Abstract
STUDY QUESTION: Does having a male co-twin influence the female twin’s reproductive outcomes?
SUMMARY ANSWER: Women with a male co-twin had the same chances of being pregnant and having children compared to samesex twin pairs.
WHAT IS KNOWN ALREADY: According to the twin testosterone transfer (TTT) hypothesis, in an opposite-sex twin pregnancy, testosterone transfer from the male to the female co-twin occurs. A large body of literature supports the negative impact of prenatal testosterone exposure on female’s reproductive health in animal models; however, evidence from human studies remains controversial.
STUDY DESIGN, SIZE, DURATION: This cohort study included all dizygotic female twins in the Aberdeen Maternity and Neonatal
Databank (Scotland) born before 1 January 1979. The 317 eligible women were followed up for 40 years for any pregnancies and the outcome of those pregnancies recorded in the same database.
PARTICIPANTS/MATERIALS, SETTING, METHODS: Fertility outcomes (number of pregnancies, number of livebirths and age at first pregnancy) were compared between women with a male co-twin (exposed group, n ¼ 151) and those with a female co-twin (unexposed group, n ¼ 166). Population averaged models were used to estimate odds ratios (OR) and 95% CI for all outcomes with adjusting
for potential confounders.
MAIN RESULTS AND THE ROLE OF CHANCE: There were no differences in chances of having pregnancies (adj. OR 1.33; 95% CI 0.72, 2.45) and livebirths (adj. OR 1.22; 95% CI 0.68, 2.18) between women from same-sex and opposite-sex twin pairs. Women with a male co-twin were more likely to smoke during pregnancy and, in the unadjusted model, were younger at their first pregnancy (OR 2.13; 95% CI 1.21, 3.75). After adjusting for confounding variables (year of birth and smoking status) the latter finding was no longer significant
(OR 1.67; 95% CI 0.90, 3.20).
LIMITATIONS, REASONS FOR CAUTION: The dataset was relatively small. For women without a pregnancy recorded in the databank, we assumed that they had not been pregnant.
WIDER IMPLICATIONS OF THE FINDINGS: Despite the evidence from animal studies concerning the adverse effects of prenatal
testosterone exposure on female health, our results do not support the TTT hypothesis. The finding that women with a male co-twin are more likely to smoke during pregnancy highlights the importance of considering post-socialisation and social effects in twin studies.
STUDY FUNDING/COMPETING INTEREST(S): European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie project PROTECTED (grant agreement No. 722634) and FREIA project (grant agreement No. 825100). No competing interests.
TRIAL REGISTRATION NUMBER: N/A
SUMMARY ANSWER: Women with a male co-twin had the same chances of being pregnant and having children compared to samesex twin pairs.
WHAT IS KNOWN ALREADY: According to the twin testosterone transfer (TTT) hypothesis, in an opposite-sex twin pregnancy, testosterone transfer from the male to the female co-twin occurs. A large body of literature supports the negative impact of prenatal testosterone exposure on female’s reproductive health in animal models; however, evidence from human studies remains controversial.
STUDY DESIGN, SIZE, DURATION: This cohort study included all dizygotic female twins in the Aberdeen Maternity and Neonatal
Databank (Scotland) born before 1 January 1979. The 317 eligible women were followed up for 40 years for any pregnancies and the outcome of those pregnancies recorded in the same database.
PARTICIPANTS/MATERIALS, SETTING, METHODS: Fertility outcomes (number of pregnancies, number of livebirths and age at first pregnancy) were compared between women with a male co-twin (exposed group, n ¼ 151) and those with a female co-twin (unexposed group, n ¼ 166). Population averaged models were used to estimate odds ratios (OR) and 95% CI for all outcomes with adjusting
for potential confounders.
MAIN RESULTS AND THE ROLE OF CHANCE: There were no differences in chances of having pregnancies (adj. OR 1.33; 95% CI 0.72, 2.45) and livebirths (adj. OR 1.22; 95% CI 0.68, 2.18) between women from same-sex and opposite-sex twin pairs. Women with a male co-twin were more likely to smoke during pregnancy and, in the unadjusted model, were younger at their first pregnancy (OR 2.13; 95% CI 1.21, 3.75). After adjusting for confounding variables (year of birth and smoking status) the latter finding was no longer significant
(OR 1.67; 95% CI 0.90, 3.20).
LIMITATIONS, REASONS FOR CAUTION: The dataset was relatively small. For women without a pregnancy recorded in the databank, we assumed that they had not been pregnant.
WIDER IMPLICATIONS OF THE FINDINGS: Despite the evidence from animal studies concerning the adverse effects of prenatal
testosterone exposure on female health, our results do not support the TTT hypothesis. The finding that women with a male co-twin are more likely to smoke during pregnancy highlights the importance of considering post-socialisation and social effects in twin studies.
STUDY FUNDING/COMPETING INTEREST(S): European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie project PROTECTED (grant agreement No. 722634) and FREIA project (grant agreement No. 825100). No competing interests.
TRIAL REGISTRATION NUMBER: N/A
| Original language | English |
|---|---|
| Number of pages | 9 |
| Journal | Human Reproduction |
| Early online date | 19 Jun 2020 |
| DOIs | |
| Publication status | E-pub ahead of print - 19 Jun 2020 |
Keywords
- twin
- testosterone transfer
- fertility
- prenatal androgen exposure
- reproductive history
- Twin
ASJC Scopus subject areas
- Obstetrics and Gynaecology
- Reproductive Medicine