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Twins and Twinning

The frequency of twins or higher order multiple births varies substantially across species and understanding the factors that control twinning is important for health and for managing livestock production systems. Dizygotic twin pregnancies in women are associated with a higher frequency of preterm birth, gestational hypertension, and pre-eclampsia with additional complications in monozygotic twin pregnancies.  Twinning in cattle can be linked to health and reproductive problems in both mothers and offspring due to increased embryo and foetal losses, malpresentation and difficult births, and the high frequency of developmental problems in female twins born as cotwins to males.  In contrast, an increased frequency of twins in sheep contributes to farm income and profitability in many productions systems.

Dizygotic twinning

Discovery of genes for twinning in sheep identified mutations in genes expressed in oocytes and ovaries (BMP15 and BMPR1) demonstrating the important role of this pathway in regulating ovulation rate and twinning within and across species (Galloway et al., 2000, 10888873; Montgomery et al., 1993, 8401591; Wilson et al., 2001, 11259271). There is evidence that mutations in GDF9 in some families (a gene closely related to BMP15 and active in the same pathway) is associated with increased twinning (Palmer et al., 2006, 16954162). Genome-wide association studies have identified variation in regulatory regions close to FSHB, SMAD3, GNRH1, and ZFPM1 associated with twinning (Mbarek et al., 2024, 38052102; Mbarek et al., 2016, 27132594). One interesting observation is that most genetic risk factors identified in the recent GWAS studies with mothers of DZ twins link directly to clear candidate genes from hypothalamic-pituitary-ovarian pathways confirming the important role of hormone signalling in intra-ovarian signalling pathways in regulation of ovulation rate and twinning (Montgomery, 2024, 39222471).

Identical twins

MZ twinning rarely runs in families, the frequency is similar in different populations and there is little evidence for genetic factors influencing MZ twinning. A fascinating recent insight revealed a unique epigenetic signature shared by MZ twins (van Dongen et al., 2021, 34584077). This stable DNA methylation signature is found in both childhood and adult somatic tissues. MZ twins keep this molecular signature across the lifespan, so this discovery allows new possibilities for understanding mechanisms of MZ twinning and for retrospective diagnosis of individuals who may have had an identical co-twin that vanished in the early stages of pregnancy. 

Unusual cases of twins

Genetic marker technology was adopted early to test whether same sex twins are identical or non-identical as this in not always obvious. Genetic markers have also been useful in identifying some unusual cases of twins. These include a case of twins who shared a placenta like identical twins but were confirmed to be non-identical (Souter et al., 2003, 12853588). This and subsequent cases show this can be a complication of assisted reproduction. Two very unusual cases report a rare phenomenon of twins that have arisen from two eggs but a single sperm (Gabbett et al., 2019, 30811910; Souter et al., 2007, 17165045). The mechanism for this is not well understood. 

References

2024

Mbarek H. Gordon S.D. Duffy D.L. Hubers N. Mortlock S. Beck J.J. Hottenga J.J. Pool R. Dolan C.V. Actkins K.V. et al. (2024) Genome-wide association study meta-analysis of dizygotic twinning illuminates genetic regulation of female fecundity. Human Reproduction 39: 240-257.

View on Pub Med (38052102)

Montgomery G.W. (2024) Genetic regulation of ovulation rate and multiple births. Reproduction Fertility and Development 36: RD24083.

View on Pub Med (39222471)

2021

van Dongen J. Gordon S.D. McRae A.F. Odintsova V.V. Mbarek H. Breeze C.E. Sugden K. Lundgren S. Castillo-Fernandez J.E. Hannon E. et al. (2021) Identical twins carry a persistent epigenetic signature of early genome programming. Nature Communications 12: 5618.

View on Pub Med (34584077)

2019

Gabbett M.T. Laporte J. Sekar R. Nandini A. McGrath P. Sapkota Y. Jiang P. Zhang H. Burgess T. Montgomery G.W. et al. (2019) Molecular Support for Heterogonesis Resulting in Sesquizygotic Twinning. New England Journal of Medicine 380: 842-849.

View on Pub Med (30811910)

2016

Mbarek H. Steinberg S. Nyholt D.R. Gordon S.D. Miller M.B. McRae A.F. Hottenga J.J. Day F.R. Willemsen G. de Geus E.J. et al. (2016) Identification of Common Genetic Variants Influencing Spontaneous Dizygotic Twinning and Female Fertility. American Journal of Human Genetics 98, 898-908.

View on Pub Med (27132594)

2007

Souter V.L. Parisi M.A. Nyholt D.R. Kapur R.A. Henders A.K. Opheim K.E. Gunther D.F. Mitchell M.E. Glass I.A. and Montgomery G.W. (2007) A case of true hermaphroditism reveals an unusual mechanism of twinning. Human Genet 121: 179-185.

View on Pub Med (17165045)

2006

Palmer JS, Zhao ZZ, Hoekstra C, Hayward NK, Webb PM, Whiteman DC, Martin NG, Boomsma DI, Duffy DL, Montgomery GW (2006) Novel variants in growth differentiation factor 9 in mothers of dizygotic twins. Journal of Clinical Endocrinology and Metabolism 91, 4713-6.

View on Pub Med (16954162)

2003

Souter V. Kapur R.P. Nyholt D.R. Skogerboe K. Myerson D. Ton C. Easterling T. Shields L. Montgomery G.W. and Glass I.A. (2003) A report of dizygous monochorionic twins. New England Journal of Medicine 349: 152-156.

View on Pub Med (12853588)

2001

Wilson T. Wu X.-Y. Juengel J.L. Ross I.K. Lumsden J.M. Lord E.A. Dodds K.G. Walling G. McEwan J. O'Connell A.R. et al. (2001) Highly prolific Booroola sheep have a mutation in the intracellular kinase domain of bone morphogenetic protein 1B receptor which is expressed in both oocytes and granulosa cells. 64: 1225-1235.

View on Pub Med (11259271)

2000

Galloway S.M. McNatty K.P. Cambridge L.M. Laitinen M.P.E. Juengel J.L. Jokiranta S. McLaren R.J. Luiro K. Dodds K.G. Montgomery G.W. et al. (2000) Mutations in an oocyte-derived growth factor gene (BMP15) cause increased ovulation rate and infertility in a dosage-sensitive manner. Nature Genetics 25: 279-283.

View on Pub Med (10888873)

1993

Montgomery G.W. Crawford A.M. Penty J.M. Dodds K.G. Ede A.J. Henry H.M. Pierson C.A. Lord E.A. Galloway S.M. Schmack A.E. et al. (1993) The ovine Booroola fecundity gene (FecB) is linked to markers from a region of human chromosome 4q. Nature Genetics 4: 410-414.

View on Pub Med (8401591)