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Issue 2, November 2001
Seeing Double: An introduction to twinning
Jean Lee
Integrative Biology, University of California at Berkeley
lee@jyi.org
The
idea of having a twin can develop into a fascinating daydream. The
fancy of having "someone just like me" exist in this universe is
a source of mystery and enjoyment. For some, human development clearly
has rendered this dream into reality. Identical twins are a real
phenomenon, and in some areas of the world, such as Nigeria, quite
common. Twins are our family members, friends, roommates, and stars
on the screen. And now more than ever, with the help of fertility
drugs, human reproduction has brought into being the mystery and
magic of twins, triplets, quadruplets, sextuplets, and even more!
But how do twins come into being in the first place, and how do
they develop inside the mother's body?
Human females undergo ovulation at approximately day 14 of the typical
28-day menstrual cycle. Unlike most mammals, female humans are biologically
unique in that they are cryptic ovulators. Women do not show visible
signs that they are in the process of ovulation, although one generally
can predict when ovulation occurs by monitoring a woman's cycle.
Usually one egg is released during this time; however, some mothers
may be genetically prone to multiple ovulations. In fact, members
in the same family line exhibit a tendency for twinning. Although
bearing identical twins tends to happen only once to a mother, having
fraternal twins more than once may be likely. This suggests the
existence of a strong genetic component between humans and the probability
of twinning.
Without the aid of fertility drugs, pregnancies resulting in twins
occur at an estimated frequency of one percent. But with the aid
of fertility treatments such as gonadotropins, which can stimulate
multiple ovulations, doctors can increase the frequency of twinning
or further multiplicities to ten or even forty percent higher than
the normal rate.
Two types of twins exist, dizygotic (DZ, or fraternal twins), and
monozygotic (MZ, or identical twins). Whereas dizygotic twins are
as dissimilar (genetically) as usual siblings and are often different
sexes, monozygotic twins are genetically identical and therefore
are the same sex.
In DZ twinning, ovulation results in two separate eggs being released
from the same menstrual cycle. Incoming sperm individually fertilize
both eggs. Not only do these eggs differ genetically, but the resulting
individuals are usually just as dissimilar as siblings born from
separate pregnancies. Since two distinct sperm fertilize each available
egg, the twins are independent in terms of sexual genetic makeup
as well. Only a single genetic difference in a chromosomal test,
for example, will establish dizygosity. Upon completion of fertilization,
dizygotic embryos implant in the uterine wall and each develop three
separate fetal membranes---the amniotic sac, chorion, and placenta;
just like two peas in different pods.
Compared to DZ twins, MZ twins (or identical twins, which are about
half as common as dizygotic twins), face quite a different start
to life. Monozygotic twin formation occurs when a sperm fertilizes
a single ovulated egg; the fertilized egg then divides into two
separate inner cell masses during the first 2 weeks of embryonic
development, or blastocyst stage. Each cell mass develops into an
embryo. Another possibility is the blastocyst splitting slightly
later around this time, resulting in two embryos. Monozygotic twins
must be the same sex and identical genetic makeup, since only one
sperm and one egg were involved in fertilization. The three fetal
membranes are usually shared, like two peas in one pod. However,
if the MZ twins were formed due to a slightly later splitting of
the zygote cell mass, the chorion and placenta may be shared, but
not the amnion. One amnion for each twin would develop. Thus, it
is possible to tell when the original zygote splits by studying
which of the three fetal membranes are shared.
The processes underlying MZ and DZ twinning seem simple enough,
yet what happens when things don't go quite as planned? Often, twinning
may cause pregnancy complications. The womb needs to nourish two
or even more individual fetuses growing rapidly. If one twin fails
to survive, the other twin is seriously at risk. An embolism, or
circulatory blockage, from the tissue of the non-living twin may
cause the living twin to suffer and eventually die. Even if both
twins survive in the womb, pre-term labor can also occur, resulting
in premature infants who may have extensive physical as well as
mental hardships.
In addition to the struggle for nutrients and survival, twins may
be physically conjoined, or bridged together. Conjoined twins -
also known as Siamese twins, after the famous conjoined siblings,
Chang and Eng - may result if the inner cell mass during a monozygotic
process does not separate completely. The extent of joined tissues
between the twins can be as slight as shared superficial skin, or
as massive as deep body and intestinal fusions. Surgery can usually
correct the conjoined state, depending upon the severity of tissue
integration. Even without surgical correction, Siamese twins may
lead relatively normal lives. Chang and Eng were born in Siam, Thailand
in 1811, with a lower thoracic ligament connecting their bodies.
Yet after spending most of their lives as a fascinating and acclaimed
exhibition, the twins settled in North Carolina, fathered twenty-one
children, and lived to the age of sixty-two.
The study of twins continues to be a fascinating and invaluable
realm of biological and genetic research. Twins separated at birth
and twins raised together are studied in order to distinguish between
genetically-inherited behaviors and behaviors that result from environmental
factors. Sometimes tests yield eerie results and similarities too
striking to be called coincidence. For example, some twins adopted
separately and who live apart for years develop nearly identical
habits (e.g. both twins chain smoke, give their children the same
names, drive the same kind of car, compulsorily flush the toilet
before using it, like a certain school subject, marry women with
the same names, etc.). The mysterious combination of both genetic
and behavioral traits, not to mention the quirk of fate, make twins
a "one of a kind" marvel.
Suggested Reading
Carlson,
B.M. PhD, MD. The Human Embryo and Developmental Biology. 1994.
Mosby-Year Book, Inc. Missouri. Pages. 39-44.
Larse, W. J. PhD. Human Embryology. 1993. Churchill Livingstone.
Pages. 445-446.
Mange, E. J., Mange A.P. Basic Human Genetics. 2nd Edition.
Sinauer Associates, Inc. Publishers. Sunderland, Massachusetts.
Wallace, Irving and Wallace, Amy. The Two: A Biography. 1978.
Simon and Schuster. Publishers. New York.
Zietman, A. and M. Brookes. Clinical Embryology: A Color Atlas
and Text. 1998. CRC Press, LLC. Pages 52-65, 244-318.
Journal of Young
Investigators. 2001. Volume Five.
Copyright © 2001 by Jean Lee and JYI. All rights reserved.
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