton pregnancy until a definitive ultrasound is performed.

Are there any early signs of twins? 

While not definitive, some women pregnant with twins may experience early signs such as more severe morning sickness, earlier and more pronounced pregnancy symptoms, or more rapid uterine growth compared to a singleton pregnancy.