The likelihood of conceiving twins is a complex trait, meaning that it is affected by multiple genetic and environmental factors, depending on the type of twins. The two types of twins are classified as monozygotic and dizygotic.

Monozygotic (MZ) twins, also called identical twins, occur when a single egg cell is fertilized by a single sperm cell. The resulting zygote splits into two very early in development, leading to the formation of two separate embryos. MZ twins occur in 3 to 4 per 1,000 births worldwide. Research suggests that most cases of MZ twinning are not caused by genetic factors. However, a few families with a larger-than-expected number of MZ twins have been reported, which indicates that genetics may play a role. It is possible that genes involved in sticking cells together (cell adhesion) may contribute to MZ twinning, although this hypothesis has not been confirmed. Most of the time, the cause of MZ twinning is unknown.

Dizygotic (DZ) twins, also called fraternal twins, occur when two egg cells are each fertilized by a different sperm cell in the same menstrual cycle. DZ twins are about twice as common as MZ twins, and they are much more likely to run in families. Compared to the general population, having DZ twins is about two times more likely if a close relative (for example, a sister) has had DZ twins.

DZ twinning is thought to be a result of hyperovulation, which is the release of more than one egg in a single menstrual cycle. To explain how DZ twinning can run in families, researchers have looked for genetic factors that increase the chance of hyperovulation. However, studies examining the contributions of specific genes have had mixed and conflicting results. Few specific genes in humans have been definitively linked with hyperovulation or an increased probability of DZ twinning.

Other factors known to influence the chance of having DZ twins include the mother’s age, ethnic background, diet, body type, and number of other children. Assisted reproductive technologies such as in vitro fertilization (IVF) are also associated with an increased frequency of DZ twins.

Scientific journal articles for further reading

Hoekstra C, Zhao ZZ, Lambalk CB, Willemsen G, Martin NG, Boomsma DI, Montgomery GW. Dizygotic twinning. Hum Reprod Update. 2008 Jan-Feb;14(1):37-47. Epub 2007 Nov 16. Review. PubMed: 18024802.

Machin G. Familial monozygotic twinning: a report of seven pedigrees. Am J Med Genet C Semin Med Genet. 2009 May 15;151C(2):152-4. doi: 10.1002/ajmg.c.30211. PubMed: 19363801.

Mbarek H, Steinberg S, Nyholt DR, Gordon SD, Miller MB, McRae AF, Hottenga JJ, Day FR, Willemsen G, de Geus EJ, Davies GE, Martin HC, Penninx BW, Jansen R, McAloney K, Vink JM, Kaprio J, Plomin R, Spector TD, Magnusson PK, Reversade B, Harris RA, Aagaard K, Kristjansson RP, Olafsson I, Eyjolfsson GI, Sigurdardottir O, Iacono WG, Lambalk CB, Montgomery GW, McGue M, Ong KK, Perry JR, Martin NG, Stefánsson H, Stefánsson K, Boomsma DI. Identification of Common Genetic Variants Influencing Spontaneous Dizygotic Twinning and Female Fertility. Am J Hum Genet. 2016 May 5;98(5):898-908. doi: 10.1016/j.ajhg.2016.03.008. Epub 2016 Apr 28. PubMed: 27132594.

Monden C, Pison G, Smits J. Twin Peaks: more twinning in humans than ever before. Hum Reprod. 2021 May 17;36(6):1666-1673. doi: 10.1093/humrep/deab029. PubMed: 33709110. Free full-text available from PubMed Central: PMC8129593.

Painter JN, Willemsen G, Nyholt D, Hoekstra C, Duffy DL, Henders AK, Wallace L, Healey S, Cannon-Albright LA, Skolnick M, Martin NG, Boomsma DI, Montgomery GW. A genome wide linkage scan for dizygotic twinning in 525 families of mothers of dizygotic twins. Hum Reprod. 2010 Jun;25(6):1569-80. doi: 10.1093/humrep/deq084. Epub 2010 Apr 8. PubMed: 20378614. Free full-text available from PubMed Central: PMC2912534.

Shur N. The genetics of twinning: from splitting eggs to breaking paradigms. Am J Med Genet C Semin Med Genet. 2009 May 15;151C(2):105-9. doi: 10.1002/ajmg.c.30204. PubMed: 19363800.