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Multiple Births: Twins and Twinning

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In most mammals the litter size is fairly constant and is roughly correlated with, among other features, body size, gestation period, life span, type of uterus, and number of teats. For example, a large mammal with a normal pregnancy of more than 150 days, a life span of more than 20 years, a simple (or unicornuate) uterus, and two breasts rarely bears more than one young (a singleton) at a birth.

 

The great majority of primates, humans included, fit into this category; multiple births among them are exceptional and occur with decreasing frequency from twins on.

 

Twinning refers to the process that leads to the production of more than one offspring at one birth. In humans the most frequent type of twinning results in the birth of two babies (twins) at once, although repetition of twinning may lead to triplets, quadruplets, or other multiples of one.

The two major types of twins are identical twins and fraternal twins. Identical twins are two individuals that have developed from a single egg fertilized by a single sperm. This fertilized egg is called a zygote.

At a relatively early stage in its growth, the zygote splits into two separate cell masses which go on to become embryos; these embryos are genetically identical to each other and are always of the same sex. Three-fourths of such embryo pairs share a common placenta.

Since they both developed from a single zygote, such twins are called monozygotic (MZ) twins. A zygote’s atypical separation into two independent embryonic structures can occur at any of several growth stages. Its incomplete or late division into two cell masses results in conjoined twins, formerly known as Siamese twins. MZ twins usually show a striking physical resemblance to one another.

It should be noted that even though hereditary characteristics such as eye colour and hair colour and texture are the same in MZ twins, these traits as well as the majority of physical characteristics may be modified during embryonic development. Identical twins may therefore not truly be “identical”; the correspondence between such twins is closer to what would be expected between the right and left sides of a single individual, which vary slightly from one another.

Fraternal twins develop from two separate eggs that have been fertilized by two separate sperm. Such egg pairs stem from multiple ovulations in the same cycle. Each egg develops singly, is fertilized singly, and forms its own individual placenta.

Since fraternal twins develop from different zygotes, they are called dizygotic (DZ) twins. DZ twins may be of the same sex or of different sexes, and they are not genetically identical to one another. Fraternal twins bear the resemblance of ordinary siblings.

The occurrence of DZ twinning varies among racial groups: multiple births are most common among people of African descent, less common among those of European descent, and least common among people of Asian descent. DZ twinning is most common in older mothers (up to about 40 years of age) and tends to recur in families having a history of multiple births, indicating that a hereditary factor may be involved. MZ twinning, on the other hand, occurs randomly in all races and follows no discernible genetic pattern; it tends to occur more frequently in older mothers, however.

In the United States, Canada, and Great Britain about 1 out of every 83.4 births is a twin birth. Reported frequencies throughout the world vary from about 1 in 70 to 1 in 145 births; however, source records from many areas are unreliable.

In North America DZ twins are more frequent than MZ twins, the relative proportions being 71.8 to 28.2; similar proportions hold among other populations of European origin. Excluding the use of fertility drugs, approximate figures for the frequency of multiple births are 1 in 80 births for twins, 1 in 6,400 for triplets, 1 in 512,000 for quadruplets, 1 in 40,960,000 for quintuplets, and so on.

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Does Ivf Normally End In Multiple Births?

A large fear on people’s mind when it come to IVF is that of multiple births. Multiple births is when more than one child is born in one pregnancy and the rates of multiple births have risen since in vitro fertilization’s introduction in the United States in the early 1980s.

Having twins, triplets or even more children can be overwhelming for many new parents and their concerns are understandable. Parents who have only one newborn baby know it can be economically challenging, so having twins or triplets can take a toll.

Parents who feel ready for one child may feel overwhelmed to find that they will soon be responsible for raising two newborn babies instead of just one. Favorably, not all IVF have an outcome of multiple births. In fact, the success rate of IVF is around 10% to 20%, which is why numerous embryos are used in each cycle to help increase these success rates.

Using more than one embryo gives couples a greater chances of conceiving than if just one is used. The amount of embryos transferred to the uterus is limited, however, to help reduce the risk of multiple births. Some studies indicate, however, that babies born as a result of in vitro fertilization are 20 times more likely to be born as multiple birth babies. One study also shows that about 45% of babies born of in vitro fertilization are multiple birth babies.

It seems a bit odd to some that couples who struggle to get pregnant in the first place may be facing twins or triplets after a fertility procedure, but studies indicate that in vitro fertilization increases the chances of multiple births versus natural conception.

IVF is performed by combining sperm from a man and eggs from a woman in a dish in a laboratory. The embryos that result are then graded to determine which have the greatest chance of success and are then transferred to the woman’s uterus where they have the opportunity to implant and develop into a child.

Researchers and scientists are working to lower the number of multiple births by reducing decreasing the amount of embryos transferred to the uterus and generating innovative methods of determining which embryos have the best chance at success.

Infertile couples who are interested in possibly using in vitro fertilization to get pregnant are encouraged to seek further information about the procedure and their own chances of multiple births from a qualified fertility specialist in their area.

Treatment an ectopic pregnancy is different for every woman, depending on the size and location where the egg implants itself, and what type of pregnancy complications are involved.

Ectopic pregnancy is the leading cause of death amongst women in the first few months of their pregnancy period, so consult a doctor immediately, if you notice anything abnormal that may be symptomatic of an ectopic pregnancy.

The first stage in the treatment involves elimination of the dangerous non-viable intrauterine pregnancy, to minimize the risk for the mother. In this, the doctor always tries to protect future pregnancy prospects for the mother.

Complications include the reduced probability of further conception; however, this greatly depends on the extent of damage to the internal organs. Future pregnancies must only be planned after proper consultation with a doctor.

Treatment Options Include -

Non-invasive Chemical Method -

An early pregnancy that is ectopic in nature can at times be cured with a methotrexate injection that will dissolve the fertilized egg. This is advantageous for the mother, as it prevents scarring of the pelvic organs. Since ectopic pregnancies do not give rise to live births, look out for symptoms, so that an early treatment course can be undertake.

Surgery -

If the ectopic nature of your pregnancy is detected in the later stages, along with pregnancy complications, then surgery may be necessary. Nowadays, the less invasive laparoscopy surgery method is widely used in its treatment. If a woman’s fallopian tube has ruptured, then before pregnancy complications develop, an emergency surgery through an abdominal incision (laparatomy) may become necessary. In very few cases, the doctor is able to repair the damaged fallopian tube, which gets removed in most instances.

After the surgery, one needs close monitoring of her HCG (pregnancy hormone human chorionic gonadotropin) levels. If this level does not show a zero reading, then additional surgery may be required for any left out ectopic tissue.

Your chance of a future pregnancy depends on the place where you had the egg implanted. If both your fallopian tubes are intact, then the probability of a successful future pregnancy is about 60%. However, if you have had one ectopic pregnancy, then the chance of a second also increases. So, doctors always advise to be aware of the symptoms, so that early treatment is done.

Expectant Management -

In a few cases, treatment of an ectopic pregnancy may be done through expectant management. This involves close observation and constant monitoring, and no treatment is given. Expectant management is undertaken in very few cases, where it is anticipated that the it will automatically resolve. However, until the condition completely normalizes, the risk of a rupture always remains.Treatment of ectopic pregnancy no doubt exists, but, why don’t you try to prevent it and also cut down on certain risk factors. This can be done by avoiding multiple sexual partners, and also using a condom while intercourse. This will help avoid STD’s and reduce the chances of PIDs (pelvic inflammatory diseases).

Treatment Of An Ectopic Pregnancy