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24th January 2010

How to get pregnant from a blowjob

posted in - Medical Oddities, - Offbeat news, - Palmdoc |

I guess the title got your attention as it certainly did get mine from my usual trawling of Reddit! Physiologically speaking, conception is impossible from the act of fellatio (now that would be the boring medical equivalent of saying it’s not possible getting pregnant from a blowjob) but it seems there was actually a Case Report published in the British Journal of Obstet and Gynaecol. In case you are cynical, the girl had an aplastic distal vagina so conception via coitus was indeed not the case. Here are the details via Open Knowledge:

The patient was a 15-year-old girl employed in a local bar. She was admitted to hospital after a knife fight involving her, a former lover and a new boyfriend. Who exactly stabbed whom was not quite clear but all three participants in the small war were admitted with knife injuries.,
The girl had some minor lacerations of the left hand and a single stab-wound in the upper abdomen. Under general anaesthesia, laparotomy was performed through an upper midline abdominal incision to reveal two holes in the stomach. These two woulds had resulted from the single stab-wound through the abdominal wall. The two defects were repaired in two layers. The stomach was noted empty at the time of surgery and no gastric contents were seen in the abdomen. Nevertheless, the abdominal
cavity was lavaged with normal saline before closure. The condition of the patient improved rapidly following routine postoperative care and she was discharged home after 10 days. Precisely 278 days later the patient was admitted again to the hospital with acute, intermittent abdominal pain. Abdominal examination revealed a term pregnancy with a cephalic fetal presentation. The uterus was contracting regularly and the fetal heart was heard. Inspection of the vulva showed no vagina, only a shallow skin dimple was present below the external urethral meatus and between the labia minora.

An emergency lower segment caesarian section was performed under spinal anaesthesia and a live male infant weighing 2800 g was born, with Apgar scores of 7 and 9 at 1 and 5 minutes, respectively. On exploration, through the nearly completely dilated cervix, it was found that the normal uterus ended in a 2 cm deep vagina and that the vagina did not exist more distally.

The uterus, adnexa and renal tract appeared normal. Routine closure of the uterus and abdomen followed; a large tube drain was left in the uterine cavity. While closing the abdominal wall, curiosity could not be contained any longer and the patient was interviewed with the help of a sympathetic
nursing sister. The whole story did not become completely clear during that day but, with some subsequent inquiries, the whole saga emerged.

The patient was well aware of the fact that she had no vagina and she had started oral experiments after disappointing attempts at conventional intercourse.
Just before she was stabbed in the abdomen she had practiced fellatio with her new boyfriend and was caught in the act by her former lover. The fight with knives ensued. She had never had a period and there was no trace of lochia after the caesarian section. She had been worried about the increase in her abdominal size, but could not believe she was pregnant although it had crossed her mind more often as her girth increased and as people around her suggested that she was pregnant. She did recall several episodes of lower abdominal pain during the previous year. The young mother, her family, and the likely father adapted themselves rapidly to the new situation and some cattle changed hands to prove there were no hard feelings.

The postoperative course was uneventful and the drain was removed on the 6th day. She started complaining about lower abdominal pain 8 months postpartum while she was still breastfeeding. An attempt was made to construct a vagina by tunneling between the urethra and rectum. A proximal vagina filled with old blood was found after 3-4 cm as described by Jeffcoate (1975). The tunnel was now dilated with appropriate instruments. It was found impossible to suture the skin of the introitus
to the wall of the proximal vagina as advocated by Jeffcoate and criticized by others (Dewhurst 1981). A mould was constructed from a 20 cm^3 plastic syringe cylinder with the distal end removed. The mould was fixed with nylon sutures to the labia and left in place for 2 weeks. The patient was discharged with a few oversized cervical dilators and instructed in their use. Follow-up was difficult, the patient was seen only some moths later with a stenosed vagina and lower abdominal pain.
Another reconstruction was attempted though scar tissue with much the same result.
Because she refused to have a hysterectomy and her cryptomenorrhea was very painful, high doses of depot medroxyprogresterone were used to induce amenorrhea. This was partly successful, but a hysterectomy become necessary to afford her relief from crippling pain when were son was 2.5
years old. By that time the son looked very much like the legal father.

A plausible explanation for this pregnancy is that spermatozoa gained access to the reproductive organs via the injured gastrointestinal tract. It is known that spermatozoa do not survive long in an environment with a low pH (Jeffcoate 1975), but it is also known that saliva has a high pH and that a starved person does not produce acid under normal circumstances (Bernard & Couman 1976).

It is likely that the patient became pregnant with her first or nearly first ovulation otherwise one would expect that inspissated blood in the uterus and salpinges would have made fertilization difficult. The fact that the son resembled the father excludes an even more miraculous conception.

I am dumbstruck. This must be the only such case report in the world. I am however reminded of this joke:

SPERM 1:are we ever going to reach the egg?
SPERM 2:stop moaning we’ve only just passed the tonsils

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15 Responses to “How to get pregnant from a blowjob”

  1. 1
    Gravatar techeah Says:

    Plausible but what are the odds!! Amazing!

  2. 2
    Gravatar dranony Says:

    the next question must then be whether it is possible to get pregnant from anal sex…
    it would seem so, if there is a rectovaginal fistula, wouldn’t it?
    (RVFs are not uncommon in some poorer nations with poor obstetric care.)

  3. 3
    Gravatar poor doctor Says:

    She must be having oral sex with the Superman as only superman’s sperm can survive the acidity of pH1.4 of gastric juice.

  4. 4
    Gravatar Palmdoc Says:

    The authors commented in the paper:
    “It is known that spermatozoa do not survive long in an environment with a low pH (Jeffcoate 1975), but it is also known that saliva has a high pH and that a starved person does not produce acid under normal circumstances (Bernard & Couman 1976).”
    - the incident was reported by Verkuyl DA. from Mafeteng Districts Hospital, Lesotho (the bit about the Cattle is a clue that this is not in the “West”)
    - Lesotho is in S Africa where 40% live below the poverty level
    http://en.wikipedia.org/wiki/Lesotho
    - Gastric pH does rise with starvation
    http://www.springerlink.com/content/u2g54233r60v623m/
    Indeed it is a highly unusual set of coincidences but physiologically plausible given the right conditions and timing. Sorry to disappoint you but no Superman sperm.

  5. 5
    Gravatar poor doctor Says:

    A starved person will be more interested in food rather than having erection and ejeculation.

  6. 6
    Gravatar Palmdoc Says:

    The one having the erection and ejaculation might not be starving but the the other party might.
    http://wiki.answers.com/Q/What_nutritional_value_is_in_sperm

  7. 7
    Gravatar poor doctor Says:

    Research misconduct do happen in medical journals http://jrsm.rsmjournals.com/cgi/content/full/99/5/232 and certainly British Journal in Obstetrics and gynaecology had their share too. So don’t believe everything in it, read them with a critical mind.

    The most famous fraud was done by obstetrician, Malcolm Pearce
    http://www.bmj.com/collections/author1.htm
    Even the editor of that time, Geoffrey Chamberlain had to resign over this fraud.

  8. 8
    Gravatar Palmdoc Says:

    Of course there might be, but less likely in a case report I should think.

  9. 9
    Gravatar poor doctor Says:

    Case report is the worst type of research articles because they are not usually subjected to stringent peer review and verification.

    The infamous paper by Malcolm Pearce is actually a case report “Term delivery after intrauterine relocation of an ectopic pregnancy” which was later found to be fraud report.

  10. 10
    Gravatar Palmdoc Says:

    So I guess the baby born to this girl with vaginal aplasia who resembles the father must be a fake after all.
    Interestingly there’s even the possiblity of Sperm in the peritoneal fluid in a man!.

  11. 11
    Gravatar poor doctor Says:

    I am not saying that it was a total fraud but I would rather think that the vaginal atresia was not complete and there might be a small tract between the vagina and cervix which is too small for naked eye.

    For a sperm to go through GIT and than survive the peritoneal cavity (part of immune system) and than meet the egg IN the fallopian tube. The odd is just too remote. They also should follow up the case with DNA test (I wonder it exist in 1988 or not) to strengthen their case.

  12. 12
    Gravatar kong1ming2 Says:

    Even if there is a small tract, how do u expect the spermatozoa to swim thru a hole too small for a naked eye? The whole process of sperm reaching the ovum does not only involve the sperms swimming part. Besides, how does a guy could achieve orgasm via a vaginal atresia even if it’s incomplete? It’s far beyond imagination to reach the excitement, plateau and orgasm phase for ejaculation. -.-”

  13. 13
    Gravatar poor doctor Says:

    That’s right. At least this possibility is more than the possibility of sperm surviving the whole length of esophagus. swim around the the stomach while mixing with gastric juice and manage to find the hole in gastric and gone into the peritoneal cavity and swim around the the cavity and manage again to find the hole to get out and find the right frimbrae end and most importantly still survive and find the OVUM.

  14. 14
    Gravatar dranony Says:

    kong1ming2, considering that the widest diameter of the head of a spermatozoon is only about 3.5 micron, how wide should an atretic segment be, to allow passage of sperm?
    does this also mean that microscopic holes in a condom will NOT allow spermatozoa to pass thru, so long as they are invisible to the naked eye?

  15. 15
    Gravatar Iamawesomejoy Says:

    medical breakthrough?

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