IVF With Twins – Likelihood, Causes, Risks, and Options

| Reviewed By Kimberly Langdon, M.D.

When undergoing IVF, it is important to be aware of potential outcomes and risks. Among these risks is an increased chance of having twins.

Whether you are hoping to carry one baby or get pregnant with two, you should know what your chances of having multiples are before you start IVF treatment.

Are twins more common with IVF? Yes, twins are more common with IVF. In fact, about 30 percent of women who have IVF become pregnant with multiples. While that can mean triplets or beyond, most multiple pregnancies are twin pregnancies, and almost half of babies born by IVF are multiples.

To know why this number is so high and what makes women more likely to have twins with IVF, you have to understand the process. 

Twins and IVF – Understanding the Relationship

There are logical reasons for IVF leading to multiples. The process is tailored to give a woman the best chance of getting pregnant, but that sometimes means getting pregnant with more than one baby.

Since this comes with risks, doctors and researchers are looking for ways to decrease a woman’s chance of conceiving multiples during IVF.

IVF Twins Percentage

Women who undergo IVF are more likely to have multiple births. Research currently shows that 40 percent of babies born to moms who had IVF were multiples.

This means there were two or more babies born, and most of the pregnancies were twin pregnancies.

Does IVF Cause Twins?

The IVF process is what puts you at a higher risk of having twins.

Since you and your doctor will want to do everything possible to ensure the embryos take and lead to a pregnancy, more than one will likely be transferred.

If more than one egg is viable, then you end up pregnant with twins, triplets, or even more.

Multiple Embryo Transfer

When it’s time to transfer embryos, there are many factors that will help you and your doctor decide if you should have a single or multiple embryo transfer.

If more than one embryo is transferred, there is always a chance that you could get pregnant with multiples, and that comes with risks.

However, transferring more than one embryo can increase your chances of getting pregnant overall. 

Your likelihood of conceiving twins increases with each embryo you add. While it’s between 15-30% when two embryos are transferred, the percentage increases with each embryo. 

Elective Single Embryo Transfer (eSET) 

Elective single embryo transfer, also known as eSET, is when only one embryo is chosen for transfer. The primary reason for going with eSET is to minimize the risk of conceiving twins.

Many doctors see this as the more responsible option, especially if a woman is younger.

For women who are younger, this can be a great choice since their egg quality should still be good.

However, if only one embryo is transferred, you are putting your chances of getting pregnant in this one embryo, decreasing the odds for many women. 

Your chance of conceiving twins with eSET is 1-2%, much lower than transferring multiple embryos.

Human eggs being fertilized in preparation for IVF embryo transfer.

Can You Choose To Have Twins With IVF?

You can talk to your doctor about your desire for twins when you get ready to undergo IVF treatment. However, your doctor will advise you of the risks, and a decision will be made from there. 

Chances of Twins With IVF 2 Embryos

When two embryos are implanted, a woman has between a 15% and 30% chance of conceiving twins. This varies depending on when the embryos were transferred, the mom’s age, and the eggs’ quality. 

Can an Embryo Split After IVF Transfer?

An embryo can split after an IVF transfer, and this can result in identical twins. However, most twins that occur through IVF are fraternal twins.

Fraternal twins come from two separate eggs while identical twins come from one split egg. Your chance of having identical twins due to IVF does not increase as much as your chance of having fraternal twins.

IVF Twins: Risks and Potential Complications

While twins are a joy in their own way, a twin pregnancy comes with its own issues. Twin pregnancies are almost always considered high risk, and this can make the entire experience much more stressful.

Miscarriage Risks

Vanishing twin syndrome, where one twin is miscarried during the pregnancy, is a risk whenever more than one baby is in the womb.

However, there is a higher risk with IVF treatment, and this can negatively affect the baby who survives.

The surviving twin is more likely to be born early and to have a low birth weight.

Premature Birth

Many twin pregnancies do not make it to term. Over 60% of twins are born before full term, which is considered 37 weeks.

Depending on how early the babies are born, they may need extra care in the neonatal intensive care unit for days, weeks, or months.

Premature babies are also at higher risk for certain health problems, such as developmental delays and cerebral palsy.


With a twin pregnancy, you will likely have to have a C-section. C-sections carry higher risks for mom and babies than a vaginal delivery.

For mom these risks include excessive blood loss, infections, blood clots, and surgical injury.

Babies born via C-section are at higher risk for breathing problems and may suffer from surgical injuries.

Gestational Diabetes

If you’re carrying twins, your chance of developing gestational diabetes is higher.

Gestational diabetes may require you to follow a special diet and take insulin, and it can cause a load of other pregnancy problems. It can also affect the health of your twins.

High Blood Pressure

Carrying twins means having twice as much of a chance of developing high blood pressure. This can lead to premature birth, preeclampsia, and problems with the placenta. 

How To Avoid Twins With IVF

While you are at higher risk of conceiving twins with IVF, you can lower your chances by making more conservative choices when it comes to embryo transfers.

Don’t allow your doctor to implant multiple embryos if you are sure you don’t want twins.

Even with only one embryo, there is a slight chance you could end up with twins if the egg splits. However, this risk is very small. 

Related Questions: 

How Much Does It Cost To Have Twins IVF?

Though costs vary, receiving IVF can be anywhere from $12,000-$30,000 depending on how many embryos you have transferred.

If you become pregnant with twins, your entire pregnancy will cost more. Your pregnancy will be considered high risk and will require more appointments and monitoring than a singleton pregnancy.

Are IVF Twins Riskier Than Natural Twins?

There are risks with every twin pregnancy. IVF can carry more difficulties because of the process, so doctors definitely will be on the lookout for problems.

However, even twin pregnancies that occur spontaneously are risky. If your twins are sharing a placenta, the risks are even higher.

Closing Thoughts

While many people dream of having twins, knowing the risks of a twin pregnancy is important, especially if you are using IVF and transferring multiple embryos.

Work closely with a professional to make the best decision for your body.