We previously published our finding that 20% of infertile women prefer a multiple gestation pregnancy to a singleton as the outcome of infertility treatment. The purpose of this follow-up study is to survey a comparable but fertile control population and compare the proportion of fertile controls that prefers a multiple birth outcome with this previously studied infertile population. We are also interested in determining the characteristics of our entire population that are associated with this desire for multiples. Questionnaire-based prospective study. A survey was administered to 464 consecutive infertility patients presenting to our academic hospital-based infertility center and to 688 consecutive general gynecology clinic patients at the same hospital. The survey queried demographics, fertility history, desires regarding birth outcomes, and knowledge of both the risks of multiple births and fertility-related health issues. Chi2, Fisher’s exact tests, and Student’s t-tests were used where appropriate for univariate analysis. Multivariable logistic regression analysis was used to establish independence of association. There was a 97% response rate (n=449, ages 19-47) in the infertile group and a 93% response rate in the general gynecology (fertile) group (n=440 including only those women aged 19-47 without known infertility). The fertile group was younger (mean age 29.6 vs. 31.0, p<.001), less well-educated (p=.006), and reported lower family incomes (p<.001) than the infertile group. As previously published, 1 in 5 infertile women expressed a desire for a multiple gestation pregnancy over a singleton. In contrast, only 1 in 10 women in the fertile control group expressed this desire (p<.001). When both populations were studied together, the preference for multiples was independently associated with the diagnosis of infertility (p=.004), nulliparity (p=.001), and lack of knowledge of the risks of twins (p=.012). Age, education level, family income, religious affiliation, general fertility knowledge, and knowledge of the risks of triplets were not associated with the desire for multiples. Infertile women are twice as likely as fertile women to express a preference for a multiple birth over a singleton. This finding is independent of the fact that they are also more likely to be nulliparous, suggesting that there is something unique about an infertile woman’s sociocultural or medical experience that encourages the idea that multiples are a positive and desirable outcome of pregnancy. Given the inherent maternal, fetal, and childhood risks of multiple gestation pregnancies, it is important for clinicians to acknowledge this potential for conflict and to counsel accordingly.