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The likelihood of having twins is higher in Bangladesh today than before. With more women having babies later on in life and more usage of infertility treatments, the number of twin births has shown an increase in twins born all around the world.
Twins happen naturally in about once in every 65 pregnancies. A couple is more likely to have twins if there are twins in the woman's family. Triplets occur naturally in 1 in 10,000 pregnancies, and quads are even rarer.
There are two types of twin pregnancy.

Identical twins

Identical twins (monozygotic) are the result of one fertilised egg (zygote) splitting into two separate cells. Each cell grows into a baby. Because they originally came from the same cell, the babies have the same genes. They are the same sex and look very like each other.

Non-identical twins
Non-identical twins are more common.
They are the result of two eggs being fertilised by two sperm at the same time. The babies may not be the same sex and will probably look no more alike than any other brothers and sisters.

Are you carrying twins?
You may suspect that you are carrying twins if:

• you are very sick in early pregnancy
• you seem bigger than you should be for your dates
• twins run in your family, or
• you have had fertility treatment

It is usually possible to find out if you're having twins through your dating ultrasound scan, which happens when you are 8-14 weeks pregnant.

You should now be told whether the babies share a placenta (meaning they are identical) or if they have two separate placentas (meaning they can be identical or not). If this is not determined, you should be offered another scan. One-third of identical twins have separate placentas. This occurs when the fertilised egg splits before implanting in the uterus, up to four days after conception.

What causes twins?

No one knows what causes identical (monozygotic) twins. It appears that all women, irrespective of ethnicity, have an equal chance of having identical twins and that the chance is approximately 1 in 350-400. Identical twins do not run in families.
Some factors more likely to make non-identical twins are:

• non-identical twins are more common in black populations
• the chance of having twins rises with age and is higher the more children you have already had
• non-identical twins run on the mother’s side of the family, but probably not the father’s

IVF (in vitro fertilisation) and assisted conception involve implanting multiple embryos. Therefore there is a higher chance of multiple pregnancies in IVF than natural conceptions. Women getting pregnant when they’re older is also a factor, as the rate of twins increases with maternal age. The rate of twins in pregnant women of different ages is:

• 6.3% in mothers under 20
• 21.7% in women who are 35-39 years old
• 56.7% in the over-45s

How can I tell if my twins are identical?

The most accurate way to tell if twins are identical is through a DNA test, which can be done after the babies are born. The placenta could also provide the answer. If your first ultrasound scan is done before 14 weeks, it should be possible to tell accurately the type of placenta your twins have. Otherwise the placenta can be examined after the birth. However, neither of these methods is foolproof.

All non-identical twins and one-third of identical twins have exactly the same type of dichorionic placenta. This is when each baby has its own separate placenta with its own separate inner membrane (amnion) and outer membrane (chorion). These types of twins are called dichorionic diamniotic (DCDA).

Two-thirds of identical twins have a single placenta with a single outer membrane and two inner membranes. These are called monochorionic diamniotic (MCDA). About 1% of monochorionic twins will also share the inner membrane. These are called monochorionic monoamniotic (MCMA).

All multiple pregnancies have a higher risk of complications, particularly premature birth. If your babies are identical it is recommended that you are scanned every two to three weeks from 16 weeks onwards and every four weeks if your babies are non-identical.

You may be advised to have a caesarean section and you should discuss this with your doctor, but it is your choice.

Feeding twins

It is possible to breastfeed twins and even triplets. You may find that a combination of breast and bottle feeding is best for you, particularly if you have triplets or more.

Myths about twins

There are many myths about twins. Here, we separate fact from fiction.

Myth: Twins run in families

Fact: There is no evidence that identical twins run in families. However, it is possible that a family could have a genetic predisposition to non-identical twins, probably due to the woman having a predisposition to releasing more than one egg each month when she ovulates.

Myth: Twins skip a generation

Fact: It is a common misconception that twins skip a generation in families. You may have heard, for example, that if your father is a twin but you're not, you're more likely to have twins yourself. There's no evidence to support this. However, some women may have a genetic predisposition to hyperovulation, where they produce more than one egg during a menstrual cycle. This makes it more likely that they will have twins. If this is the case, twins are just as likely to be born to each generation as they are to skip one.

Myth: Having lots of morning sickness means you’re pregnant with twins

Fact: Not necessarily. Although some mothers expecting multiple births report lots of morning sickness, other mothers who are pregnant with twins or more don’t experience any morning sickness. Some pregnant women have nausea and vomiting and some don’t, whether or not they’re carrying twins.

Myth: Twins speak their own secret language

Fact: Twins have an innate understanding of each other and, as a result, may speak in their own code. Also, because they spend so much time together, one may pick up words said wrongly by the other twin that they both understand, which can be perceived as a twin language by other people.

Myth: All pregnancies start out as twin pregnancies

Fact: It isn’t true that all pregnancies start out as twin pregnancies. However, thanks to early pregnancy scans, it has been discovered that more pregnancies than we thought do start out with two fertilised eggs.
It's possible that if you're scanned before 12 weeks, you'll see two foetal heartbeats and two foetal sacs, but one will have disappeared by the 12-week scan. This is because one of the embryos failed to thrive and it has been reabsorbed into the womb. This is referred to as vanishing twin syndrome and has no physical effect on the surviving baby.