When Can Twins Be Seen on Ultrasound? (Plus Early Signs)

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The ideal time to detect twins via ultrasound is after 10 weeks, although it may be possible for your doctor to identify them sooner. Normally, doctors will wait until the 10-week point unless there are any potential complications.

According to the Cleveland Clinic, your first ultrasound is used to:

  • Confirm pregnancy and check for early pregnancy complications.
  • Determine your baby’s gestational age and due date.
  • Check your baby’s growth, movement, and heart rate.
  • Look for multiple babies (twins, triplets, or more).
  • Examine your pelvic organs and the amount of amniotic fluid.
  • Check the location of the placenta and the baby’s position.
  • Detect problems with your baby’s organs, muscles, or bones.

When Twins Can Be Seen on Ultrasound

Twins can show up on an ultrasound as early as 5 weeks into the pregnancy, but it’s also possible for an ultrasound to miss them before the 10-week mark.

It depends on the type of ultrasound and how the twins are positioned.

My twins were confirmed at my 10-week scan, and it was a complete surprise!

Twin Pregnancy Ultrasound 5 Weeks

Five weeks is very early to have an ultrasound, but your doctor may have reasons to ask for one.

It is possible to identify a twin pregnancy this early, though it can also be missed.

Twin Pregnancy Ultrasound 6 Weeks

Most ultrasounds will be able to see twins at 6 weeks if your doctor orders one this early.

Your doctor may have a hard time figuring out if your twins are mo/mo or mo/di this early, but di/di twins may be easier to recognize at this point since they have their own chorionic and amniotic sacs.

Twin Ultrasound 7 Weeks

At 7 weeks, your doctor usually can see twins on an ultrasound if they are in the right position, but it is possible for an ultrasound to miss twins at 7 weeks.

If one twin is positioned behind the other, then the ultrasound tech and doctor might not see him.

A twin may also be missed if there is a problem with the viability of one of the twins.

Twin Ultrasound 8 Weeks

By 8 weeks, an ultrasound should be able to confirm two babies in one womb.

You will probably be experiencing many other symptoms of a twin pregnancy by this point as well.

Twin Ultrasound 10 Weeks

You may not have an ultrasound until the 10-week mark. This is called the dating ultrasound and should help pin down a due date.

During this ultrasound, your twins should be easy to find and identify.

However, your doctor may not be able to tell you exactly what type of twins you’re having just yet.

Early Signs of Twin Pregnancy

You may feel a bit different when you’re pregnant with twins, but you will need verification from an ultrasound to be sure you are truly carrying two.

First 2 Weeks

You likely won’t notice pregnancy symptoms during the first two weeks, even if you’re carrying twins.

A pregnancy test will also not come up positive this early in most cases.

Unless you are receiving fertility treatment, you won’t likely have any reason to wonder if you’re pregnant this early.

Twin Pregnancy Symptoms at 4 Weeks

By week four, you may feel implantation cramps or experience implantation bleeding.

Though you probably won’t yet know you’re pregnant, fatigue and breast tenderness could clue you in to the fact that something is different.

Early Signs of Twins: 5 Weeks

Five weeks may bring a positive pregnancy test, a larger belly, and morning sickness that lasts throughout the day.

Since your body is carrying two babies, your pregnancy symptoms will be more intense than if you were only carrying one baby.

Additional Ways To Confirm Twin Pregnancy

Doppler ultrasound can be used to detect and monitor the fetal heartbeats.

In a twin pregnancy, the doctor may be able to identify two distinct heartbeats, confirming the presence of two fetuses.

Blood tests, such as the measurement of human chorionic gonadotropin (hCG) levels, may provide some indication of a multiple pregnancy.

Higher-than-average levels of hCG can suggest the presence of more than one fetus.

However, this is not a definitive method, and ultrasound is generally more accurate.

Ultrasound is the most reliable and commonly used method for confirming a twin pregnancy.

Early Pregnancy Ultrasound

A dating ultrasound may be performed when you are anywhere from 6-10 weeks along.

This ultrasound will confirm your pregnancy and give the doctor an idea of when your due date is.

If you’re pregnant with twins, that may be discovered at this very first ultrasound, and you may even be able to hear their hearts beating.

This early ultrasound is transvaginal, and you will be able to see where your babies are in your womb.

Depending on the type of twins you’re having, you will see one or two sacs, a membrane separating your twins, or nothing separating them at all.

Twin Pregnancy Ultrasound Schedule

Your specific situation will determine how many ultrasounds you have and when you have them.

However, you can expect to have ultrasounds more often if you’re carrying multiples, no matter what type you’re having.

If your babies are sharing a placenta, expect an ultrasound every two weeks from the 12th week and beyond.

Twins who each have their own placentas can expect a dating ultrasound, a 20-week ultrasound, and ultrasounds every 4 weeks after that.

When Do Twins Form?

Twins form during the earliest weeks of pregnancy before you know you’re pregnant.

An egg that splits and creates identical twins can split at different times in those early days, and that will determine whether the twins are mo/mo or mo/di.

Fraternal twins are formed when two eggs are released and are fertilized by two different sperm.

This also takes place in the earliest weeks of your pregnancy.

Factors That Increase Your Chances of Having Twins

Several factors can increase the likelihood of having twins.

While these factors may contribute to an increased chance of having twins, the occurrence of twins is still largely influenced by chance. 

  • Family History: A family history of twins, especially on the mother’s side, can increase the likelihood of having twins.
  • Maternal Age: Women over the age of 30 are more likely to release more than one egg during ovulation, increasing the chance of fraternal twins. This is because older women may have higher levels of follicle-stimulating hormone (FSH).
  • Number of Pregnancies: Women who have had multiple pregnancies before are more likely to have twins in subsequent pregnancies. This is believed to be related to hormonal changes that occur with each pregnancy.
  • Race and Ethnicity: Rates of twinning can vary among different racial and ethnic groups. For example, women of African descent are more likely to have twins than women of Asian descent.
  • Diet and Nutrition: Some studies suggest that women who consume a diet rich in dairy products may have a higher likelihood of conceiving twins.
  • Body Mass Index (BMI): Some studies have shown a correlation between higher BMI and an increased chance of having twins.
  • Fertility Treatments: Women undergoing fertility treatments, such as in vitro fertilization (IVF) or the use of fertility medications, have an increased risk of having twins.
  • Previous Use of Contraceptives: Some studies suggest that women who were using oral contraceptives before conception may have a slightly increased chance of having twins.

What To Expect With a Twin Pregnancy

Women carrying twins often gain more weight compared to those with a singleton pregnancy.

This is because there are two babies developing along with the extra amniotic fluid and placental tissue.

Twin pregnancies typically require more frequent prenatal checkups and ultrasounds to monitor the health and growth of both babies and are considered higher risk compared to singleton pregnancies. 

There’s an increased likelihood of complications such as gestational diabetes, preeclampsia, and preterm labor.

Due to the larger size of the uterus and increased weight gain, women carrying twins may experience more physical discomfort, including back pain, abdominal stretching, and difficulty breathing.

Some pregnancy symptoms, such as morning sickness and fatigue, might be more intense with a twin pregnancy due to the higher levels of hormones.

Women with twin pregnancies may need to pay extra attention to their diet and may require additional supplements.

Twins are more likely to be born prematurely (before 37 weeks). Preterm birth can be associated with a range of health challenges for the babies. 

While many women with twins deliver vaginally, there’s a higher likelihood of needing a cesarean section, especially if the babies are in a breech position or there are other complications.

Managing a twin pregnancy can be emotionally and physically demanding. Emotional support from family, friends, and healthcare providers is essential.

Difference Between Single and Twin Pregnancy Symptoms

You may know that your twin pregnancy is different from a singleton pregnancy just by the symptoms.

With a twin pregnancy, you can expect a larger bump to appear sooner.

You will also likely experience more extreme morning sickness and exhaustion due to increased HCG levels.

How Is a Twin Pregnancy Different?

If you are pregnant with twins, expect to see your doctor much more often.

You may also be referred to an MFM doctor to help manage your pregnancy if it’s considered high-risk.

When Will I Know if My Twins Are Identical or Fraternal?

Sometimes your doctor will be able to tell from an ultrasound if your twins are identical or fraternal, but that’s not always the case.

Your doctor will look at the number of amniotic and chorionic sacs, but that still doesn’t tell the full story of what type of twins you’re having. 

If your doctor can confirm that your babies are different genders, then you will know they are fraternal.

You may choose to have DNA tests if your twins are the same gender and your doctor can’t tell you for sure if they are identical or fraternal.