As a little girl, I was fascinated and astonished when my mom told me that her grandmother (my great-grandmother) had two sets of twins among her 11 children. The idea of having multiples seemed surprising and adventurous to me while I was growing up.

Giving birth to twins, triplets, or quadruplets felt like a blessing when I was a young girl, the same as winning the lottery. I had no idea back then that I, too, was going to hit one such jackpot. Although the number of women with multiple pregnancies has increased in the last few decades, conceiving twins naturally is still a rare phenomenon—it happens in about 1 out of 250 pregnancies. This rate increases with the introduction of fertility treatments and assisted pregnancy programs.

How do twins happen?

A twin pregnancy happens when a single fertilized embryo splits into 2 separate embryos or 2 separate eggs released by the ovaries get fertilized.

When a single egg is fertilized and then splits into 2, the result is MoMo twins (which stands for monoamniotic monochorionic twins—my jackpot), or MCDA twins (monochorionic diamniotic).

They are monozygotic twins who share the same placenta, look identical, and are of the same sex. As adventurous and tempting as the idea of having such twins may feel, this process is entirely natural, and no tricks or remedy can force the embryo to split into multiples.

However, the probability of twins can be increased by improving the chances of more than 1 egg getting released by the ovaries. When 2 or more eggs are released and fertilized, it boosts the chances of a twin pregnancy. These are called fraternal twins, who are non-identical and can be of the same or different sex.

How to get pregnant with twins

What are the odds of having twins? If you’re also one of those couples who go all mushy at the sight of a twin stroller in the mall or park, you must be wondering how to conceive twins.

There is no secret trick to winning the “two-in-one-go” jackpot, but still, many factors play a role in making this happen. There’s also age-old wisdom, home remedies, and suggestions on how to raise the chances of the ovaries doing extra work every month and releasing multiple eggs.

We’ll help you understand each of them and debunk some of the myths about twin conception.

1. Age: Women over 30 are more likely to release more than 1 egg in some of their cycles. This increases their chances of conceiving twins.
2. Family history and genes: Maternal family genes are believed to play a more significant role than a father’s family history. If the mother has a history of twins or is a twin herself, that helps conceive twins. Some believe twins skip a generation though no scientific study confirms it.
3. Diet: Some food types, like dairy or animal-based products, are said to boost the chances of a twin pregnancy. There is no evidence to back this claim, but it’s related more to the growth hormones found in meat and dairy products than the food itself. While a healthy and balanced diet is recommended to conceive and carry a healthy baby, no particular food type is a proven method for multiple pregnancies.
4. Breastfeeding: It’s also a prevalent belief that breastfeeding increases the chances of twin pregnancy, but no medical research or evidence supports it.
5. Height and weight: A study showed that women of heavier weight and larger size have increased chances of conceiving twins. While there’s no medical proof of this, it can be understood that weight in these cases means better nutrition, which helps in childbirth. However, this does sound ironic as being overweight negatively affects fertility.
6. Fertility treatments and medications: These can play a significant role in multiple pregnancies. According to the CDC, fertility treatments account for more than one-third of twin pregnancies in the US. Although I also underwent fertility treatment for more than 2 years, my twins are identical (MoMo twins), which is a natural process, and no procedure can make that happen.
   • Fertility treatments include drugs that boost ovulation and, at times, lead to the release of more than 1 egg by the ovaries. If sperms fertilize more than 1 egg, it will lead to a twin/multiple pregnancy.
   • Infertility patients receive fertility assisting hormones like follicle-stimulating hormone (FSH) and luteinizing hormone (LH) to improve the quality and quantity of eggs released every month. This can also lead to superovulation (drug-induced release of multiple eggs).
   • Fertility programs like in vitro fertilization (IVF) extract 1 (or more eggs) from women and fertilize them in lab dishes. The fertilized embryo is then implanted back in the woman’s body to establish a pregnancy. Doctors usually prefer fertilizing and injecting more than 1 embryo to ensure success. Therefore, treatments like IVF can lead to a pregnancy with twins or multiples.

Risks involved in twin pregnancy

It feels special to be in 0.4% of the world’s population who can create twin babies, but this privilege comes with complications and risks. While I did win a jackpot with my pregnancy, it tested my strength and patience at every step.

Some of the risks and complications of a twin pregnancy are:

• Severe morning sickness: Pregnancy symptoms are severe due to increased pregnancy-related hormones. This causes intense morning sickness and can sometimes lead to hyperemesis gravidarum. While I wasn’t diagnosed with hyperemesis gravidarum, my nausea and aversions persisted until the end of the 5th month.
• Preterm labor: I went into labor by the 36th week, and as my doctor said, a larger number of fetuses increases the chances of early delivery. While early labor occurs in 10% of singleton pregnancies, up to 60% of women pregnant with twins go into preterm labor.
• Bed rest during pregnancy: Twin pregnancies are considered high risk, and in many cases, mothers are prescribed bed rest for the majority of the pregnancy. In extremely high-risk patients, the bed rest can be extended to cover the entire term of the pregnancy, just like my doctor put me on bed rest for all 8 months of my pregnancy.
• C-section: Multiple pregnancies have a higher probability of C-section delivery, which means a longer recovery time for the mother and increased risk during labor and delivery.
• Preeclampsia: This term describes the condition where the mother’s blood pressure and protein levels shoot up. If the symptoms are severe, she can suffer a stroke, seizures, and other complications.
• Gestational diabetes: 5% of women suffer from gestational diabetes, and this number doubles for twin pregnancies.
• Other complications: In my case, there were gastrointestinal problems like severe heartburn and constipation, leading to hemorrhoids. Another complication with multiple pregnancies is postpartum depression.

The challenges involved are not only physical; it’s also emotionally exhausting to be constantly worried about complications and the well-being of your unborn babies. You are always anxious about the pregnancy and also life after delivery. With multiple babies, issues like time management and finances can also stress you out. This anxiety and worry can further aggravate problems such as high blood pressure, heartburn, and indigestion.

Final thoughts

I would highly recommend that every couple weigh all the pros and cons before working towards twin conception. Although no procedure guarantees a multiple pregnancy, it’s always better to be aware and prepared for what’s in store.