bestoftwins

Jul 022012
 

Twins are a wonder of nature. There are basically two types of twins, defined by their genetic relationship: identical twins (monozygotic twins) and fraternal twins (dizygotic twins).
Contents:
Identical (Monozygotic) Twins
Fraternal (Dizygotic) Twins
Monozygotic vs. Dizygotic Twins

Identical (Monozygotic) Twins

Identical Twins

Identical Twins (Flickr: evilpeacock)

Identical twins came from a single egg that split into two. They’re genetically identical and (obviously) always the same gender. Early first trimester ultrasound scan can identify approximately two-thirds of monozygotic twins. Our own twins were mis-diagnosed at a second-trimester ultrasound as identical (they weren’t). This type of twins is rare, comprising less than 1% of pregnancies in the United States. The chance of having identical twins is double for couples undergoing assistive reproductive procedures, though it’s not clear why.

Because they share a genetic profile and usually grow up together, identical twins are often sought for twin studies in the psychiatric and biomedical fields. Obviously, though genetically identical, they are unique individuals with different personalities and occasionally differences in appearance or disease susceptibility.

Monochorionic and Dichorionic Twins

About 75% of identical (monozygotic) twins are monochorionic, meaning that they share the same placenta. Such twins are watched carefully during pregnancy, as their rate of mortality is four times that of a singleton baby. The remaining 25% of twins are dichorionic (each in a distinct placenta), which has a mortality rate of two times that of a singleton.

Monoamniotic/Diamniotic Twins

Most twins are monochorionic-diamniotic (abbreviated MoDi), meaning that they share a placenta but each have their own amniotic sac within the mother’s uterus. About one-fifth of MoDi twin pairs experience something called twin-to-twin transfusion syndrome (TTTFS), in which blood moves from one twin to the other while in the womb. This is a concern, because one baby usually has too little blood, and one has too much. At birth, the donor twin is usually smaller, with paleness, dehydration, and anemia; the recipient twin is larger with redness and elevated blood pressure. As long as the twin-to-twin transfusion is mild, both babies are expected to fully recover.

Monochorionic-monoamniotic twins (same placenta, same amniotic sac) are very rare (2% of twins) and have the greatest risk of mortality or birth defects.

Fraternal (Dizygotic) Twins

Fraternal Twins

Fraternal Twins. (Flickr: EtanSivad)

Fraternal twins came from different eggs and are siblings, but not genetically identical. This is the more common type of twin, representing about two-thirds of twin pregnancies. When conceived naturally, fraternal twins indicate that two eggs were released by the mother’s ovaries instead of one. The chance of having fraternal twins increases with age (when a woman’s cycle can become less regular), and certainly with certain types of assistive reproductive technologies. With IVF, for example, multiple embryos are usually inserted to increase the likelihood of success.

Like any other siblings, fraternal twins share about 50% of their DNA. They are also of interest for biomedical studies because they’re age-matched and usually grow up in the same environment.

Monozygotic vs. Dizygotic Twins

Sometimes, particularly in the medical and research communities, you might hear of twins referred to as monozygotic or dizygotic. These terms refer to whether or not the twins came from the same zygote (fertilized egg). Here is a diagram that illustrates the difference:

Monozygotic and dizygotic twins

The Two Types of Twins (Credit: umm.edu)

Monozyotic twins come from a single fertilized egg; dizygotic twins come from two.

Research on Twins

There is a significant amount of research conducted using pairs of twins, particularly genetic studies. Identical twins are of particular interest because they share the same DNA. However, there can be rare, subtle differences — occasionally a mutation may occur in one twin and not the other — and sometimes these may cause disease. Such discordant twins, as they’re called, are important because they have relatively few genetic differences so the cause might be easier to find.

Fraternal twins are also of interest to researchers because they’re not genetically matched (though they share 50% of their DNA), but they are the same age and usually share the same environment.

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Jul 012012
 

Having TwinsI’m part of a secret society, one that I didn’t even know about two years ago. Like most secret societies, it’s one that you only learn about after you’ve joined. It’s called The Twin Club. There’s just one admission requirement: having twins or multiples. You’ll be informed of your admission by someone you know who’s already in the club – a relative, perhaps, or a friend, or even a casual acquaintance.

Suddenly, you two share an important connection: You both will be raising twins.

For me, it was a distant and somewhat-older cousin who lived on the east coast. Unlike most of the cousins whom I saw every major holiday growing up, she and her siblings made rare appearances and had a different last name. And because I was more than a decade younger than her, I’m sure I offered little in the way of interesting conversation.

Induction: Having Twins or Multiples

But she did keep in touch with the family, and about eight years ago I was in the room when we got the call: my cousin was having triplets! There was a shout of shock and excitement, and very likely (for seasoned parents in the room) some thoughts of sympathy. She and her husband already had a daughter who was about to be joined by two brothers and a sister. They were adorable and I did meet them once or twice, but otherwise I didn’t give it much thought.

Then, about 18 months ago, we made our own proud announcement to the family: we were pregnant with twins. When word of this reached the east coast relatives, I received a long, touching, and very personal e-mail from my distant cousin about what a joy it is to have multiples and how happy she was for us. Hands-down it was the longest conversation I’d ever had with her. It was a side of her I’d never experienced.

It was my welcome notice to the Twin Club.

Benefits of the Twin Club

I would soon learn that the club has many benefits. You share an immediate close personal bond with any other parent of multiples. Because the pregnancy, birth, and first few months (or years) are extra-challenging, it’s like you’ve been in battle together with those other parents and grown closer because of it. Upon finding out that someone else has twins, you lock eyes with him or her and share a too-knowing smile. It doesn’t matter what type of twins you each have. You’re connected.

Because of this bond, we go to extra lengths for one another. We share twin baby gear that we no longer need. For example, a random co-worker of a distant aunt will suddenly offer you a free double stroller. She might not know you, but she’s heard of you, and she’s a club member. A server at a restaurant will approach and introduce himself or herself. You’ll get extra service at that restaurant. Both of these things happened to us in real life. Other benefits we’ve noticed:

  • Extra attention. You get noticed when you have a new baby, but you get fawned over when you have twins or triplets. Get ready for that. Everyone wants to know the twins’ names and if they’re identical.
  • Conversations with strangers. Everyone knows someone who is, has, or is going to have twins. You’ll hear about it from complete strangers.
  • Shared wardrobe. You might not appreciate it as much, but your little ones can share many (or if they’re the same gender, all) of their clothes, shoes, etc.
  • Sympathy, if not enough. People do recognize the challenges of raising twins and they really feel for you. You’ll get offers of babysitting, food, and lots of baby gear. Don’t be afraid to say yes – you can always pass these things on to others who might need it more, and no one’s feelings get hurt.

If You Don’t Have Twins…

Sorry, but you can’t be granted access to this exclusive club. There are lots who’d like to join, but the chances of having twins are about 3%. They know someone with twins, or want them badly. Maybe they even had siblings that were twins. We are pleased to have these invited guests from time to time, but they will never be full members of our little society. Not until they look at an ultrasound screen and see two heartbeats instead of one.