Can IVF Lead to Twins or Triplets? Here’s What Parents Should Know

ByAnjali Gupta
Updated: 6 May 2025, 5:13 pm

Carrying more than one baby through IVF can feel exciting but also bring uncertainty. IVF, or in vitro fertilisation, involves the transfer of embryos into the uterus, often more than one, to improve the chances of pregnancy. This significantly raises the likelihood of twins, triplets, or more compared to natural conception. While this can bring joy, it also requires special attention and planning. Understanding why multiple pregnancies happen, what changes to expect, and how to care for yourself during this journey can ease anxiety and support healthier outcomes for both you and your babies.

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The possibility of having twins, triplets, or more can spark a range of emotions from joy and anticipation to anxiety and overwhelm. With IVF, the chances of carrying multiple babies increase due to the practice of transferring more than one embryo. While this improves success rates, it can also result in a more complex pregnancy journey.
In this article:

Knowing why multiples happen, what they could mean for your physical and emotional health, and how to navigate the challenges that come with them can help you feel better prepared. Whether you're planning treatment or already pregnant, a little foresight can make a big difference in how you experience and embrace this unique journey.

Why IVF Sometimes Results in Multiples

In natural conception, the odds of twins are quite low; about 1 in 70 pregnancies. But with IVF, those odds increase significantly, especially if your doctor transfers more than one embryo. The risk of twinning in IVF pregnancies is generally estimated to be between 20% and 30%, depending on individual factors like age, embryo quality, and transfer protocols.This happens not because IVF creates twins, but because more than one embryo is sometimes transferred to improve the chance of at least one implanting. Occasionally, even a single embryo can split into identical twins.With IVF, transferring two or even three embryos used to be more common in India. However, newer guidelines encourage single embryo transfers (SET) when possible, especially for younger women or those using genetically screened embryos. That said, the chance of multiples, especially twins, still exists.

How Common Are Twins, Triplets, or More?

Let’s look at the numbers. If two embryos are transferred during IVF, your chance of twins can rise to 25%–30%. Triplets and higher-order multiples (quadruplets, quintuplets) are rare, but not impossible. These often occur when three embryos are transferred, or when one splits into identical twins while another implants separately. While clinics are moving towards more cautious embryo transfer practices, older methods and patient preferences still make twin pregnancies fairly common.

Types of Multiple Pregnancies

Understanding what kind of multiple pregnancy you’re experiencing can help you and your doctors plan the right care. Whether you’re expecting twins or more, it’s useful to know how they come about. This also gives context for your prenatal scans, your risk level, and what kind of delivery may be safest. Twins
  • Identical (monozygotic): These occur when a single fertilised embryo splits into two. They share the same genetic material and are always the same sex.
  • Fraternal (dizygotic): These happen when two separate eggs are fertilised and implant. They may or may not look alike, and can be of different sexes.
Triplets and Higher-Order Multiples
  • Types and Combinations: These can be a mix of identical and fraternal sets. For instance, one set of identical twins and one singleton could form triplets.
  • Natural vs. Assisted Conception: Naturally occurring higher-order multiples are extremely rare. Assisted reproductive technologies significantly raise the chances, especially with multiple embryo transfers.

What You Might Experience

Being pregnant with twins or triplets can feel different from the start. You may notice:
  • A faster-growing belly
  • Stronger morning sickness
  • More fatigue and body aches
  • An earlier need to slow down work or physical activity
You’ll likely need more frequent check-ups, scans, and possibly medications to prevent early labour. You might be advised to rest more, especially in the third trimester. It’s normal to feel emotionally overwhelmed, too, especially if you were only expecting one baby.But remember: having multiple babies isn’t a medical emergency; it’s just a pregnancy that requires closer monitoring and more support.

What Are the Risks?

While most women with multiples go on to have healthy babies, the pregnancy is usually considered high-risk. That doesn’t mean something will go wrong, but your care team will be more vigilant. Some risks include:
  • Preterm birth: Most twins are born before 38 weeks; triplets often come earlier.
  • Gestational diabetes or high blood pressure: These are more likely when carrying more than one child.
  • Low birth weight: Multiples tend to be smaller and may require NICU support.
  • Increased C-section likelihood: Most twin pregnancies in India are delivered via caesarean.
  • Maternal fatigue and postpartum recovery: Looking after two (or more) babies after birth can be physically and emotionally draining.
It’s seen that mothers with IVF twins have a notably higher rate of pre-eclampsia and preterm deliveries compared to those with single babies. This is why it's important to plan your care team and the delivery hospital carefully.

What to Ask Your Doctor

If you’re about to start IVF or have just found out you’re pregnant with more than one, here are some helpful questions:
  • How many embryos are being transferred, and why?
  • What is the chance of multiples in my specific case?
  • What kind of pregnancy care will I need if I’m carrying twins?
  • What are my delivery options?
  • Can I breastfeed twins or triplets?
Don’t hesitate to bring up your concerns. Doctors today aim for singleton pregnancies through IVF, but they’ll explain if transferring two embryos improves your odds based on your age or history.If you’re already expecting twins, ask your obstetrician about rest, nutrition, and signs of early labour to watch for. Your body will give you signals. Paying attention and responding early can make a big difference.

Preparing Emotionally and Practically

Emotionally, a multiple pregnancy can bring unexpected worries: “Will I be able to care for two babies?” “Will they be born early?” “Do I need a bigger home?”These are all valid thoughts. Try to:
  • Talk to other parents of twins (online groups can help)
  • Involve your partner, family, or support system in care planning
  • Make a financial plan early; two babies can double the costs
  • Ask your hospital about NICU readiness, just in case
Remember, your feelings don’t make you any less excited or grateful. It’s okay to love your babies and still feel overwhelmed. Talking to a psychologist, especially one familiar with fertility journeys, can help ease your mind.

FAQs

  1. Can I request twins during IVF?You can express your wishes, but your doctor will balance them against medical safety. Twins come with higher risks, so most doctors transfer only one or two embryos after a thorough discussion.
  2. Do twin pregnancies always need a C-section?Not always, but most twins in India are delivered via C-section, especially in private hospitals. Triplets are almost always delivered surgically.
  3. Can I breastfeed both babies?Yes. With the right support, breastfeeding twins is possible. You may choose to supplement with formula, too, and that’s perfectly fine.
Disclaimer: Medically approved by Dr Rohan Palshetkar, Consultant IVF Specialist, Bloom IVF, Palshetkar Patil Nursing Home, Opera House