Frequently asked questions about multiple births
These are frequently asked questions about multiple births
How do identical twins happen?
Identical twins form when one egg has been fertilised by one sperm and the zygote splits into two. This happens at the very earliest stage of development, when the zygote is no more than a cluster of a few cells. … If this egg then splits into two, an identical twin pregnancy can result.
Is it true that giving birth to twins runs in families?
It’s not true for identical twins, but it is true for fraternal twins.
Unlike identical twins, who both come from the same fertilized egg, fraternal twins develop from two different eggs released at the same time. (Although they have the same birthday, fraternal twins are genetically no more alike than any other sibling.) The tendency to release more than one egg in a single cycle (hyperovulation) is a genetic trait that can be passed from mother to child.
Hyperovulation also happens for other reasons that have nothing to do with genetics. Women in their early 30s, for example, are significantly more likely than women under 20 to release more than one egg at a time. (This tendency starts to decrease after the age of 35, however.)
Contrary to widespread belief, twinning doesn’t skip a generation, although it may sometimes appear to when a son inherits the gene and passes it on to his daughter. A man who carries the gene doesn’t have a greater chance of having twins himself because his genes don’t affect his partner’s ovulation.
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By contrast, identical twins don’t run in families. The splitting of a fertilized egg seems to happen at random. A woman who is an identical twin is no more likely to give birth to twins than anyone else.
How to triplets come about?
Triplets
Triplets are three babies carried in the womb during a single pregnancy. Like twins, triplets and other higher-order multiples can be categorized by their zygosity. While many people are familiar with the terms “identical” and “fraternal” in describing multiples, and use these terms to define whether twins or triplets look similar, what they are really referring to is how the multiples form.
Monozygotic Triplets
It is rare for triplets to be completely monozygotic, meaning that all three children formed from a single egg that split three ways or splits into two and then one of the two splits again, ultimately resulting in three embryos with the same general DNA characteristics.
A monozygotic triplet pregnancy carries the risks of a monozygotic pregnancy with a shared placenta, plus the additional risks of a triplet pregnancy.
A pregnancy of this type is more likely to encounter problems such as pre-eclampsia, preterm labor, and even transfusion syndrome.
Because of the rarity, identical triplets often make headlines, for example when a monozygotic triplet pregnancy resulted after a single embryo was implanted in an in-vitro procedure. Allison Penn gave birth to Logan, Eli, and Collin in March 2008. Her doctors identified the situation as the only known case of a single embryo transfer resulting in triplets.
What are the Odds?
Research varies on the instances of monozygotic triplets. A 2012 case report of a healthy set of three identical triplet boys conceived spontaneously lists the incidence at 1 in 100,000 live births, with most of the reported cases conceived through assisted reproductive techniques. That paper noted that only seven other cases were known that were spontaneously conceived. A 2015 paper notes the rate of incidence of identical triplets is 100 times more frequent with assisted reproductive techniques than spontaneous conception but is still extremely rare.
Meanwhile, estimates seen in popular media range from between 1 in 60,000 and 1 in 200 million. This may be due to some numbers reflecting the rate of conceptions/pregnancies rather than with live triplet births.
Sources:
Gandham S, Ogueh O. Spontaneous Monochorionic Triplet Pregnancy With No Fetal Anomaly or Feto-Fetal Transfusion. BMJ Case Reports. 2012;2012(nov22 2). doi:10.1136/bcr-2012-007114.
Gurunath S, Makam A, Vinekar S, Biliangady R. Monochorionic Triamniotic Triplets Following Conventional in Vitro Fertilization and Blastocyst Transfer. Journal of Human Reproductive Sciences. 2015;8(1):54. doi:10.4103/0974-1208.153131.
Information compiled from internet sources: https://www.verywellfamily.com/identical-triplets-2447414
What to Expect When You’re Pregnant with Triplets
Pick Your Team
For starters, pick a good doctor and medical team. They’ll become your new best friends for the next few months.
Women pregnant with triplets should expect to see their doctor every two weeks, says Dr. Dimitry Zilberman, director of Georgetown University Hospital’s Prenatal Diagnostic Ultrasound Center.
This will continue until your fetuses reach 24 weeks. After that, it’s a doctor visit once a week to make sure everything’s OK until the birth.
Eating for Four?
That was the case for Rupal Shah when she was pregnant with triplets five years ago. She had acid reflux that left her unable to eat much. Her doctors told her to eat whatever she could tolerate and leave it at that.
Symptoms
In many respects, moms of triplets will have more intense symptoms during pregnancy. They’re more likely to feel exhausted and sense the growth within their bodies sooner.
Maria Damjan, a mother of 2-year-old triplets and a 4-year-old girl, says she felt her uterus expanding the day she found out about her triplet pregnancy. She remembers needing maternity clothes at week eight. That was about three months earlier than she needed them with her first child.
Many women also retain water, particularly in their ankles.
Water retention is normal. But it can also be a sign of preeclampsia, a life-threatening condition. That’s one of the reasons why doctors monitor multiple pregnancies so carefully.
Exercise
Zilberman says women who are carrying triplets can go about their regular daily routines, as long as they’re comfortable.
Exercise should be fine, but get your doctor’s approval first. Some women choose to wear maternity belts for extra support. You may need to take frequent breaks from activity.
“Listen to your body,” Zilberman says. “If you are short of breath or the movement is very difficult, go from running to biking or walking.”
“It helps to make the entire pregnancy comfortable and recovery faster,” she says. “That said, don’t overdo it. I was so bummed that I could no longer run, but I had to think about what’s best for the babies, not just myself.”
Bed Rest
Zilberman doesn’t recommend bed rest for the majority of his patients. But he admits that it’s a controversial topic among high-risk pregnancy doctors.
She spent the next 15.5 weeks on bed rest, and the final three weeks at the hospital. Two of her babies went home from the hospital with her. The third one stayed in the NICU for just a few days.
If you are considering undergoing IVF or another fertility treatment, talk to your doctor about the risks of delivering multiples before you get pregnant. About 20 percent of triplet pregnancies result in the delivery of one child with a major long-term handicap. Talk to your doctor about how you can stay healthy throughout pregnancy and delivery.
The Takeaway
Any pregnancy comes with its share of jitters. Considering the heightened risks, it’s no surprise that moms of multiples might feel especially anxious.
Two doctors recommended that Damjan reduce her pregnancy to one fetus, something she did not want to consider. Then she found a specialist. With careful monitoring, he told her that he believed she could carry three babies safely. His team became her champions, she says. She drew strength from their confidence.
Shah remembers getting aggravated during her pregnancy because of the physical discomfort. She did breathing exercises and listened to Indian hymns to relax.
“The best advice I ever got was to keep calm, relax, and enjoy the moment,” she says. “There’s a light at the end of the tunnel. It’s so worth it the minute you deliver and you see your children.”
Source: https://www.healthline.com/health/pregnancy/pregnant-with-triplets#4
How to have twins
The idea of having twins tends to polarise people. Some couples say they’d love the chance to parent two babies and others react in an entirely different way. If you are a twin or have twin siblings then your concept of the reality is likely to be very different to someone who’s never had anything to do with more than one baby at a time.
Are twins common?
Many reproductive experts believe that as humans we probably have more twin pregnancies than any of us are aware of. Technological advances have found that it is reasonably common for there to be more than one embryo conceived and implanted, but of these, only one is viable and survives.
How do twins happen?
If you are keen to increase your chances of conceiving two babies then it’s important to understand how twins are made.
There are two types of twins; identical and non-identical. Identical or monozygotic twins are formed when one egg is fertilized by one sperm which then divides into two separate embryos. Each shares exactly the same genetic components and identical genetic structures. Identical twins also share a placenta.
Non-identical or dizygotic twins form from two separate eggs being fertilised by two separate sperm. These twins are their own unique little individuals and share no more genetic composition than siblings with the same parents. Each baby in a non-identical twin pair will have its own placenta.
Another name for non-identical twins is fraternal; the other name for identical twins is non-fraternal.
What about twins in families?
Twins do run in families. But the genetic predisposition for having twins only applies to the mother. It is her family history which influences the chances of her having hyper ovulation.
Any woman can have identical twins and family history does not play a role with these.
What are the odds of having twins?
Currently in Australia 1.6% of all pregnancies result in multiple births and of these, 98% are twins. Naturally conceived twins occur once in around every eighty nine births. The majority of twins who are born are non identical and a result of two eggs being fertilised.
Some fraternal twins look very similar; others share some resemblance whilst the remainder may not even look the slightest bit related.
What will help boost my chances of having twins?
- Being older rather than younger helps. It seems to be a twist of nature that just before a woman enters peri-menopause, her ovaries start releasing more than one egg each month. This “fertility spike” is also influenced by a surge of oestrogen. Fertility research has proven that twin pregnancies are much more common in women who are over 35 years. But this only applies to non-identical twins.
- Have fertility assistance such as in vitro fertilisation or take fertility drugs. These stimulate the ovaries to support more than one ovarian follicle each month towards maturity. The result is that more than one egg is released.
- Pick your own genetics carefully! Though we all know this is impossible. But if you come from a family where non-identical twins are common then your family history and genetic endowment means that you’ve got a greater chance of having them yourself. But identical twins can occur in any family.
- Be of African/American heritage. Women from this ethnic background have a distinctly higher rate of twin pregnancies.
- Having been pregnant before. Women who have previously had a baby or two have a higher chance of conceiving with twins.
- Have a big family. This theory is based on pure maths; the more times you conceive the greater the likelihood of conceiving more than one baby.
- Get pregnant while you are on the pill. Difficult as this can be overall, there is a higher incidence of women conceiving with twins when they are on oral contraceptives.
- Try to conceive straight after you have stopped taking the pill. The theory is that for the first couple of cycles the woman’s body is going through a hormonal readjustment phase.
- Already have a set of twins. Because the likelihood of conceiving with twins again is higher in women who’ve already had them.
- Be heavier rather than lighter so that you’ve got a higher body mass index (BMI). Some researchers claim that a woman with a BMI of greater than 30 boosts her chances. But considering a healthy range during the fertile years is 20-25 and 30 would put you into the overweight/obese category then this is not a healthy recommendation.
- Taller women tend to conceive more twins. But there is nothing you can do about your height, other than blame your parents!
- Take a folic acid supplement before you conceive. The general recommendation for women who are planning to conceive is to start taking folic acid supplements one month before conception.
- Encourage your partner to eat some oysters. The urban myth about oysters being an aphrodisiac is not entirely without basis. Oysters are high in zinc and this helps with sperm production. The more healthy and mobile his sperm are, the greater the likelihood of being able to fertilise an egg or two. If he’s keen to take supplements, the recommendation for men in their fertile years is 14mg/day. Green leafy vegetables, cereals, bread, seeds and wheat germ are all excellent sources of zinc.
- Be a twin yourself. Mothers who are twins are more likely to have twin babies. There is no influence on the male partner’s side, only the mother’s. But it does seem that fathers may pass the twin gene onto their daughters for their future conception possibilities.
- Eat more yams/sweet potatoes. It is a fact that more women conceive with twins who live in areas where yams are a major component of their diet. It seems that a naturally occurring chemical component of the yams helps to support ovarian function.
- Keep breastfeeding your older baby or toddler. Women who are producing prolactin and breastfeeding are more likely to conceive with twins. Though some women do not resume regular ovulation and menstrual cycles for the entire time they are breastfeeding; this is very individual.
What’s fact and what’s fiction when having twins?
- The idea that conceiving twins skips a generation is not true. Although there can appear to be a pattern in some families of this happening, the odds of having identical twins is the same for every woman.
- Eating a diet which is high in dairy foods, milk and meat is said to help, especially at the time of ovulation. But there is no scientific evidence to support this.
- Alternative therapies do not increase the likelihood. There is no scientific evidence to support the theory that accupuncture, naturopathy, aromatherapy, chiropractic or flower essences increase the likelihood of having twins.
Source: https://www.huggies.com.au/childbirth/multiple-births/twins/how-to
