Can you get pregnant from anal sex?

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First, to make sure we all know what's being asked: Pregnant is when an egg fertilized by sperm grows in a biosex female reproductive system. "Anal" is slang for sex play that involves the anus and/or rectum.
So the question is: can sperm in or around the anus fertilize an egg and keep growing?

Yes. You can get pregnant from anal. Here are three known ways.
1. Sperm swim from the anus to the vagina,
2. There's a hole in the tissues separating the vagina and the rectum, and,
3. The rectum is directly connected to the uterus
I'll explain with drawings.

If this is the internal reproductive system of a biosex female (vagina, uterus, Fallopian tubes, and ovaries) then getting pregnant usually happens because a penis in the vagina put sperm there, and then that sperm swim to the egg a few inches away. This is a challenging journey comparable to a marathon, yet some sperm are capable of even more. They can swim from the vaginal opening down here, to the egg in the Fallopian tube. Or the perineum, between the vagina and the anus, to the egg in the Fallopian tube. I've even heard of cases where sperm was ejaculated on a person's underwear or inner thigh and it led to pregnancy.

The question is: can they swim out the rectum, across the perineum, up the vagina and live? It's unlikely.

More likely is from the anus, across the perineum, and up.
And when semen goes in the rectum, it tends to come back out like a spitball of semen and fecal matter, right by the vulva shortly after ejaculation which can get its bearings and travel north.

Ideally the rectum is intact, and it's separated from an intact vagina. But sometimes, people are born with or develop passageways that connect the two organs.

These are called fistulas, and in this context there are two notable types: recto-vestibular, where the hole is closer to the vaginal opening and recto-vaginal, where the hole is anywhere along the vaginal canal. Like I said, these fistulas could be congenital, meaning just the way the person's born. But they could be from an injury giving birth, surgery in the area, or inflammation of the rectum like Crohn's disease. They could be caused by cancer in the vagina or rectum or caused by the radiation used to treat that cancer. Again, not a likely route to pregnancy, but still possible.

Let's talk about birds for a moment. Birds expel digestive wastes through one hole: the cloaca, which is the same hole they use for procreation. In comparison, I urinate out of a meatus, defecate out of an anus, and then there's my vagina for procreation (among other things). I have three separate holes.

But not all bodies are like mine. Not all bodies are like yours. In some human bodies these three holes meet and fuse together, creating a cloaca. In medical terms this is called "persistent cloaca," or a form of anorectal malformation. If it's diagnosed, surgery is done to make three distinct pathways for pee, poop and pregnancy. Sometimes though, it's not discovered, or the surgery doesn't work.

A Woman's Health article by Alicia Fedders describes a woman who had been treated for persistent cloaca as a child. But the surgery either didn't stick or trauma from it altered her body so that her rectum connected to her uterus. In her case, she became pregnant from having anal sex. As in, she increased the likelihood of getting pregnant by having anal instead of vaginal, not the other way around. Now you know anal sex is a possible route to pregnancy and sometimes a more effective one. Please make decisions accordingly. If you're avoiding pregnancy, use birth control 100% of the time.

And an important side note: if you're avoiding sexually transmitted infections, which are easily passed through mucous membranes during anal sex, please use protection. I care about you. Stay Curious.

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