Chances of Twins After Miscarriage: How Fertility Is Affected

| Reviewed By Amanda Lundberg, BSN, RN

There is no proof to substantiate the statement that the likelihood of giving birth to twins rises after experiencing a miscarriage.

However, there is some evidence that seems to support the idea that fertility may be slightly higher in the first few months following a lost pregnancy.

According to the National Institutes of Health:

“Data suggest that women who try for a new pregnancy within three months can conceive as quickly, if not quicker, than women who wait for three months or more.”

My close friend experienced not one but two miscarriages before celebrating the arrival of her twin girls.

When she suspected a direct correlation between the two losses and the subsequent double blessing, her doctor explained that while she was indeed blessed, the miscarriages had no influence at all on the successful pregnancy that followed.

The Chances of Twins After Miscarriage

Some people believe that you are more fertile in the few weeks to months following a miscarriage and are more likely to conceive twins.

There is no scientific evidence to back this claim. 

The odds of conceiving twins after a miscarriage are generally not influenced by the fact that a miscarriage occurred. 

The likelihood of having fraternal twins is primarily determined by factors such as genetics, maternal age, and family history of twins.

Identical twins form when a fertilized egg splits, and this event is completely up to chance.

If you explore various forums on the topic, you’ll come across many women who suffered a miscarriage before their twins were conceived.

However, the occurrence of a miscarriage itself does not directly affect the likelihood of having twins in subsequent pregnancies.

Hyperovulation After Miscarriage

A woman experiences hyperovulation when she releases more than one egg during ovulation.

Typically, hyperovulation is a genetic disposition, and having a miscarriage does not necessarily increase your chances of hyperovulating.

However, hyperovulation is always possible, and chances may be higher when your hormones and menstrual cycle are trying to regulate after a pregnancy loss. 

Your Odds of Hyperovulating

Hyperovulation, the release of multiple eggs during a single menstrual cycle, is not uncommon.

The likelihood of hyperovulation is influenced by various factors, including genetics, age, and ethnic background.

  • Genetics: Family history plays a significant role in hyperovulation. If a woman’s mother or grandmother, or if the woman herself, has a history of conceiving fraternal twins, there may be a genetic predisposition to hyperovulation.
  • Age: Women over the age of 30 are more likely to hyperovulate compared to younger women. As a woman ages, her body may produce higher levels of follicle-stimulating hormone (FSH), which can stimulate the ovaries to release more than one egg.
  • Ethnicity: The incidence of hyperovulation varies among different ethnic groups. Some populations, such as people of African descent, tend to have a higher rate of twinning, including fraternal twins.
  • Number of Previous Pregnancies: Women who have had multiple pregnancies may have a higher chance of hyperovulating. However, this is not a universal rule, and individual variations exist.
  • Body Mass Index (BMI): There is some evidence to suggest that women with a higher BMI may have an increased likelihood of hyperovulation. However, the relationship between BMI and twinning is complex and not fully understood.
  • Diet and Nutrition: Some studies have suggested a link between certain dietary factors and an increased likelihood of conceiving twins. For example, women who consume diets rich in dairy products may have a slightly higher chance of hyperovulating.

Hyperovulation Symptoms

While it would be nice to know if you are hyperovulating, there are no physical symptoms.

The only way to know that you are definitely hyperovulating is via ultrasound. 

How To Increase Chances of Twins Naturally

Unfortunately, there is nothing you can do (naturally) to ensure that you will conceive twins. Conceiving twins naturally happens one of two ways: 

  1. A woman hyperovulates, and two eggs are fertilized, resulting in fraternal twins
  2. A fertilized egg randomly splits into two, resulting in identical twins

Both of these are beyond any woman’s control.

Hyperovulation is often due to genetics, and having an egg split is something that happens by chance alone. 

With that being said, things such as increasing your folic acid intake, eating “hyperovulation foods,” and taking the birth control pill have all been said to boost your chances of conceiving twins.

Do these things actually work? For some, maybe, but there is no evidence to support that any of these methods truly lead to conceiving twins. 

Conceiving After Miscarriage

The time after a miscarriage is often a sensitive one emotionally, physically, and sexually.

Miscarriage can bring some real pain, fear, and anxiety that can leave couples struggling to figure out when, or if, they should start trying again.

However, if you are committed to trying to become pregnant, take comfort in the fact that most women who experience a miscarriage continue on to have a successful pregnancy. 

How Miscarriage Impacts Fertility

There is no evidence that supports the claim that having one or more miscarriages can make a woman more fertile in the long run.

There is, however, a study that suggests fertility may be higher within the first few months following a miscarriage.

The study shows that couples may be more likely to quickly conceive after a miscarriage if they try to conceive within three months compared to those who wait longer after the miscarriage. 

Conceiving After Miscarriage Tips

When you are ready to try again, there are plenty of steps you can take to support your efforts in trying to conceive and having a healthy pregnancy: 

  • Address any underlying health problems. Schedule a preconception checkup with your healthcare provider. If left untreated, conditions such as high blood pressure, diabetes, and thyroid problems can make it difficult to get pregnant. 
  • Focus on your health. Take time to focus on your diet and exercise habits. Maintain a healthy weight, and limit your caffeine intake. Each of these is a factor in getting pregnant and maintaining a healthy pregnancy. 
  • Discontinue unhealthy behaviors. Stop consuming alcohol, smoking, and using drugs. 
  • Try to reduce stress. Stress can interfere with the functioning of your hormones and ovulation. 
  • Track your ovulation. Use an ovulation predictor kit that tells women when they are most fertile.

Signs of Ovulation After Miscarriage

Symptoms of ovulation will be the same as they were before the pregnancy loss. Look for the clues to determine when ovulation is near: 

  • Stretchy, clear vaginal mucus
  • Cramping 
  • Slight increase in body temperature

You can also have an idea of when you are ovulating by tracking your menstrual cycle or using an ovulation predictor kit.

The timing of ovulation after a miscarriage can vary widely. 

Some women resume ovulation as little as two weeks after a miscarriage, but most women find that it takes about 4-8 weeks to ovulate after pregnancy loss.

Why Some Doctors Advise Waiting To Conceive After Miscarriage

While there is no perfect amount of time to wait before trying to conceive again, many healthcare providers encourage women to wait at least a few months to ensure they are emotionally and physically ready to support a healthy pregnancy. 

Physical Recovery

Depending on how far along a woman was when she miscarried, her body might need some time to recover.

It may take a few months for the uterus to recover and for the endometrial lining to become strong again.

This is especially true if she was several months into the pregnancy or suffered an ectopic pregnancy.

It may also take a few months for a woman’s hormones to regulate once again after her pregnancy.

If a woman’s body isn’t ready to support a pregnancy, she may experience a repeat miscarriage after she conceives again. 

Emotional Recovery

Medically, it is safe to conceive after a few normal menstrual cycles following a miscarriage if tests or treatments are not being done to determine the cause of the miscarriage.

However, there is emotional healing to consider as well.

Miscarriages can be traumatic and discouraging and can cause an emotional setback for many couples.

Some physicians may recommend that a couple wait until they have accepted their loss before attempting to conceive again. 

Multiple Miscarriages

If you have experienced more than one miscarriage, your doctor may recommend waiting until testing has ruled out a discernible (and often treatable) health factor, such as a hormone imbalance or an incompetent cervix. 

Waiting 3 Months After Miscarriage

Many physicians advise waiting about three months after a miscarriage before trying to conceive again.

This gives the woman’s body time to recover, reset, and have a few normal menstrual cycles before conceiving again. 

When You Are Most Fertile After Miscarriage

There is no evidence that suggests there is a time following miscarriage when a woman is “most fertile.”

The best time to conceive is when you and your partner feel physically and emotionally ready. 

However, there is one study that found a greater percentage of women conceived when trying within three months of an early (less than 20 weeks) miscarriage compared to those who waited longer. 

A husband stands behind his wife being supportive and offering comfort.

How To Reduce the Risk of Having Another Miscarriage

While it is important to work closely with your doctor, here are some general tips that may help reduce the risk of experiencing another miscarriage:

  1. Schedule a preconception appointment with your healthcare provider before trying to conceive. They can address any underlying health issues and provide guidance on optimizing your health for pregnancy.
  2. Adopt a balanced and nutritious diet that includes a variety of fruits, vegetables, whole grains, and lean proteins.
  3. Avoid smoking, alcohol, and illicit drugs as they can contribute to an increased risk of miscarriage.
  4. Limit caffeine intake. High levels of caffeine consumption have been associated with an increased risk of miscarriage.
  5. If you have chronic health conditions such as diabetes, hypertension, or thyroid disorders, work closely with your healthcare provider to manage these conditions before and during pregnancy.
  6. Minimize exposure to environmental toxins and hazards that may pose risks during pregnancy.
  7. Consider genetic counseling, especially if you’ve experienced recurrent miscarriages. Genetic counselors can assess the risk of genetic disorders and provide information about testing options.
  8. Achieve and maintain a healthy weight before pregnancy. Both underweight and overweight conditions can impact fertility and increase the risk of complications during pregnancy.
  9. Start taking prenatal vitamins with folic acid before conception. Folic acid is essential for the development of the neural tube in the early stages of pregnancy.
  10. Find healthy ways to manage stress, such as exercise, meditation, or relaxation techniques. Chronic stress may potentially impact pregnancy outcomes.
  11. Once pregnant, attend regular prenatal checkups. Early detection and management of any potential issues can contribute to a healthier pregnancy.
  12. Consult with your healthcare provider before taking any medications during pregnancy as some medications may pose a risk to the developing fetus.

How Soon Can You Get Pregnant After a Miscarriage at 5 Weeks?

Technically, you can get pregnant as soon as your next ovulatory cycle begins.

Most doctors recommend abstaining from sex for at least 2 weeks or until all bleeding has stopped to reduce the risk of infection.

Many women who miscarry at five weeks do not even realize they are pregnant and are experiencing a miscarriage. 

Because 5 weeks is a very early time to miscarry, it’s likely that there will not be much physical trauma that needs to heal, and it may be easier to get pregnant sooner.

When Does Miscarriage Risk Drop for Twins?

Miscarriage is a heartbreaking possibility for any pregnancy, but the risk is higher with the more babies you carry.

The chance of a twin miscarriage that affects both babies is 5-10%.

The majority of miscarriages, both twin and singleton pregnancies alike, happen during the first 12 weeks.

The risk drops significantly after the first trimester. 

Why Does Breastfeeding Increase the Chance of Twins?

Most people think you cannot get pregnant while breastfeeding. Surprise… you can! In fact, you may even get pregnant with two! 

While you are breastfeeding, your levels of prolactin and luteinizing hormone (LH) are higher.

Both have a direct effect on ovulation, and the combination may increase your chances of conceiving twins.