Having twins or triplets can be an exciting prospect for many expecting parents. While the chance of conceiving multiples occurs naturally in about 3% of pregnancies, there are certain factors that can increase your odds. Understanding your family history, using fertility treatments, and making lifestyle changes can all boost your chances of having more than one baby. With thoughtful planning and working closely with your doctor, you may be able to tip the scales in favor of conceiving twins or triplets.
What factors increase the chance of having twins or triplets?
There are several factors that can increase a woman’s chance of conceiving twins or triplets naturally:
- Family history – Having fraternal twins runs in families. If you have twins in your family, especially on your mother’s side, you are more likely to conceive twins yourself.
- Ethnicity – African American and Latino women are more likely to have twins than Caucasian women.
- Age – Women over 30 have a greater chance of twins. The odds continue rising as women age.
- Having previously given birth – Women who have already had at least one child are more likely to have twins in subsequent pregnancies.
- Frequent pregnancies – Having pregnancies close together, less than 6 months apart, increases the chance of twins.
- Body Type – Taller and larger women have higher odds of twins.
In addition, taking fertility drugs or undergoing procedures like IVF can greatly increase your chances of conceiving multiples. Speak to a fertility specialist about your options.
How do fertility drugs boost the chances of twins or triplets?
Fertility medications work by stimulating the ovaries to release multiple eggs during ovulation, rather than just one egg. With multiple eggs available for fertilization, there is a greater chance that more than one will get fertilized and implant in the uterus. Some medications that can increase multiple births include:
- Clomiphene citrate – An oral anti-estrogen drug used for ovarian stimulation. Twins occur in 5-12% of pregnancies with this drug.
- Gonadotropins – Injectable hormones FSH and LH used for controlled ovarian hyperstimulation. Twins occur in up to 30% of pregnancies with gonadotropins.
- Human chorionic gonadotropin (hCG) – A hormone given to trigger ovulation. Used in conjunction with other fertility drugs.
Speak to your doctor about medication dosage when trying to conceive. Higher doses further increase the chances of multiples but also heighten the risk of complications.
How does IVF increase the chance of conceiving twins or triplets?
In vitro fertilization provides the highest chance for having twins or triplets. During IVF, eggs are fertilized with sperm outside the body in a laboratory, then transferred into the uterus. IVF boosts the chance of multiples through:
- Controlling the number of embryos transferred – Most commonly, two or three embryos are transferred, allowing for twins or triplets if more than one implant successfully.
- Fertility medications – Women take ovarian stimulating drugs during IVF to produce multiple eggs for retrieval. This allows multiple embryos to be created.
- Assisted hatching – A small hole is sometimes made in the outer shell of embryos to help them implant, increasing the chance of multiples.
- Culture media – Chemical solutions embryos grow in may encourage splitting into identical twins.
About 30% of IVF pregnancies result in multiples. Discuss with your doctor how many embryos to transfer – single embryo transfers lowering the risk of multiples but may decrease success rates.
How does IUI or a fertility drug regimen increase chances of twins?
Intrauterine insemination (IUI) and fertility drug regimens can also lead to twins by causing the simultaneous release of multiple eggs. Here’s how they boost your odds:
- Fertility medications – Oral drugs like Clomid or injectable gonadotropins are often combined with IUI cycles. As with IVF, these ovulation stimulating medications cause more eggs to mature and be released.
- Back-to-back IUIs – Some doctors recommend doing two or more IUIs in a row to increase likelihood of conception. This doubles or triples the chance of multiples if more than one egg gets fertilized.
- Donor sperm – Sperm from a young, healthy donor may be more likely to result in twins when used in an IUI cycle.
Overall, twins occur in about 10% of IUI pregnancies. Triplets or more are rare, in 1-2% of IUI pregnancies. Your doctor can help adjust medication doses and the number of IUIs to try for multiples while minimizing risk.
What lifestyle changes may increase chances of conceiving twins?
Certain lifestyle factors and dietary changes may help boost your odds of twins a bit. Some ways to potentially increase your chances naturally include:
- Getting to a healthy weight – Women within a normal BMI range tend to ovulate more regularly and release more eggs.
- Taking multivitamins – A prenatal with folic acid helps ensure optimal egg quality.
- Eating dairy – Some research shows women who consume dairy regularly are more likely to conceive twins.
- Consuming wild yams – Yams contain a natural hormone that may stimulate the ovaries.
- Having regular sex – Having sex every day during your fertile window can increase the chance of releasing multiple eggs.
However, no lifestyle change definitively results in twins. Work with your doctor on a healthy conception plan and be open to multiples if it happens naturally.
What are the risks associated with having twins or triplets?
While exciting, carrying and delivering twins or triplets can increase health risks for both mother and babies. It is important to be aware of these risks.
- Pregnancy risks: Preeclampsia, gestational diabetes, anemia, excessive bleeding, and miscarriage.
- Delivery risks: Preterm birth, low birth weight, emergency C-section, and postpartum hemorrhage.
- Newborn risks: Developmental delays, disabilities, respiratory issues, and higher infant mortality rates.
- Mental health risks: Increased rates of anxiety, depression and postpartum depression from challenges of parenting multiples.
Your medical team will monitor you and your babies closely during your pregnancy. Bedrest or reducing to twins maybe recommended depending on your situation. Knowing the risks allows you to make informed decisions about fertility treatments and preparing for multiples.
Can I naturally conceive twins if I already have a child?
Having previously given birth makes it more likely for a subsequent pregnancy to result in twins. This is especially true if your first child was conceived naturally. Here’s why:
- Higher FSH levels – Women who have carried a pregnancy already tend to have higher FSH or follicle stimulating hormone. FSH boosts the ovaries to mature and release multiple eggs per cycle.
- History of hyperovulation – If you released multiple eggs and conceived your first child naturally, your body may continue to ovulate abundantly.
- Shorter time to conceive – Women who have been pregnant before tend to conceive their next child more quickly, usually within 6-12 months. Quick conceptions are linked to hyperovulation.
However, age becomes a mitigating factor. As women get into their mid to late 30s, egg quality and reserve diminish even if they’ve had a child before. This can lower the chances of naturally conceiving twins. Talk to your doctor about your odds.
Can I increase my chances of identical twins?
Identical or monozygotic twins happen when one fertilized egg splits into two embryos. This is a rare, random occurrence that cannot be increased through fertility treatments. However, there are a few factors that make identical twins slightly more likely:
- Family history – Identical twins run strongly in families. If you have identicals in your family, you are more predisposed to having them.
- Age – Strange as it sounds, older women are more likely to conceive identicals than younger women.
- Ethnicity – African Americans have higher rates of identical twins than Caucasians or Hispanics.
- Prior delivery – Having previously carried a pregnancy to term increases odds of identicals.
- Conceiving while breastfeeding – Releasing eggs before menstrual cycles resume while nursing seems to increase the chances of identical twins.
But again, identical twinning cannot be planned for or prevented. It will either happen spontaneously or it won’t. Talk to your doctor if you have a strong family history of identicals.
When should I see a fertility specialist about conceiving twins?
Seeing a fertility specialist is recommended if:
- You are over 35 years old – A specialist can help identify and treat any barriers to conception, and help maximize your remaining fertile years.
- You have been trying for 6 months with no success if under 35, or 3 months if over 35 – A fertility evaluation can identify if you need assistance conceiving.
- You already have secondary fertility issues – Problems like PCOS, endometriosis or low sperm count may require medications or procedures like IUI or IVF to conceive.
- You want to get pregnant with twins – A specialist can review your history and recommend tailored fertility treatments for conceiving twins.
A reproductive endocrinologist has the knowledge and resources to provide individualized guidance on factors like your ovulation patterns, egg supply, genetic testing, and which fertility treatments can best help you successfully conceive twins within a reasonable timeframe.
Should I see a high risk pregnancy specialist if expecting twins?
Yes, seeing a maternal fetal medicine (MFM) specialist is recommended if you become pregnant with twins or triplets. An MFM has special training in managing higher-order multiples pregnancies. They will work closely with your existing OBGYN to provide enhanced monitoring and care including:
- More frequent ultrasounds to check each baby’s growth and development.
- Testing for risks like twin-to-twin transfusion syndrome for identical twins sharing a placenta.
- Consulting on nutrition, optimal weight gain and activity restrictions.
- Determining the best time and method of delivery of your babies.
- Providing steroid shots and arranging NICU care if early delivery is likely.
MFMs are familiar with unique risks multiples face and best practices for keeping mom and babies as healthy as possible. Taking a team approach with your regular OB, reproductive endocrinologist and maternal medicine specialist ensures the highest chance of the best outcome.
Conclusion
For couples hoping to conceive twins or triplets, there are several proven methods to increase your chances – from fertility drugs and IVF to lifestyle changes if trying naturally. While there are risks to multiples, working closely with your medical providers can help minimize those concerns. In many cases, the rewards of having twins or triplets far outweigh any additional risks or complications. If considering growing your family with multiples, your doctors can help you create a plan tailored to your unique fertility situation.