How to Increase Chances of Having Twins

By Dr (TCM) Attilio D'Alberto | Traditional Chinese Medicine Practitioner, Wokingham

"How can I have twins?" is a question I'm asked occasionally in clinic — usually by women with a family history of twins, or those who would welcome completing their family in one pregnancy. It's worth being honest from the start: the factors that genuinely increase the chance of conceiving twins are limited, mostly not within your control, and the most reliable methods (IVF with double embryo transfer, ovulation-induction drugs) carry significant risks. This page covers what the actual evidence shows, the small lifestyle and dietary levers, the role of TCM, and — equally important — the medical reality of twin pregnancies that anyone hoping for twins should understand before pursuing the goal.

On this page

1. Types of twins
2. Background twin rates
3. What actually increases dizygotic twin rates
4. Diet — what the evidence says
5. Assisted reproduction
6. TCM perspective
7. Twin pregnancy risks — the honest picture
8. Common myths
9. What does NOT influence twin rates
10. Sensible advice
11. FAQs

Types of twins

• Identical (monozygotic) twins — one fertilised egg splits spontaneously. Rate is approximately 3-4 per 1,000 births worldwide and is largely constant across populations. Random; not significantly influenced by maternal factors.
• Non-identical (dizygotic) twins — two separate eggs released and fertilised in the same cycle. Rate varies considerably by maternal age, ethnicity, family history and lifestyle. This is the type that can be influenced.

Background twin rates

• UK overall twin rate: approximately 16 per 1,000 pregnancies (1.6%).
• West Africa (highest natural rate): 18-30+ per 1,000 in some regions, particularly the Yoruba people of Nigeria.
• East Asia (lowest natural rate): 6-9 per 1,000.
• Maternal age 35-39: twin rate roughly double that of women under 25.
• With IVF: historically up to 30%; now closer to 10-15% with single embryo transfer policies.
• With clomid: 5-10% twin rate.
• With letrozole: 3-7% twin rate (lower than clomid).
• With gonadotrophin injections: 20-30% twin rate.

What actually increases dizygotic twin rates

• Family history of dizygotic twins on the mother's side — the strongest natural predictor. Genes that predispose to hyperovulation are inherited.
• Maternal age (up to ~37) — FSH rises with age and can stimulate multiple follicle development. After 37 the increase plateaus and reverses.
• Previous pregnancy — twin rate rises with parity (number of previous births).
• Height — taller women have slightly higher twin rates, possibly due to higher IGF-1.
• Weight (higher BMI) — modest increase in twin rate at BMI 30+, again likely IGF-1 mediated.
• Ethnicity — West African ancestry strongly increases twin likelihood; East Asian ancestry decreases it.
• Recent stopping of the contraceptive pill — small early-cycle bump in twin rate immediately after stopping the pill.
• Conceiving while breastfeeding — small increase, possibly hormonally mediated.
• Diet (modest effects) — see below.

Diet — what the evidence says

• Dairy consumption — observational studies show vegan and vegetarian women have lower twin rates than dairy consumers, attributed to bovine IGF-1 in milk. The size of the effect is modest.
• Yams (Dioscorea) — the West African yam contains phytoestrogens long thought to contribute to the high twin rate among Yoruba women. Less studied in Western diets.
• Folic acid — early speculation that high-dose folic acid increased twin rates has not been confirmed in trials. Standard preconception folate doses (400 mcg) are safe and recommended.
• IGF-1-rich diet — overall protein-rich, growth-stimulating diets are associated with slightly higher twin rates.
• Cassava (West Africa) — also implicated as a phytoestrogen source.

None of these dietary factors approach the strength of genetic, age, ethnic or assisted-reproduction effects.

Assisted reproduction

• IVF with double embryo transfer — historically 30%+ twin rate. Most UK clinics now favour single embryo transfer (SET) due to multiple-pregnancy risks; HFEA policy has driven multiple-pregnancy rates down significantly.
• Clomid (clomiphene) — 5-10% twin rate. Sometimes used for women who specifically want twins, though this is controversial and not standard practice.
• Letrozole — 3-7% twin rate; lower multiple risk than clomid, often preferred.
• Gonadotrophin injections (FSH stimulation) — 20-30% twin rate; require careful monitoring to avoid OHSS and high-order multiples.
• IUI (intrauterine insemination) — twin rate depends on ovarian stimulation used.

Important: UK fertility clinics generally do not provide assisted reproduction with the goal of producing twins, because of the substantially higher maternal and neonatal risks.

TCM perspective

In Chinese medicine, the release of multiple eggs in a cycle relates to abundant Kidney jing and yin nourishing the follicular phase. Women with strong constitution, regular cycles, healthy AMH and good follicle development have a slightly higher chance of multiple ovulation. TCM treatment is not designed to induce twinning, but optimising Kidney yin, blood, and qi creates the best possible conditions for follicle development. This means the eggs that are released are higher-quality, regardless of number.

Some women also report that after a course of TCM they have ovulated multiply — confirmed on scan or by elevated day-21 progesterone. This is not the goal but is a known outcome in some women whose Kidney jing has been substantially restored.

Twin pregnancy risks — the honest picture

Twin pregnancies are higher-risk than singleton pregnancies in nearly every measured outcome. Anyone considering increasing their twin chances should understand:

• Premature birth — over 50% of twins are born before 37 weeks; 12% before 32 weeks (compared with 7% and 1% for singletons).
• Low birth weight — far more common.
• Gestational diabetes — twice as common.
• Pre-eclampsia — three times more common.
• Caesarean section — much more likely.
• Postpartum haemorrhage — more common.
• Twin-to-twin transfusion syndrome — affects monochorionic twins; serious and sometimes fatal.
• NICU admission — common.
• Maternal mortality — slightly increased.
• Perinatal mortality — significantly increased compared with singletons.
• Cerebral palsy and developmental issues — higher rates due to prematurity.
• Maternal mental health — postnatal depression and anxiety more common.
• Practical demands — feeding, sleep deprivation, cost.

Common myths

• "Eating yams will give me twins" — exaggeration. The Yoruba twin rate is multifactorial; transplanting yams into a Western diet doesn't replicate it.
• "Folic acid causes twins" — disproven in trials.
• "Twins skip a generation" — myth. Twin genes are inherited like any other.
• "Twins run in the father's family" — paternal genetics don't influence dizygotic twin rates (only maternal hyperovulation matters).
• "Acupuncture causes multiple pregnancy" — there's no evidence for this.
• "Stopping the pill increases twins" — small effect, not reliable.
• "Vitamin D causes twins" — no evidence.
• "You can choose twins by timing intercourse" — no evidence.

What does NOT influence twin rates

• Father's genetics or family history.
• Sexual position or technique.
• Acupuncture treatment.
• Most herbal supplements (other than dietary IGF-1 effects).
• Time of day or month of conception.
• Most preconception vitamins at standard doses.
• Lunar cycles, astrology, prayer (although faith may help acceptance).

Sensible advice

• If you have a family history of dizygotic twins on the maternal side, your odds are already elevated.
• Optimise overall fertility — your chance of any pregnancy goes up, and twins remain a possibility.
• Don't use ovulation-induction drugs just to try for twins — risks outweigh the benefit.
• Don't rely on dietary tweaks — effect sizes are small.
• Take folic acid and standard preconception supplements — for healthy pregnancy, not twins.
• Understand twin pregnancy risks realistically before trying to influence the outcome.
• If you're using IVF, current practice strongly favours single embryo transfer for safety. Discuss with your clinic.
• Focus on a healthy pregnancy — that's the goal, whatever number arrives.

Frequently asked questions

How can I increase my chances of having twins naturally?

Realistically you can't increase them by much. The main natural predictors — family history, age (up to 37), ethnicity, height — are not within your control. Modest dietary effects from dairy and IGF-1 may exist but are not reliable.

Does dairy really increase twin rates?

Observational evidence suggests slightly higher twin rates in dairy consumers vs vegans, attributed to bovine IGF-1. The effect is modest and not reliable enough to recommend dietary change for this purpose.

Will folic acid give me twins?

No. Early speculation has not been confirmed in trials. Take standard preconception folate (400-800 mcg of methylfolate) for healthy pregnancy, not for twins.

Does maternal age increase twin chance?

Yes, up to about 37, then it reverses. Higher FSH in mid-thirties women can stimulate multiple follicles.

Is IVF the best way to have twins?

It produces the highest twin rates, but UK clinics now strongly favour single embryo transfer for safety. Most won't transfer two embryos just for twin preference.

Are twin pregnancies higher risk?

Yes, significantly. Premature birth, gestational diabetes, pre-eclampsia, low birth weight, NICU admission and Caesarean section are all far more common with twins than singletons.

Do twins run in the father's family?

No, for dizygotic twins only the mother's hyperovulation tendency matters. The father's family history of twins doesn't affect his daughter's twin chances directly.

For support with fertility and optimising your chances of healthy conception, contact me or book a consultation at my Wokingham clinic.

My Fertility Guide

Related reading: Getting pregnant after 30 | Getting pregnant with PCOS | Fertility

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