Abstract

Introduction: Twin births have always fascinated doctors, scientists and society, from their biological mystery to their public health implications. While carrying twins is exciting, demands extra care, a lot to learn, cope up and prepare for delivering, 4-6 weeks in advance of normal 40 weeks. Over the past few decades, the world has seen a quiet & significant rise in twin births. Most of this increase comes from fraternal twins, which are shaped by maternal age and medical interventions and not from identical twins, which remain steady at around 3-4 per 1,000 births. This article is an analysis of two such twin pregnancies in 2025, one from paternal side another from maternal side of the author over the past century. Both were from current couples from paternal side genetic history and with history using oral contraceptives for spacing after the first girls were born and second paras after 6-8 years. Author hypothesizing that first few cycles after stopping oral contraceptive pills is an additional risk for twin pregnancies “The frequency of multiple births has increased by about 33% since the 1980s, largely due to assisted reproductive technologies such as In-Vitro Fertilization (IVF), during which, multiple eggs can be used at the same time to maximize the chances of a successful pregnancy, leading to twin births. Other reasons are i) age at birth >30 years ii) familial trend or genetics and iii) Oral contraceptives known to prevent pregnancy, as there would be a high chance of conceiving twins due to numerous hormonal changes in the body during the first couple of cycle after stopping. The global twin birth rate is about 12-16 per 1,000 live births. The proportion of twin births in India rose from 0.9% in 1993 to 1.5% in 2021. Fraternal twins account for about 70% of all twin pregnancies whereas Identical twins account for 20-25% and multiple pregnancies to rest. Identical twins occur roughly 3 to 4 per 1,000 births worldwide.
Materials & methods: This article is prompted by two twin pregnancies, among nearly 100 couples followed by this author in the last one year supported by literature search.
Outcome: While the first case had age and contraceptive use as trigger factors, delivered in May 2025 and kids doing well. The second case has family history of twins, age and non-ART medicinal treatment for ovulation who is expected to deliver in January 2026.

Keywords:Twins; Dizygotic twins; Fraternal twins; Identical twins, Monozygotic twins; Chorionicity; Amnion city; Anemia; Blood transfusions; Pre-term delivery; Congenital anomalies

Abbreviations: LMP: Last Menstrual Period; TBR: Twin Birth Rate; IUGR: Intrauterine Growth Retardation; HDP: Hypertensive Disorders of Pregnancy; PPH: Post-Partum Hemorrhage; LBW: Low Birth Weight