Reversal of anovulation with clomifene (trade names including Clomid) has a relatively less but yet significant risk of multiple pregnancy. Delivery interval
A 15-year German study of 8,220 vaginally delivered twins (that is, 4,110 pregnancies) in Hesse yielded a mean delivery time interval of 13.5 minutes. The delivery interval between the twins was measured as follows:

Within 15 minutes: 75.8%
16–30 minutes: 16.4%
31–45 minutes: 4.3%
46–60 minutes: 1.7%
Over 60 minutes: 1.8% (72 instances)The study stated that the occurrence of complications "was found to be more likely with increasing twin-to-twin delivery time interval" and suggested that the interval be kept short, though it noted that the study did not examine causes of complications and did not control for factors such as the level of experience of the obstetrician, the wish of the women giving birth, or the "management strategies" of the procedure of delivering the second twin. There have also been cases in which twins are born a number of days apart. Possibly the worldwide record for the duration of the time gap between the first and the second delivery was the birth of twins 97 days apart in Cologne, Germany, the first of which was born on November 17, 2018. Complications during pregnancy
Vanishing twins
Researchers suspect that as many as 1 in 8 pregnancies start out as multiples, but only a single fetus is brought to full term, because the other fetus has died very early in the pregnancy and has not been detected or recorded.
Twins are two offspring produced by the same pregnancy. Twins can be either monozygotic (identical), meaning that they develop from one zygote, which splits and forms two embryos, or dizygotic (non-identical or fraternal), meaning that each twin develops from a separate egg and each egg is fertilized by its own sperm cell. Since identical twins develop from one zygote, they will share the same sex, while fraternal twins may or may not. In rare cases twins can have the same mother and different fathers (heteropaternal superfecundation). In contrast, a fetus that develops alone in the womb (the much more common case, in humans) is called a singleton, and the general term for one offspring of a multiple birth is a multiple. Unrelated look-alikes whose resemblance parallels that of twins are referred to as doppelgängers. Statistics
The human twin birth rate in the United States rose 76% from 1980 through 2009, from 9.4 to 16.7 twin sets (18.8 to 33.3 twins) per 1,000 births. The Yoruba people have the highest rate of twinning in the world, at 45–50 twin sets (90–100 twins) per 1,000 live births, possibly because of high consumption of a specific type of yam containing a natural phytoestrogen which may stimulate the ovaries to release an egg from each side. In Central Africa, there are 18–30 twin sets (or 36–60 twins) per 1,000 live births. In North America, South Asia (India, Pakistan, Bangladesh, Nepal), and Southeast Asia, the lowest rates are found; only 6 to 9 twin sets per 1,000 live births.