North America and Europe have intermediate rates of 9 to 16 twin sets per 1,000 live births.Multiple pregnancies are much less likely to carry to full term than single births, with twin pregnancies lasting on average 37 weeks, three weeks less than full term. Women who have a family history of fraternal twins have a higher chance of producing fraternal twins themselves, as there is a genetically linked tendency to hyper-ovulate. There is no known genetic link for identical twinning. Other factors that increase the odds of having fraternal twins include maternal age, fertility drugs and other fertility treatments, nutrition, and prior births. Some women intentionally turn to fertility drugs in order to conceive twins. Types and zygosity
The vast majority of twins are either dizygotic (fraternal) or monozygotic (identical). Less common variants are discussed further down the article. Fraternal twins can be any of the following:

Female–female twins: Sometimes called sororal twins (25%). Male–male twins: Sometimes called fraternal twins (25%). Female-male twins: This is the most common pairing (50%), simply by virtue of it encompassing both "female-male" (25%) and "male-female" (25%) twins.Among non-twin births, male singletons are slightly (about five percent) more common than female singletons. The rates for singletons vary slightly by country. For example, the sex ratio of birth in the US is 1.05 males/female, while it is 1.07 males/female in Italy.
Heterotopic pregnancy
Heterotopic pregnancy is an exceedingly rare type of dizygotic twinning in which one twin implants in the uterus as normal and the other remains in the fallopian tube as an ectopic pregnancy. Ectopic pregnancies must be resolved because they can be life-threatening to the mother. However, in most cases, the intrauterine pregnancy can be salvaged. Management of birth
For otherwise healthy twin pregnancies where both twins are head down a trial of vaginal delivery is recommended at between 37 and 38 weeks. Vaginal delivery in this case does not worsen the outcome for the infant as compared with Caesarean section. There is controversy on the best method of delivery where the first twin is head first and the second is not. When the first twin is not head down a caesarean section is often recommended. It is estimated that 75% of twin pregnancies in the United States were delivered by caesarean section in 2008. In comparison, the rate of caesarean section for all pregnancies in the general population varies between 14% and 40%. In twins that share the same placenta, delivery may be considered at 36 weeks. For twins who are born early, there is insufficient evidence for or against placing preterm stable twins in the same cot or incubator (co-bedding). Human twin studies
Twin studies are utilized in an attempt to determine how much of a particular trait is attributable to either genetics or environmental influence.