Skip to main content

Surro Twins: Carrying Multiples During a Surrogacy Journey

It’s possible for a surrogate to carry and give birth to surrogate twins or multiples even when only one embryo is implanted. Because of the risk of embryo splitting and monozygotic twins (estimated to be about 1% in IVF procedures), most fertility specialists recommend transferring only one embryo. The pregnancy complications risk of twins is higher than a singleton pregnancy, the risk of greater multiples only increases the chances for complications. Some surrogates want to carry surro twins and would be overjoyed at the prospect of being pregnant with surro twins. This should be carefully discussed with a qualified fertility specialist and OB-GYN, however, because of the added risks.

Here are the ways in which surrogate twins can occur during any surrogacy journey:

Multiple Embryo Transfers

During the IVF process, more than one embryo may be transferred to the surrogate’s uterus. This has historically been done to increase the chances of a successful implantation of at least one embryo. More recent studies have erred on the side of caution as the chances of improved implantation of at least one embryo appear to be negligible. If both embryos successfully implant and develop, twins or multiples can result.

Spontaneous Twinning

Even in the case of a single embryo transfer, there is a possibility of the embryo splitting and developing into identical (monozygotic) twins. This isn’t a common occurrence, but can and does happen.

Selective Reduction

In some cases, if the surrogate becomes pregnant with more embryos than desired, selective reduction may be considered. This involves reducing the number of fetuses through a medical procedure, typically to reduce health risks for both the surrogate and the remaining fetuses.

Surrogacy and Twins

Some surrogates have various reasons for being excited about the prospect of being pregnant with twins. Being pregnant with twins offers a distinct and unique experience compared to a singleton pregnancy. Some women may find the idea of carrying and nurturing two babies simultaneously to be an exciting and fulfilling challenge. Some surrogates may desire a twin pregnancy for personal reasons, influenced by experiences within their community or family.

It’s important to note that while many surrogates may have positive feelings about the idea of being pregnant with twins, the reality of carrying and caring for multiple babies can present additional challenges and risks. Multiple pregnancies often involve more complex medical care, increased physical demands on the surrogate’s body, and higher risks of complications compared to singleton pregnancies. Therefore, it is crucial for potential surrogates considering or experiencing a twin pregnancy to have access to appropriate prenatal care and support from healthcare professionals.

It’s also not common for surrogates to ask for higher compensation levels in the event of twins. Most assisted reproduction attorneys representing surrogates will include a provision for higher compensation and expenses should twins occur. Always discuss general terms and compensation levels with a qualified attorney.

Twins vs. Singleton Pregnancies

Carrying twins, compared to a singleton pregnancy, presents additional risks and challenges for the surrogate. Here are some of the potential risks associated with a twin pregnancy:

Preterm Birth:

Twins are more likely to be born prematurely, which means they are delivered before completing the full 37 weeks of gestation. Preterm birth can result in various complications, as the babies may have immature organ systems and may require specialized care in a neonatal intensive care unit (NICU).

Low Birth Weight:

Twins are more likely to have a lower birth weight compared to singletons. This can be due to factors such as limited space in the womb for each baby to grow, competition for nutrients, and the increased likelihood of preterm birth.

Gestational Diabetes:

The risk of developing gestational diabetes is higher in twin pregnancies. This condition affects the body’s ability to regulate blood sugar levels during pregnancy and may require dietary modifications, medication, or insulin management.

High Blood Pressure and Preeclampsia:

Twin pregnancies have an increased risk of high blood pressure and preeclampsia, a condition characterized by high blood pressure and organ damage, usually affecting the liver and kidneys. Preeclampsia can be potentially serious and may require early delivery of the babies.

Placental Complications:

Twin pregnancies are associated with a higher incidence of placental complications. These may include placental abruption (where the placenta separates from the uterine wall prematurely), placenta previa (when the placenta partially or completely covers the cervix), or unequal sharing of the placenta between the twins (unequal placental sharing).


Iron-deficiency anemia is more common in twin pregnancies due to the increased demands on the mother’s blood supply to support the growth of two babies.

Cesarean Delivery:

The likelihood of needing a cesarean section is higher in twin pregnancies. Factors such as the position of the babies, the size of the babies, or complications during labor can increase the likelihood of a cesarean delivery.

It’s important to note that while these risks are associated with twin pregnancies, not all who are pregnant with twins will experience them. The specific risks and complications can vary depending on factors such as maternal age, overall health, and the type of twins (identical or fraternal). Close monitoring by healthcare professionals experienced in managing twin pregnancies can help identify and address any potential concerns to ensure the best possible outcome for both the surrogate and the babies.

surrogacy without the expensive surrogacy fees. Signup with Surrogacy Place today.What Are Twiblings?

Twiblings usually refers to two children that are siblings and were created via IVF at the same time, but were not carried by the same surrogate, thus not being biological twins in any traditional respect. Twiblings are created by transferring two embryos into two separate surrogates around the same time. Each gestational surrogate carries a pregnancy with children born roughly around the same time (occasionally on the same day!).

Twiblings share a unique connection through the shared experience of being carried at the same time and therefore are extremely close in age, similar to natural twins.

Twibling journeys, when two different surrogates carry pregnancies simultaneously, is often referred to as a “simultaneous surrogacy” or “double surrogacy” arrangement. In a simultaneous surrogacy, an Intended Parent or Intended Parent couple work with two different surrogates, each carrying a pregnancy at the same time. The goal is for both surrogates to give birth around the same time, resulting in siblings born to two different surrogates, but with a close age gap.

Simultaneous surrogacy can be an option for individuals or couples who wish to have siblings born close in age but may not be able to do so naturally or through a single surrogate pregnancy. Since many surrogates are reluctant to carry twins because of the increased risks of complications and pre-term labor, simultaneous surrogacy has become an increasingly popular option for those that want to grow their families quickly.

The simultaneous surrogacy process involves finding and selecting two separate gestational surrogates, ensuring that they meet the necessary medical and psychological requirements. Each surrogate undergoes the necessary fertility treatments, such as in vitro fertilization (IVF), using the Intended Parents’ or donors’ genetic material. The resulting embryos are then transferred to the respective surrogates’ uteruses.

Throughout the pregnancy, the Intended Parent or couple can be involved in various aspects, such as attending ultrasound scans, preparing for the arrival of the children, and forming a relationship with the surrogates.

Once the surrogates give birth, the Intended Parents assume legal custody of the children. The children are not technically twins, but rather biological siblings sharing a genetic connection with their respective parents or donors.

What happens if an Intended Mother becomes Pregnant while a Surrogate is Pregnant?

Though rare, this does happen! 

In certain situations, it is possible for an Intended Mother to become pregnant with her own child while a surrogate is also pregnant. This can happen if the Intended Mother has viable eggs. In most cases, the Intended Mother chooses to proceed with her own pregnancy while the surrogate continues to carry the pregnancy for the Intended Parents.

It’s worth noting that situations where both the Intended Mother and the surrogate are simultaneously pregnant can be complex and require careful coordination and support from fertility specialists and legal professionals to ensure the best interests of all involved parties and the children are protected.

Although attitudes may differ depending on the individuals involved, the overwhelming majority of Intended Parents and surrogates see simultaneous journeys with Intended Mothers and surrogates as a blessing.

Frequently Asked Questions about Surro Twins, Twiblings, and Simultaneous Surrogacy

What are Surro Twins?

Surro Twins or Surrogacy Twins refer to twins or multiples born during a surrogacy journey. While the goal is typically to transfer only one embryo to minimize risks, there is still a chance of having twins due to factors such as embryo splitting or multiple embryo transfers.

How can Surro Twins occur during a surrogacy journey?

Surro Twins can occur through multiple embryo transfers during IVF, the spontaneous splitting of a single embryo resulting in identical twins, or the consideration of selective reduction if the surrogate becomes pregnant with more embryos than desired.

What are the risks and challenges associated with carrying twins during a surrogacy journey?

Carrying twins presents additional risks compared to singleton pregnancies, including preterm birth, low birth weight, gestational diabetes, high blood pressure, preeclampsia, placental complications, anemia, and a higher likelihood of needing a cesarean delivery.

What are Twiblings?

Twiblings are siblings born through in vitro fertilization (IVF) at the same time but carried by different surrogates. They are not technically twins, but share a close connection due to being born around the same time.

What is simultaneous surrogacy?

Simultaneous surrogacy, also known as double surrogacy, involves two separate surrogates carrying pregnancies for the same intended parent(s) simultaneously. This arrangement allows for siblings to be born to two different surrogates with a close age gap.

How does simultaneous surrogacy work?

Simultaneous surrogacy involves finding and selecting two separate gestational surrogates who undergo IVF using the genetic material of the intended parents or donors. The resulting embryos are transferred to each surrogate’s uterus, and both surrogates carry the pregnancies at the same time.

surrogacy without an agency - signup for Surrogacy Place's online surrogacy matching program now

Bridget Myers

Bridget Myers grew up in small town in Maryland. She started her career as a substitute teacher before meeting the love of her life and moving to the suburbs of Chicago. She has a passion for dogs and painting. Bridget got involved in Surrogacy Place after researching surrogacy for her best friend. Since joining the team at Surrogacy Place, she has developed a passion for advocating on behalf of Intended Parents and surrogates and doing her part for meaningful reform in the industry.