The CDC
has released a final report on
births in the United States in 2014, showing an all-time record number
of twins. We're not talking about a monumental increase, here - 2014 saw
33.9 sets of twins per 1,000 births, versus 33.7 in 2013 - but several
factors suggest this increase could become a trend.
STAT points
out that mothers continued to get older in 2014. The average age for a
first-time mother is now 26.3, up from an even 26 in 2013. The teen
birth rate is dropping sharply (9 percent in 2014 alone, with some
states seeing decreases higher than 50 percent since 2007) due to better
efforts to educate teens and provide them with longterm birth control
like IUDs. Births for women in the first few years of their twenties are
on a slower (but still steady) decline. Meanwhile, the birth rate for
women in their 30s, 40s and even 50s have increased over the years to
varying degrees.
Why does this mean more twins? There are actually a couple of factors
likely at play here. For starters, even though conceiving is generally
more difficult for older moms, these women are actually
more likely to have twins, at
least according to some research.
As women reach the end of their reproductive years, their bodies
produce higher quantities of the hormone that triggers the maturation of
an egg-producing follicle. That means a woman is more likely to have
two eggs available for fertilization during a single cycle in her 30s
than she is during her 20s. This doesn't always result in fraternal
twins, because
older eggs are also more likely to be unviable. But when enough women in this age group get pregnant, a significant portion of them can be expected to have fraternal twins.
The second factor is that many of these older mothers are using IVF to
conceive. In the past, IVF caused a sharp increase in the number of
births with three babies or more, because doctors would implant a high
number of embryos in the hopes of creating at least one viable
pregnancy. As of 2013,
more than one-third of U.S. twins and three-quarters of triplets (and
higher) births could be linked to IVF. But now triplet (and higher)
births are at a 20-year record low, even as twins continue to rise.
This shift is almost certainly due to a 1998 change in guidelines that
discouraged doctors from implanting more than two embryos at a time. Now
that IVF success rates are so high, implanting just two embryos (or
even just one) is often sufficient, and implanting more than that puts
mothers at a high risk of carrying a dangerous multiple pregnancy.

Rachel Feltman runs The Post's Speaking of Science blog.