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Account of a girl impregnated after oral sex shows sperms' survival skills.
Feb. 3, 2010— -- A strange tale of oral sex, a knife fight and the most unlikely of pregnancies recently brought to light by the blogosphere has doctors touting the triumphant persistence of sperm.
In 1988, a 15-year-old girl living in the small southern African nation of Lesotho came to local doctors with all the symptoms of a woman in labor. But the doctors were quickly puzzled because, upon examination, she didn't have a vagina.
"Inspection of the vulva showed no vagina, only a shallow skin dimple," so doctors delivered a healthy baby boy via Caesarean, the authors wrote in a case report published in the British Journal of Obstetrics and Gynaecology.
Her birth defect -- called Mullerian agenesis or Mayer-Rokitansky-Küster-Hauser syndrome -- didn't necessarily surprise doctors, but her pregnancy did. Even the 15-year-old girl could not believe she was pregnant.
Yet by looking at her records the hospital staff realized the young woman was in the hospital 278 days earlier with a knife wound to her stomach. The average pregnancy lasts 280 days. After interviews, they gathered that "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."
The girl arrived at the hospital with an empty stomach -- and therefore with little stomach acid around -- and doctors found two holes from a stab wound that opened her stomach up to her abdominal cavity. The case report said doctors washed her stomach out with a salt solution and stitched her up.
"A plausible explanation for this pregnancy is that spermatozoa gained access to the reproductive organs via the injured gastrointestinal tract," the authors wrote.
Infertility experts note the story, which resurfaced on a Discovery magazine blog, is not only a testament to Murphy's Law but one to arguably nature's most impressive swimmers: sperm.
"Here's an unbelievable set of coincidences," said Dr. Richard Paulson, head of the University of Southern California Fertility Program in Los Angeles. "But it's totally plausible."
Although doctors know that sperm needs a low acid (high pH) environment to survive, and would likely die eventually in the low pH of stomach acid, doctors also said that sperm comes in a protective fluid: ejaculate, a nourishing medium meant to protect the sperm.
Besides, "out of hundreds of millions of sperm if you knock out 90 percent of them, you're still going to have tens of millions of sperm," said Dr. Peter Schlegel, chairman of urology at New York Presbyterian Hospital/Weill Cornell Medical Center in New York.
"Sperm are pretty hardy," said Paulson, who pointed out that sperm must make it out of the acidic environment of the vagina before reaching more friendly territory at the cervix and in the uterus. Once in the abdominal wall, Paulson estimated that the sperm could survive for days.
"It's a long way from the stomach into the lower abdomen, it's a heck of a trip, but they made it," said Paulson. "You just need sperm somewhere in the area of an egg."
Paulson said in the early days of fertility treatments in the 1980s, doctors injected sperm in the lower abdomen hoping for the coincidental encounter with an egg. The procedure, called DIPI or direct intraperitoneal insemination, has largely been replaced by more effective methods.
Schlegel pointed out that although fertilization typically takes place in the fallopian tubes, doctors know that sperm can normally swim up and out of the reproductive organs into the abdominal cavity.
"The sperm are naturally there at times, and eggs are naturally there," said Schlegel. "Eggs are released from the ovary, and they sort of dance around before they get taken up by the fallopian tube."
So it seems, Schlegel concluded, that the sperm could also be taken up by the fallopian tube, as could a fertilized egg.
But some doctors are still suspicious of, or at least bewildered by the tale. The girl's birth defect is well known and by age 15, doctors say most girls would have been doubling over in pain with an abdomen filled with menstrual fluid that cannot escape.
The menstrual fluid of several periods would make it even more unlikely for a pregnancy to occur.
"She'd have pain all the time and would have a stomach full of blood all the time, and would have to be operated on, or she would eventually die," said Dr. Sherman J. Silber, director of the infertility center of Saint Louis at St. Luke's Hospital in Missouri.
Dr. Howard A. Zacur, a reproductive endocrinologist at Johns Hopkins, also had doubts. "The case report here suffers from the fact that an individual with a completely obstructed vaginal outlet would have been expected to have blood accumulation in the vagina, and/or uterus," he wrote in an e-mail.
The authors of the report guessed a pregnancy could only be possible if the girl had ovulated once or at most twice before her pregnancy.
Whatever the true story of the woman, and her now grown son, Silber said it could send a message to ordinary couples planning pregnancy.
"This story is a crazy story, and there's no way to make sense of it," said Silber. "But the data on sperm is that normally it's quite good in an alkaline environment for two or three days -- that's why the average couple wastes a lot of energy when they're trying to get pregnant."
Silber said he sees many couples who buy into the idea that they should time sex to coincide with the woman's ovulation. But Silber said the remarkable survivability of sperm means most couples don't have to change their normal sex lives at all.
"The average American married couple tends to have sex two or three days a week," said Silber, author of "How to Get Pregnant."
If sperm can survive for two or three days, that means the average sex life of an American married couple results in living sperm swimming around the woman's body every single day of the week.
"The practice to check when you ovulate and not to have sex until you're ovulating is stupid," Silber said.
Silber said because ovulation calendars and methods to detect ovulation are somewhat inaccurate, couples could miss ovulation and have sex too late.
"Twelve hours after ovulation, the eggs aren't good any more. You want to have the sperm there ready and waiting for when you ovulated," said Silber. "It's absolutely true that sperm can last a long time."

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14 year old daughter ready for sex help!!!
hi
my 14 year old daughter has just told me shes ready to have a sexual relationship with her bf whos 16. I have always told her that when shes ready to let me know and we can sort out contraception etc, but now shes told me its freaked me out a bit as i didnt expect it so soon I really dont know how to deal with it as if i say no she will probably do it anyway but without my support, but if i say yes its like saying yeah go ahead its fine
please advise

Legally, if she has sex with her bf, he can be arrested for statutory rape as you DD is under 16.

Personally, if she was my daughter, I would sit her down and explain to her why she is still to young to be having sex. At 14 she is still a child. I know there are girls out there having sex at 14, but if you can prevent it, I would try my damdest. xx
i would much prefere to prevent it, but im not sure of the right way to go about it without making her feel im been controling and unfair as they do at that age when you say no to something, id like to discourage her but also make it her desision not to have sex
14 year old daughter and her boyfriend, advice please
All you can do is explain the reasons why she shouldn't, unwanted pregnacy, STI's, also explain that her bf WILL be arrested if they have sex, as he is over the age of consent, and she is under. its easy forn her tosay no one will find out, but it could happen. She tells a freind or he does, and someone calls the police. And if they are so 'in love', he will wait, if hes not willing to wait then hes not worthy of being her bf, cause she worth more than that. xx
Wow what a great relationship you have got with your daughter, very hard as you have said though to know what to do now, from her point of view she has done exactly what you have asked her to, no mean feat at 14 and is trying to be completly honest with you, i think that is really amazing.

I'm sure you have and will give her all the do's and don't as you sound like you have that kind of relationship.

If you think she is going to sleep with him anyway, i would let her know that you still think she is a bit young but if she is still sure that she wants to do this then help arm her the pill and condoms, if she's going to do it anyway then at least it will be safely, mostly down to yourself being such an open and honest mother.

Really hard one though, you have my sympathy's,it's a hard slog this teenage thing.:)
hi
thanx for that. we do have a great relationship and can talk about anything. I think im going to arm her with all the reasons against it see how she still feels after that and if shes still dead set on it arrange to go to the family planning centre with her and her bf. I will let her know that although im not happy about it im still there for her. really i want to lock her in her bedroom till shes 21 lol I just hope im doing the right thing
I think you are a fantastic mum, your dd is so lucky.
 I became sexually active at 14 with my bf who I had been with for 18 months.
I could not speak to my parents about such a toboo subject.
So bf & I went to doc together.
As you quite rightly said she will probably do it anyway.
My advise is talk as much as possible, keep the door open for her to start a disscusion anytime she wants.
If they do then your job is to make sure they get as few opportunities as poss, such as not been alone in house etc.
Hiya

It's a difficult one really.. and something I haven't yet had to deal with yet so my answer is from a theoretical point of view.

I think you should sit down and explain to her that she is too young and explain why the age of consent is there. I would tell her (perhaps even look at sites on the net) about STD's and pregnancy and explain that even using contraception carefully does not make sex 100% safe. Perhaps even let her read some of the unplanned pregnancy stories on here?

Having said that, I do think if she is going to do it then she is going to do it. I was on the pill from aged 14 for my periods and I think it would be worth her going to the docs and going on it perhaps just incase. Also perhaps you could put some condoms in a box for her and give them to her.

Good luck with everything, you sound like a fab mum xx [smilie=056.gif]
hi
thanx for that. we do have a great relationship and can talk about anything. I think im going to arm her with all the reasons against it see how she still feels after that and if shes still dead set on it arrange to go to the family planning centre with her and her bf. I will let her know that although im not happy about it im still there for her. really i want to lock her in her bedroom till shes 21 lol I just hope im doing the right thing
Well done you for being so open with your daughter, it is rare. I also have a 14 yr old daughter and dread what you are going through! I think you are going about it right and I think as long as she takes "on board" what you say she will make an "adult" decision.
Good luck.
My 14 year old daughter refuses to go to school.
Firstly, I think that the fact that your daughter is willing to discuss this with you is fantastic!
Not many 14 year olds would do that, you must have a great relationship.
I can't give any advice that hasn't already been given, just express your concerns about sex at such a young age (reminding her that it is illegal, as well) but remember if she is intent on doing it, then she probably will. So make sure she knows about the contraception available to her at her age.
Good luck hunni
xx
You must have a very open relationship that's fab.

People are right when they say she is under the legal age of consent. It would only take a teacher at school to find out and they would inform the police which is a whole heap of trouble nobody needs.
Thanx so much for all your help. its given me plenty to discuss with her. I have arranged an evening with her tonight and my husband and son are making themself scarce. will let you know how it goes and thanx to all of you
I think you're going about it completely the right way! Yay you

My DD is nearly 11 and I so hope our relationship is the same as yours when she's 14. We're close now and I try to be honest but we've not reached the teens yet, it could all change and that is scary!
12 yr old daughter has had sex. Help!!!
14 year old son refusing to go to school
how lucky you and your dd are to have such an open and respectful relationship. I think the fact that you have this relationship that your dd feels comfortable to come to you about this is wonderful and shows her to be a fairly mature young woman, rather than just jumping in without any prior thought or planning.

I dread my dd being older, she is only 7 and still seems like my little baby girl but i really hope that when she is older we have as close and open a relationship.

I would say the same as everyone else, make sure she has all the facts, and point out that her bf could be arrested. But then i guess as you say ultimately you want to be supportive. The idea of taking them both down to the family planning clinic is a good idea, make sure they're both safe.

Good luck talking to your dd this evening, and who knows, maybe she will listen to your concerns and decide she wants to wait after all, good luck.
I just hope my daughter is as sensible as yours when the time comes and comes to me first. Your obviously doing great as a Mum.

I have odd religious beliefs that involve chastity before marriage, I have found when talking to the teenagers at church about it, it works not to point out the pregnancy and STDs they know that usually and feel invulnerable. What I find helps is talking about the positives of not having sex too early that usually generates a more useful discussion.

I found that being chaste as a teen gave me a better relationship with boyfriends we needed to find other ways to have fun together, its easier to walk away if you have to or its not working out,,  There are others but would probably sound bonkers to a teenager who wasn't considering chastity, but if you can talk about the aspects that will give her a better relationship with her boyfriend, and her own emotional growth its going to be more positive.

-Charley

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