Am I Expecting Multiples?

Early Signs That Two or More Are on the Way

By April E. Clark

When Lisa Rossell was 4 weeks pregnant, she suspected that she could be carrying more than one baby. Her pants fit tight in the waistline and her human chorionic gonadotropin (hCG) beta blood test results came back at an eye-opening 5,221 mIU/ml.

"My nurse practitioner told me they never diagnose multiples from just the hCG and progesterone levels, so we had an early ultrasound at 6 weeks," says Rossell, a special education teacher from Indianapolis, Ind. "She told me not to panic, but my hCG level had doubled to 10,000 and then again to 20,000. With test results that high, I was scared there were three. During my first ultrasound, I was so nervous we wouldn't hear two heartbeats that I was crying and shaking.

"Afterwards, I felt so happy and blessed to be having twins, but then I also felt overwhelmed until about 3:30 a.m. that next morning. I even woke up my husband, Keith, in the middle of the night and said, 'What are we going to do? We can't afford twins!'"

With a strong family history of multiples and having been previously prescribed a 150 milligram-dose of clomiphene citrate (Clomid), the popular infertility drug that can stimulate ovaries to produce eggs, Rossell is not surprised that she is expecting twins.

"Two of my cousins have had twins," she says. "And my grandma was pregnant with three sets of twins and one set of triplets, which she unfortunately miscarried."

If it turns out that two or more are on the way, you're not alone. A recent study published in Obstetrics & Gynecology found that the overall multiple birth ratio increased 59 percent between 1980 and 1999. Some researchers and physicians suggest increased use of fertility drugs such as Clomid and infertility treatments such as in vitro fertilization have resulted in this booming multiple-birth trend.

"Of women whose only fertility problem is irregular or no ovulation at all, about 80 percent will ovulate and about 50 percent will become pregnant within six months of Clomid treatments," says Dr. Gary S. Berger, an InterNational Council on Infertility Information Dissemination Inc. (INCIID) advisory board member and co-author of The Couple's Guide to Fertility: How New Medical Advances Can Help You Have a Baby

Want to see more?

• Multiple Pregnancy: Too Much of a Good Thing?
• High-Tech Babies: In Vitro Fertilization
• Keep Those Babies in There: Avoiding Premature Delivery With Twins
• Talk about it!