Can I have twins with IVF?

Patients who undergo IVF in North Cyprus want to ensure that they have the best chance of twin pregnancy on the first attempt. For this reason, our EuroCARE IVF fertility doctor may request multiple embryos to be transferred, which increases the chances of a twin pregnancy.

How does IVF work?

IVF is an advanced fertility treatment that involves collecting eggs from the female ovaries in order to fertilize them with the partner’s (or donor) sperm in our laboratory. The resulting embryos will develop for a few days in our lab, before being transferred to the womb.

Embryo Transfer 

The embryo transfer is the last step of the IVF treatment in Cyprus. Three to five days after the retrieval, an embryologist will identify the healthiest looking embryos using a microscope. Embryos are transferred on day 3 (cleavage stage) or day 5 (blastocyst stage) after fertilization. Embryo transfer on day 5 is also known as blastocyst transfer.

While anesthesia is generally not required, you might be given a light sedative if this makes you feel more comfortable with the procedure. During the embryo transfer, a pre-filled catheter will be passed through the cervix and into the uterine cavity. Embryos will be placed into the uterus along with a small amount of fluid intending to establish a pregnancy. The transfer procedure takes about 15-20 minutes.

Once the procedure is over, patients can have bed rest. You may experience very light cramping. The embryo(s) will begin to implant in the uterine lining within the next six to twelve days.

After the embryo transfer, our expert fertility doctor may prescribe medications to help increase the chances of conception and maintain a healthy pregnancy. The medications are often discontinued once a pregnancy has been confirmed and is producing adequate amounts of hormones on its own.

Who is IVF for?

IVF treatment is recommended for:

• Women suffering from endometriosis
• Couples with a genetic condition that can be passed onto the child
• Women with premature ovarian failure
• Women with blocked or damaged fallopian tubes
• Women with ovulation problems
• Women with polycystic ovarian syndrome (PCOS)
• Patients who are unlikely or have failed to conceive through IUI or other fertility treatments
• Same-sex couples and single women
• Men affected by infertility due to low sperm count or sperm motility
• Women with structural abnormalities of the uterus
• Women who have had their uterus or fallopian tubes surgically removed
• Individuals with a genetic disorder that affects their ability to become pregnant
• Unexplained infertility
• Secondary infertility

Getting Pregnant After 40

If you are over 40 and are struggling to conceive naturally, fertility treatment may be required. Here at EuroCARE IVF, we offer numerous fertility treatments to improve your chances of conception, including:

• IVF Over 40. IVF in Cyprus is possible if you can provide good-quality eggs for fertilization. After the age of 40, your ovarian reserve will be significantly diminished, and your fertility levels declined. However, there is still a chance you can provide a few viable eggs from which good-quality embryos may be created using ICSI (intracytoplasmic sperm injection).
• Tandem IVF. Tandem IVF is very similar to IVF in Cyprus. Tandem IVF involves fertilizing two sets of eggs, one provided by you and the other one provided by an egg donor. Donor eggs are fertilized simultaneously when your own eggs are fertilized with the sperm in our lab and are then cultured for a few days. The two sets of embryos are graded for quality, and the best ones are selected for transfer.
• Egg donation. Egg donation in Cyprus is an alternative option if you are over 40 and still want to build a family. Egg donation uses high-quality eggs provided by young, healthy donors who are between the ages of 21 and 28.
• Embryo donation. Embryo donation in Cyprus is another viable option for conception after the age of 40. During embryo donation, we use fresh donor eggs and fertilize them with frozen donor sperm provided by a reputable sperm bank. The resulting embryos are graded and selected for transfer.

IVF Twins 

There are two types of twins that may result from IVF in North Cyprus: dizygotic (fraternal) and monozygotic (identical). Identical twins are created by one fertilized egg that splits and develops into two babies with exactly the same genetic composition. Identical twins are more likely to be of the same sex (gender) and to share the same placenta while growing in the womb.

Fraternal twins, on the other hand, develop from two sets of eggs and two sperm cells. They are genetically different, just like two siblings born at different times. Fraternal twins may be of the same sex or one of each sex, and usually grow in separate placentas.

IVF Twin Pregnancy Rate

Around one in five IVF pregnancies result in multiple births. This is about 25% of IVF pregnancies. The chance of having twins through natural conception is 1 in 80 or 6% of pregnancies. With IVF, your chances of fraternal twins depend on maternal age and the number of embryos transferred.

The rate of identical twins is slightly higher in IVF pregnancies. It is still unclear why this happens, but scientists believe it has to do with embryo implantation. Identical twins occur in 1-5% of IVF pregnancies compared to 0.4% in natural pregnancies.

Identical Twins: Interesting Facts

• The reasons why an egg splits after fertilization are generally unknown.
• Identical twins do not run in families. Identical twins happen by chance.
• About a third of all twins are identical twins. Fraternal twins are twice as common as identical.
• Identical twinning for patients undergoing IVF is twice as frequent as with natural conception.
• Identical twins are unique individuals that share the same genetic makeup. They are influenced by the environment in the womb as well as other external and internal factors once they are born.

Fraternal Twins: Interesting Facts

• Fraternal twins are genetically similar to any other siblings. They share about 50% of the DNA of each parent.
• They can be conceived at different times. This is possible in cases of hyperovulation when multiple eggs are released, or with a short interval of a few days in between after conception.
• They may or may not look alike. They can have different hair color, eye color, and personalities. Sometimes, they may be so similar that they are assumed to be identical twins.
• Fraternal twins usually run in families. A tendency towards hyperovulation can be a genetic trait. The same gene responsible for hyperovulation may be passed onto the female child. Then, the daughter will have high chances of becoming pregnant with twins.

Getting pregnant with twins

The average length of pregnancy for a single baby is around 40 weeks. Gestation for twins, either identical or fraternal, typically lasts around 36-38 weeks. The increased demands on your body (no comma) and the inability of the babies to receive all the nutrients may cause twins to arrive early.

If you’re pregnant with twins, you’ll need a higher level of prenatal care. You will have more appointments and tests during your pregnancy including blood tests and ultrasounds. These tests allow your doctor to monitor the development of the babies and ensure a successful twin pregnancy.

Twin Pregnancy Early Symptoms

If you are pregnant with twins, you may notice some very early pregnancy symptoms, including morning sickness, fatigue, mood swings, breast tenderness, nausea, vomiting and constipation. High hCG levels are another early indication of a twin pregnancy.

Chances of having twins with IVF

Some factors that affect your ability to conceive twins include:

• A family history of twins. If twins run in your family, then your chances of conceiving twins (or multiples) are higher.
• Previous pregnancy. If you have been pregnant before, you are more likely to conceive via IVF in Cyprus, and therefore, have higher chances of a twin pregnancy.
• Age.  If you are over 30, you are more likely to have twins due to increasing FSH (follicle-stimulating hormone) levels.
• Body type. If you are tall and overweight, you are more likely to conceive twins than if you are short and thin.

Your chances of having twins will depend on several factors including previous pregnancies, family history of having twins, age, number and the quality of embryos per transfer, cause of infertility, etc. For example, a woman with a family history of fraternal twins using her own eggs is more likely to conceive twins during fertility treatments than a woman with no family history of twins. A young woman with high-quality eggs is more likely to conceive twins than a woman of advanced reproductive age.

The twin and multiple rates also depend on the number, stage of development, and quality of embryos that were transferred during IVF in Cyprus. If you conceive twins or more, good prenatal care will ensure a healthy, successful pregnancy.

Can I have twins with IVF?

The chances of having twins are higher through IVF. Depending on your personal circumstances, we may place more than one embryo into your uterus to increase the chances of a successful pregnancy. However, it’s still possible to have twins from having only one embryo transferred during your IVF treatment in Cyprus.

We grade embryos for their quality prior to the transfer. Embryo selection is done in two main ways:

Quality Assessment

After fertilization, embryos develop in our lab for a few days. During this time, embryos are assessed to determine which one has the best chance of implantation. Based on the results, embryos are selected and transferred on day 3 (cleavage stage) or day 5 (blastocyst stage) of development. You will discuss your options with our fertility specialist regarding the date and the number of embryos for transfer. The ultimate goal will be to transfer the right amount of high-quality embryos to ensure a positive pregnancy result. Extra good-quality embryos may be frozen using a technique called cryopreservation. Embryos are preserved and stored at the EuroCARE IVF clinic in Cyprus for future IVF cycles.

Genetic screening

• Preimplantation Genetic Screening – PGS in Cyprus is used to screen embryos for chromosomal abnormalities. Chromosome imbalance can increase the risk of miscarriage and birth defects.

• Preimplantation Genetic Diagnosis – PGD in Cyprus is used to screen embryos for specific single gene defects that are known to be carried by one or both parents. Only unaffected high-quality embryos are selected for transfer.

Can one embryo result in twins?

We can transfer one embryo if you want to minimize the risk of a twin pregnancy. However, even with one embryo being transferred, there are still chances to become pregnant with identical twins.

Some factors that may increase the chance of identical twins after single embryo transfer include using thawed embryos for transfer, using blastocyst embryos, and assisted hatching. Blastocyst embryos are embryos that have reached an advanced stage of development (blastocyst stage). Assisted hatching is a special technique that is used together with IVF in North Cyprus to facilitate the process of implantation in the uterine lining.  

At this point, it is difficult to determine whether a twin pregnancy has occurred due to single embryo transfer alone or as a result of multiple factors including single embryo transfer and sexual intercourse post transfer that results in another egg being fertilized at the same time.

Assisted Hatching and Twins

Assisted hatching is a technique used during IVF in North Cyprus to help embryos attach to the wall of the uterus post transfer. The technique involves making a small opening into the zona pellucida, a membrane surrounding the embryo, to facilitate the hatching and implantation into the uterine lining.

Assisted hatching may be performed if you are over 38 and have had multiple unsuccessful IVF cycles, or the resulting embryos have a distinctively thick zona pellucida (especially after embryo freezing), which makes it difficult for the embryos to implant.

Several studies found that assisted hatching may increase the chance of monozygotic (identical) twins up to four times. The technique can possibly cause an embryo to split into two identical parts around the time of implantation.

Reaching a twin pregnancy with EuroCARE

What are your chances of having twins via IVF in North Cyprus? If you would like to know more about your chances of having twins and the services we offer here at EuroCARE IVF, please connect with our friendly patient coordinators.