With the entrance of the “octo-mom” and several other multiple births, one does not have

to look very far to see that multiple births are on the rise. Every year there seems to be talk in the

news about a multiple birth in the United States. The increase has been met with high emotions on

morality and ethics as of lately, however, this aspect will not be presented here. The statistics do

seem to show a trend toward higher multiple births. Arguments have been made as to what the

causes of the increase in multiple births could be.

Of course in the “octo-mom” case, in vitro-fertilization was the suggested cause. Scientists

have also suggested that the rise in multiple births have come about by many other factors. Some

other possible causes are a mother’s medical condition and the stopping of birth control

medications. Scientists explain that the fact that many women are waiting longer to start families

has caused an increase in multiple births. Scientists have also suggested that fertility medications

have caused an increase in multiple births. Another cause of multiple births, according to

scientific research, is ethnicity (hereditary traits). These are the main evidence scientific research

has suggested that multiple births are on the increase. The top reasons covered here will be age,

race, family history, and fertility treatments.

According to pregnancy-period.com, from 1980-1997 twin births are up 52% and multiple

births are up 300%. This site also states that the possible causes for the increases are fertility

drugs, in vitro-fertilization, and delayed family planning. These numbers do suggest a dramatic

increase in multiple births. According to scientific research conducted, age and fertility treatments

are the leading two causes of the increase in multiple births. Heredity, according to pregnancy-

period, is not a leading cause but can be a major factor.

 According to infoforyourhealth.com, heredity causes are spoken of in great detail. It too

suggests that age and fertility treatments are a contributing factor in the increase of multiple births.

There was in fact, however, a woman in Argentina in 1992 that conceived duodecaplets (12)

children spontaneously. There is also a rule of the probability of having multiples, naturally,

known as Hellin’s Law. According to Hellin’s Law, the rate of a twin birth is 1/89 that of a single

birth. The rate of having triplets is 1/89 that of a twin birth, and so on. The odds are increasingly

minimal at each stage.

Infoforyourhealth.com also adds that in Canada, multiple births are up 35% between 1979

and 1999. The factors they suggest that make for a higher risk of conceiving multiples are age,

ethnicity, and fertility treatments. According to their evidence, if the mother is 35 years old or

older, she will be more likely to conceive multiples. They also state that African women have 16

fraternal twin pairs per 1,000 births. Caucasian women have 8 fraternal pairs per 1,000 births.

East Asian women have 3 fraternal pairs per 1,000 births. This evidence would suggest that either

ethnicity plays a contributing factor or the hereditary genetics involved with their background is.

They also state that 35% of pregnancies using fertility treatments result in more than one child.

Their evidence also seems to lean toward the increase being attributed to age, ethnic origin, and

whether or not fertility treatments were used.

According to statistics from the Centers for Disease Control and Prevention (CDC), there

were approximately 99,639 in vitro or related procedures done in 2000. Of those 99,639, only

25,228 (25.3%) of the cases were successful. Of the successful pregnancies, 30.7% were twin

births and 4.3% were triplet births. These numbers suggest that a substantial amount (35%) of

Assisted Reproductive Technologies (ART) result in a multiple birth when successful.

 Upon reviewing all the data and evidence, the results show that multiple births are on the

rise and that the areas of increased chances are age, race, family history, and fertility treatments.

However, as a father of twins myself, my wife does not fit any of these examples of increased risk.

She conceived our girls at the age of 23 years old and did not use fertility medications or in vitro

fertilization. My cousin’s wife had twins and she did not fit any of the increased risk criteria. Two

of my wife’s friends had twins; only one fit the heredity profile. A friend of mine knows two

couples that have had twins, one used in vitro fertilization and one did not. In both cases, neither

was older than thirty years old and was Caucasian.

Considering the facts about the chances of having a multiple birth, I thought that it is

unusual to know this many people that does not fit the criteria for increased likelihood of having

multiple births, yet did. Considering that one has a 1/89 chance in having twins and increasing

unlikelihood of having multiple sets beyond twins, it is strange to find several people that one

knows that isn’t in the “high risk” category. Upon evaluating the scientific research available,

taking into consideration my own personal experiences, I decided to do a statistical research

analysis of my own. I hypothesize that the main factors of age, fertility medication, family history,

or ethnic background does not play as much of a part in being a “higher risk” factor as has been

reported.

The first part of my research was to look at the financial reports for two publicly traded

major fertility medication pharmaceutical companies. I reviewed Schering-Plough and Bristol-

Meyers Squibb to see how much of an increase in sales for fertility medications that each did for

the last few years. I was unable to find any information on fertility drugs that they produced

individually on their financial statements. The sales revenue was so much of a minute amount of
their overall pharmaceutical sales that they were placed under the “other drugs” column of their

respective financial report.

For instance, Schering-Plough had high enough sales in HIV medication and Hepatitis C

medication to list them on their financial reports individually, but had to list their fertility

medications under a lump sum “other pharmaceutical” category. For instance, they sold $57

million worth of Follistim/Puregon (fertility medication) in 2007, according to the MD&A

(Managements Discussion & Analysis). They sold $45 million of Nuvaring (birth control) in

2007. The numbers are still much less than the sale of Temodar Capsules (brain tumor treatment)

at $861 million for 2007. This does not indicate that sales for fertility medications are increasing

or not, however these numbers do display a minimal amount of profits being reaped from some

fertility medications. Organon, a subsidiary of Schering-Plough, also manufactures Clomid, a

popular fertility medication. Clomid also was not listed individually on the sales portion of the

financial report for 2007. There is a possibility that the medications weren’t as revenue producing

as the others that they were not listed separately.

The second part of my statistical analysis was performed by way of a survey. I went to

four different message forums on the internet and posted a poll. The message forums are mainly

for people that are pregnant with or have already had twins or multiples. I posted several questions

with multiple choice answers for respondents to answer. The questions gathered data for: the age,

in which their multiple was conceived; the use, or lack thereof, of fertility medications or in vitro

fertilization; how many children were conceived at one time; the ethnic background of the

respondent; whether or not the respondent has a family history of twins or multiples; and how far

back in the family the twins or multiples appeared. The message forums used in this survey were
Got Twinz? You’re In The Right Place, Twin Stuff, Twins Magazine, and She Knows Pregnancy

And Baby.

I carefully reviewed the data to determine if my hypothesis is correct or not. I went straight

to the source. These forums have mothers of twins and multiples that took time from their busy

schedules to respond to my survey. They contain women of all age groups and different cities and

states. The data is accurate to the best of my knowledge and ability. I have worked diligently to

provide ethical and accurate data collection methodology and presentation.

The following information details the findings of the web forum survey. The respondents

include all those who chose to participate from different regions, ages, and ethnic backgrounds.

The respondents were given the option to remain anonymous or to respond publicly in the different

forums by replies, or threads, to the discussion of the survey. The series of questions the

respondents chose to answer in part or in entirety are in Appendix A.

The questions were given as a whole, yet analyzed individually. The intentions of the survey

were to gather data from mothers of multiples and to compare the data against the scientific

information given earlier. In order to obtain as accurate information as possible, the survey was

left open as long as possible to obtain at least 30 respondents. In most cases, there were far more

than 30 respondents to each individual question. Appendices B through F contain the results of the

data that was obtained in the form of a frequency distribution chart. The titles reflect the

information that was being searched for. The left hand column contains the possible outcomes.

The middle column contains the exact number of respondents that fall in the given outcomes. The

right hand column gives the percent of respondents that fall into the intervals on the left hand side

to all possible respondents.

 The next step is to analyze the data for each individual question from the survey. The

clearest way to evaluate the data is by way of the percentages under the column of “Relative

Frequency” in the Appendices. Through diligent transferring of the raw data into a frequency

distribution chart, the data can then be evaluated as they are presented in the Appendices. The first

data set to be analyzed is the debate of the mother’s age being a contributing factor of the

likelihood of multiples.

In the research of the mother’s age, there were 155 total respondents. The highest

percentage of respondents fell in the “30 up to 34” year old range at conception. The second

highest percentage of respondents fell in the “25 up to 29” year old range at conception. The third

highest percentage of respondents fell in the “20 up to 24” year old range at conception (See

Appendix B). The respective percentages were 43%, 32%, and 13%.

Scientists, as mentioned earlier, have suggested that women are more likely to have a

multiple birth at the age of 35 years old or older. They also suggest that women are waiting until

later years of their life to start families which has increased the multiple birth rates. The research

conducted here shows otherwise. The “35 and up” range is only a combined 12% of the

respondents surveyed. The three highest percentages all individually fall below the age of 35 years

old. Combined the percentages of “34 years of age and under”, make up 88% of the respondents

surveyed. Therefore, the vast majority of mothers that conceived multiple children did so under

the age that scientists suggest.

Secondly, we’ll look at the suggestion that fertility treatments are the cause of the increase in

multiple births. There were 133 total respondents to this portion of the survey. The highest

percentage (70%) of the 133 respondents selected that their multiple conception occurred
spontaneously. This information is located as a frequency distribution chart in Appendix C.

Again, the vast majority of respondents in this research do not fit the “high risk” profile that

scientists have stated.

The next data set covered deals with the suggestion that the mother’s family history

increases the likelihood of having multiples. Although this is not related to race or ethnicity, it is

relevant here in this research. As mentioned earlier, scientists have suggested that African women

are more likely to conceive multiples. The mother’s family history and perhaps DNA involved

could, theoretically, be traded down through an ethnic group of individuals. Therefore, research

was conducted on the mother’s family history to analyze to see if the scientific information that

suggests “twins run in the family” is accurate or not.

In Appendix D, there appears to be almost a perfect split in the cases of multiples running in

the family or no known history of multiples. There is a slight majority of the respondents (54%)

that had no knowledge of any multiples occurring within their families prior to their own multiple

conceptions. Of the respondents, 31% of the mothers stated that multiples had occurred in their

immediate family. Of the respondents, 16% of the mothers stated that there had been multiples in

their family at least three generations back. The combined percentages of respondents that had a

family history of multiples were 47%. Again, no knowledge of prior multiples had a slight edge of

54%. There appears to be nearly a 50/50 probability of multiples occurring or not. Therefore, this

research suggests that one is just as likely to have multiples if they run in the family or not. In fact,

there was a slight likelihood of having multiples if there were no prior multiples in the family.

Scientists have suggested that the ethnic background of the mother increases her likelihood

to conceive multiples. Appendix E shows the data obtained from the research analysis done here.
Caucasians were the highest percentage (97%) of respondents out of the 133 total respondents in

this survey. There was not a great deal of diversity displayed in this portion of the survey. There

was one respondent of African ethnic background, two Asian and one biracial Asian-Caucasian

respondent. While this study was meant to pull a sample from a random population, the numbers

were overwhelmingly of Caucasian ethnic background.

Interpretation of this data can be for or against scientific research. The research done here,

on ethnicity, I have determined to be inconclusive in regard to ethnic background. The argument

could be made that other ethnic backgrounds are not representative of the population out of all the

message forums that this survey was facilitated. That argument may very well be valid. In

looking at the numbers in this particular portion of the survey, this research project may not be

indicative enough to discard “scientific facts” mentioned earlier.

In conclusion, it is suggested that there may be merit to open up further research in favor of

my hypothesis. In regards to age, the numbers stated in this survey totally discard the facts

presented by scientists. The uses of fertility treatments, again, are overwhelmingly discounted by

the number of spontaneous occurrences. The family history of multiples are nearly equally as

likely if there had been a history or had not. Three out of four of the factors scientists suggest are,

according to this research project, inaccurate. The forth factor of race is not necessarily discounted

here because of the analysis and interpretation of the numbers that appear in Appendix E.

It is suggested that the hypothesis should be considered. The argument that is used on the

basis of the ethnic background could also be used to discount other parts of this research project as

well. For instance, the argument could be made that the message boards may have an unbalanced

number of women of 35 years old or less that could possibly have been exposed to the survey.
However, the mother’s use of fertility treatments and the family history portions would be

independent of the mother’s age.

Accidentally, there was some data that was also taken into consideration. A side note that is

worth mentioning here is that apart from the survey questions found in Appendix A, many of the

mothers responded in a forum reply post. Although it was not asked whether or not the multiples

or twins were of identical or fraternal nature, many mothers volunteered this information.

Statistical analysis was conducted on nearly every piece of information that the respondents

provided. Just for the sake of evaluating the data for research purposes, I ran an analysis of

identical and fraternal twin information volunteered by the respondents. The analysis

demonstrated the same contradictory outcomes that most scientific evidence suggests. Scientific

evidence suggests that identical twins are much less likely to occur than fraternal twins. Of the 31

respondents that volunteered this information, 15 had identical twins or multiples. That is

approximately 48% that turned out to be identical. On the other hand 16 of the 31 respondents had

fraternal twins or multiples. That is approximately 52% that turned out to be fraternal.

There are nearly just as many identical multiples as there are fraternal ones in this random

group of respondents. Whether a multiple is identical or fraternal would be completely independent

of the mother’s age or ethnic background. An argument has been made that there is evidence that

perhaps multiple births have increased by other means than the popular scientific suggestions. It

is suggested that there is enough evidence here for further evaluation at another time. This project

was facilitated under limited resources and a short amount of time. Should more research come

about from this project, Appendix F provides some factual information on the types of multiples

that were studied here.

 One thing that is of no speculation is the fact that children, multiples or not, are a blessing

from God. From a Christian Worldview, God has blessed many with the gift of bringing forth life!

There are challenges and trials at times. There are also fun times and memorable moments that

will surpass the parents’ lifetime and be ingrained into the children after the parents are gone.

One’s true legacy does not come from material possessions or wealth or fame, for after the owner

passes away, all is lost or becomes someone else’s. True legacy comes from the life one has

brought forth and will leave in this world to make it a better place after one is gone. All else shall

pass, yet the character and the love one shows their children will be passed down after one is gone.

Isaiah 44:2a (CEV) states, “I am your Creator. You were in my care even before you were born.”

Appendix A

At what age did you conceive your twins or multiples?

15 up to age 19
 20 up to age 24

25 up to age 29

30 up to age 34

35 up to age 39

40 up to age 44

45 up to age 50

50 and up

Did you use any fertility treatments to help you conceive?

Fertility Medication

In Vitro-Fertilization

Occurred Spontaneously

None of the above

Do twins or multiples run in your family?

Yes, immediate family

Yes, but at least three generations back

No, not that I’m aware of

Appendix A (continued)

How would you define your ethnic origin?

 Asian

African

Caucasian

Middle Eastern

Latin-Hispanic

Other

For your multiple births, how many children did you have at one time?

2-twins

3-triplets

4-quadruplets

5-quintuplets

More than 5

Appendix B

Age of the mother at conception

 Frequency Relative Frequency

15 up to 19 0 0%

20 up to 24 20 13%

25 up to 29 49 32%

30 up to 34 67 43%

35 up to 39 14 9%

40 up to 44 3 2%

45 up to 49 2 1%

50 and up 0 0%
 Total 155 100%

Appendix C
Fertility Treatments
Relative
Frequency Frequency

Fertility Medication 12 9%

In Vitro-Fertilization 23 17%

Occurred Spontaneously 93 70%

None of the Above 5 4%

Total 133 100%

Appendix D

Family History of Multiples

Relative
Frequency Frequency

31%
Yes, In Immediate Family 35

Yes, but at least 3 generations 16%

back 18

54%
No, not that I am aware of 61

100%
Total 114
 Appendix E
Mother's Ethnic Backgroun
Frequency Relative Frequency

Asian 2 2%

Asian-
Caucasian 1 1%

Caucasian 129 97%

Middle Eastern 0 0%

Latin-Hispanic 0 0%

African 1 1%

100
Total 133 %
 Appendix F
Number
Conceived
Frequency Relative Frequency

2-twins 136 99%

3-triplets 1 1%

4-quadruplets 1 1%

5-
quintuplets 0 0%

5 and over 0 0%

Total 138 100%

 Work Cited

Bristol-Myers Squibb: http://investor.bms.com/phoenix.zhtml?c=106664&p=irol-

reportsAnnual April 2009
Centers for Disease and Prevention:
http://www.cdc.gov/nchs/data/nvsr/nvsr47/nvs47_24.pdf April 2009
Got Twinz? You’re In The Right Place: http://www.gottwinz.net/forums/ April 2009
Holy Bible (CEV): Isaiah 44:2a “I am your Creator. You were in my care even before you
were born.”
Info For Your Health: http://www.infoforyourhealth.com/Womens'%20Health/Multiple
%20Births.htm April 2009
Pregnancy Period: http://www.pregnancy-period.com/multiplebirths.html April 2009
She Knows Pregnancy and Baby: http://talk.pregnancyandbaby.com/ April 2009
Schering-Plough: http://phx.corporate-ir.net/phoenix.zhtml?c=89839&p=irol-reportsannual
April 2009
Twins Magazine: http://forum.twinsmagazine.com/ April 2009
TwinStuff Community: http://www.twinstuff.com/forum/index.php April 2009