Question: Is it the male or female contribution than can determine if it will be
twins or not? Sperm or Egg? C.J (USA)
Answer: As you may have seen on our section on multiple pregnancy, there are two
broad groups of twins: Identical and non-identical. This basically refers to whether
the twins are a result of a split of a fertilized egg (identical) or are resulting
from two separate eggs being fertilized by two different sperms (non-identical).
The majority of twins are non-identical. These will only occur when the woman has
released more than one egg. It is therefore purely female determined. There is a
known genetic predisposition to non-identical twins and that is why this phenomenon
may run in families. However, in most cases, occurrence of twins will be a sporadic
event rather than a result of genetic predisposition.
For identical twins, where a single fertilized egg splits to result in two identical
embryos, the genetic predisposition is not so clear. There is evidence that, in a
few cases at least, genetic predisposition may play a part here as well but to a
much smaller extent. There is a very interesting case of identical twins Diane and
Darlene Nettemeir who, in 1999 married identical twin brothers Mark and Craig Sanders...
Yes, you guessed it: Diane and Craig ended up having a set of identical twins themselves.
That does strongly suggest a genetic predisposition.
Minocycline use in pregnancy
Question: I was taking Acnamino which contain Minocycline hydrochloride. Minocycline
is one of a group of antibiotics called tetracyclines. I stopped them just over 2wks
ago, so is it safe to start trying for a baby, I just want to be sure it’s safe?
Thanks. E (UK)
Answer: You are right, Minocycline is a type of Tetracycline and this group of antibiotics
should not be used during pregnancy. However, you can be reassured that after two
weeks, the drug has definitely been cleared from your system. Drug stay in the body
system is measured by what is called a half-life. Each drug is metabolised differently
so they all have different ‘half-lives’. The half-life of Minocycline is 11 - 22
hours. This means, after a few days of stopping the drug, there is none in your system.
You should be reassured.
Treating a blighted ovum
Question: I am pregnant 9 weeks . But doctor told me you have to do D&C
because there is no fetal pole or heart beat of the baby. I don’t want
to do D&C so please advise me the name of medicine for bleeding. F (Pakistan)
Answer: What has been found, presumably on an ultrasound scan, is what is known as
a blighted ovum or anembryonic pregnancy. In this, while the egg is successfully
fertilized, for some obscure reason, the baby never develops. A scan will therefore
show only clear fluid in an otherwise empty gestational sac.
What your doctor is offering you is what we term as a surgical treatment of the miscarriage
(Blighted ovum is classified as a form miscarriage). While you are quite right in
saying that there are medical options if you want to avoid a surgical solution, it
is important that such medications are prescribed and administered by the doctor
treating you. These medicines are safe and effective but they need to be taken under
Conception after a blighted ovum
Question: My daughter had blighted ovum during June but she is unable to conceive
for the past 4 months. her period is delayed by 2 to 5 days. What is the problem?
Please solve the problem she and her husband have good reproductive parameters. S
Question: I would like another child but my last four have been caesarean sections.
Is it safe to try again? G.M (UK)
Answer: Contrary to popular belief, there is no absolute limit on the number of
safe caesarean section that is recommended by doctors. However, it is clearly the
case that, the more caesarean sections you have, the higher the risk of major complications.
These may include such lethal complications as uterine rupture with a high chance
of losing the baby. There is also an ever increasing risk of requiring an emergency
caesarean hysterectomy (removing the whole womb at the time of caesarean section)
as a life-saving measure. The risk to injury to adjacent internal organs such as
the urinary bladder and bowel is also potentially increased.
With four caesarean sections behind you, you will be well-advised to discuss your
plans before-hand with your obstetrician who will do a thorough review of events
and findings at your last caesarean and use the information to advise you on the
wisdom or not of embarking upon another pregnancy.
Heavy vaginal bleeding in early pregnancy
Question: can an early pregnancy still be ok even if the bleeding is heavy? K.S (UK)
Answer: Unfortunately, in most cases of heavy early pregnancy vaginal bleeding,
that will be a sign that you are looking at a pregnancy loss. Fetal viability may
still be possible in the few cases where the pregnancy started off as a twin pregnancy
and miscarriage of one of the twins takes place. The bleeding in such a situation
can be substantial but a scan will show a viable (remaining) fetus.