Male pregnancy

Male pregnancy is the incubation of one or more embryos or fetuses by male members of some species. Most species that reproduce by sexual reproduction are heterogamous—females producing larger gametes (ova) and males producing smaller gametes (sperm). In nearly all animal species, offspring are carried by the female until birth, but in fish of the family Syngnathidae (pipefish, seahorses and the leafy seadragon), males perform this function.[1]

This article is about pregnancy in male organisms. For the sympathetic condition, see Couvade syndrome.
Pregnant male seahorse

Human males incubating fetuses are a subject of popular imagination and a recurring theme in speculative fiction. In some very rare genetic conditions, genotypical males develop as female and possess the anatomy required for gestation; these intersex people have carried fetuses to term and given birth. In the absence of uterus transplantation, cases of viable ectopic pregnancies in females provide a potential model for successful pregnancy in males, but any attempt at such would be extremely dangerous for both the father and the fetus. Trans men may also become pregnant, provided they have not had a hysterectomy.

Non-human animals
Further information: Syngnathidae and Seahorse

The fish family Syngnathidae has the unique characteristic of a highly derived form of male brood care referred to as "male pregnancy".[2] The family is highly diverse, containing around 300 different species of fish. Included in Syngnathidae are seahorses, the pipefish, and the weedy and leafy seadragons. The males of some of these species possess a brood pouch on the trunk or tail; in other species, the eggs are merely attached to the male's trunk or tail when the female lays them. Although biologists' definitions of pregnancy differ somewhat, all members of the family are considered by ichthyologists to display male pregnancy, even those without an external brood pouch.

Fertilization may take place in the pouch or in the water before implantation, but in either case, syngnathids' male pregnancy ensures them complete confidence of paternity.[3] After implantation in or on the brood pouch or brood patch, the male incubates the eggs. Many species osmoregulate the brood pouch fluid to maintain proper pH for the developing embryos. In at least some species, the male also provisions his offspring with nutrients such as glucose and amino acids through the highly vascularized attachment sites in or on his body.

This period of incubation can take much longer than the production of another clutch of eggs by the female, especially in temperate regions where pregnancies last longer,[4] leading to a reproductive environment in which sexual selection can be stronger on females than on males due to increased male parental investment. This reversal of traditional sex roles has only been found in pipefishes, whereas seahorses have largely been accepted as monogamous.[5] Some pipefish species display classical polyandry because of this unique situation. Male syngnathids usually prefer females with large body size and prominent ornaments such as blue skin pigmentation or skin folds. Syngnathid males in some species are apparently capable of absorbing eggs or embryos while in the brood pouch.[6] In these cases, embryos with the highest survival rate are those whose mothers display the preferred phenotype.

Syngnathidae is the only family in the animal kingdom to which the term "male pregnancy" has been applied.[1]

Humans

Ectopic implantation

Human males do not naturally possess a uterus to gestate offspring.[1] The theoretical issue of male ectopic pregnancy (pregnancy outside the uterine cavity) by surgical implantation has been addressed by experts in the field of fertility medicine, who stress that the concept of ectopic implantation, while theoretically plausible, has never been attempted and would be difficult to justify – even for a woman lacking a uterus – owing to the extreme health risks to both the parent and child.[7][8]

Robert Winston, a pioneer of in-vitro fertilization, told London's Sunday Times that "male pregnancy would certainly be possible" by having an embryo implanted in a cis man's abdomen – with the placenta attached to an internal organ such as the bowel – and later delivered surgically.[9][10][11] Ectopic implantation of the embryo along the abdominal wall, and resulting placenta growth would, however, be very dangerous and potentially fatal for the host, and is therefore unlikely to be studied in humans.[9][12] Gillian Lockwood, medical director of Midland Fertility Services, a British fertility clinic, noted that the abdomen has not evolved to separate from the placenta during delivery, hence the danger of an ectopic pregnancy. Bioethicist Glenn McGee said "the question is not 'Can a man do it?'. It's 'If a man does have a successful [ectopic] pregnancy, can he survive it?'"[10]

Since 2000, several hoax web sites have appeared on the Internet[12] purporting to describe the world's first pregnant cis man. While some rely on legitimate scientific claims, no such experiment has ever been reported. Fertility clinician Cecil Jacobson claimed to have transplanted a fertilized egg from a female baboon to the omentum in the abdominal cavity of a male baboon in the mid-1960s, which then carried the fetus for four months; however, Jacobson did not publish his claims in a scientific journal, and was subsequently convicted on several unrelated counts of fraud for ethical misconduct.[8]

Uterus transplantation
Main article: Uterus transplantation

Unlike an ectopic pregnancy which places both the fetus and host in danger, uterus transplantation into a male, if successful, would provide protection to both the fetus and host and remove much of the danger to both.

According to Karine Chung, director of the fertility preservation program at the University of Southern California's Keck School of Medicine, transplanting a uterus into a human male would not be much different from transplanting one into a female, as "male and female anatomy is not that different."[13] The uterus would either have to be donated by a willing donor or be tissue-engineered using the male's stem cells and then implanted into his pelvic region.[14] Afterward, the standard in vitro fertilisation (IVF) procedure would be followed to insert the fetus into the male's newly formed womb.

A uterine transplant was performed in Saudi Arabia in 2000, from one woman to another, but it did not result in a pregnancy.[15] This advance drew speculation about the possibility of a male receiving a womb transplant, and bearing a child from the transplanted womb.[16]

Intersex people

Certain rare disorders of sex development in karyotypical (46, XY) males cause the paramesonephric ducts to develop into the Müllerian structures required for pregnancy, as in a female. While affected intersex women are infertile (producing no gametes), they may successfully carry and deliver a pregnancy with assisted reproductive technology (ART). There are also documented cases of individuals with XY-predominant mosaicism conceiving naturally, including a person with a 96% XY karyotype and ovotestes (true hermaphroditism).[17] There has been a reported case of an XY-predominant woman who experienced regular menstruation, two natural pregnancies, and gave birth.[18]

Transgender men
Main article: Transgender pregnancy

Some transgender men can become pregnant, if they have functioning ovaries and a uterus.[19][20][21]

Fetus in fetu
Main article: Fetus in fetu

Fetus in fetu, though not an actual pregnancy, is an extremely rare condition in which a mass of tissue resembling a fetus forms inside the body. This is a developmental abnormality in which a fertilized egg splits as if to form identical twins, but one half becomes enveloped by the other, and an entire living organ system with torso and limbs can develop inside the host.[22] The abnormality occurs in 1 in 500,000 live births in humans.[23]

The case of Sanju Bhagat, also known as Sanjay Kumar,[24] a man from Nagpur, India, attracted attention in 1999 for the length of time (36 years) he had carried his parasitic twin inside his body, and the size of the growth. Since Bhagat had no placenta, the growth had connected directly to his blood supply.[25] In an extremely unusual case, a 2-year-old boy became pregnant with his parasitic twin inside his stomach feeding off him like a normal fetus would feed on its mother. The boy required a Caesarean section. It is virtually impossible that the fetus could survive this process due to being underdeveloped.[26]

See also: Reproduction and pregnancy in speculative fiction
Part of a series on
Sex and sexuality in
speculative fiction

Some science fiction writers have picked up on these issues, in "cross-gender" themes—e.g., Octavia E. Butler's Bloodchild and Other Stories. Ursula K. Le Guin's novel The Left Hand of Darkness contains the sentence "The king was pregnant", and explores a society in which pregnancy can be experienced by anyone, since individuals are not sexually differentiated during most of their life and can become capable of inseminating or gestating at different times. Lois McMaster Bujold's Ethan of Athos features an all-male society in which men use artificial wombs, but experience many of the psychological effects of pregnancy (anticipation, anxiety, etc.). In Marge Piercy's feminist utopian novel Woman on the Edge of Time, neither men nor women get pregnant, leaving that to artificial wombs, but both sexes may lactate and nurse the infant; the specifically female experiences of pregnancy and nursing were opened to men in the cause of gender equality.[27] Larry Niven's 1969 essay "Man of Steel, Woman of Kleenex" ends with considering Superman as a carrier for his own baby, due to the difficulties a human female might encounter carrying a superpowered fetus.

The concept of male pregnancy has been the subject of popular films, generally as a comedic device. The 1978 comedy film Rabbit Test stars Billy Crystal as a young man who inexplicably becomes pregnant instead of his female sex partner. In Monty Python's 1979 film, Life of Brian, there is a political satire scene in which a character demands that any man has a "right to have babies if he wants them," which is ridiculed as impossible. The 1994 science fiction comedy/drama Junior stars Arnold Schwarzenegger as a fertility researcher who experiments on himself; the screenplay was inspired by a 1985 article in Omni magazine.[8] In the 2017 film Mamaboy stars Sean O'Donnell as Kelly Hankins as a teenager who decides to undergo an experimental procedure that enables him to carry his girlfriend's baby to term.

The concept appears frequently as a comedic gag in numerous television programs as well. In a 1981 episode of the Canadian sketch comedy series Bizarre, the show’s resident daredevil character Super Dave Osborne (Bob Einstein) performs, as one of his many stunts, carrying and giving birth to a baby. The 1990 BBC television comedy drama Frankenstein's Baby features a Dr. Eva Frankenstein helping a male patient to become the world's first pregnant man.[28] In the BBC science fiction comedy series Red Dwarf, the main character Dave Lister becomes pregnant after having sex with a female version of himself in an alternate universe. In an episode of Sliders, the quartet "slides" into an alternate world in which babies develop during their final months in the father because a worldwide disease has kept women from being able to carry children beyond their first trimester. In the popular fantasy series Charmed's fifth season, during a dream spell gone wrong, Leo ends up pregnant with Piper's baby for a good deal of the episode, leading to her referring to him as an "incubator" and at times berating him for "upsetting the baby". In Doctor Who (series 11), an episode features a man going into labor pain. In the Ozzy & Drix episode "Ozzy Jr.", Ozzy thinks he is having a baby but is actually a parasite growing in his belly caused by an infection by Strepfinger. In the Ren & Stimpy "Adult Party Cartoon" episode "Stimpy's Pregnant", Stimpy is thought to be pregnant but Mr. Horse finds out that he is actually constipated.

The possibility of extraterrestrial life having different reproductive sexuality is the basis for many references. In the Star Trek: Enterprise episode "Unexpected", Trip Tucker becomes pregnant with the offspring of a female of another species. In the video game The Sims 2 male characters can be impregnated via cheat codes or alien abduction. In the American Dad! episode "Deacon Stan, Jesus Man", the boy Steve becomes impregnated after giving the mouth-to-mouth resuscitation to the extraterrestrial Roger, then unwittingly passes it on to his girlfriend via a kiss. In the animated series Futurama, the extraterrestrial Kif can be impregnated by a touch. In the SciFi Channel miniseries, Farscape: The Peacekeeper Wars, the extraterrestrial Rygel becomes impregnated with human John and Aeryn's baby. In the series Alien Nation, when Tectonese main character George Francisco and his wife Susan decide to have a third child, it is revealed that, in order to conceive, a Tectonese couple needs a third party, called a binnaum, to complete impregnation, and that the male carries the baby—encased in a pod—during the final months of gestation. In the animated series The Fairly OddParents in the TV film Fairly OddBaby, the fairy Cosmo was pregnant of Baby Poof. Additionally, Robert Sheckley's 1989 short story Love Song From the Stars also contains this element. In the twenty-second episode of My Friends from Afar, Xiang Lin was pregnant, but the baby turned out to be an egg.

In the Ben 10: Alien Force episode "Save the Last Dance", it is revealed that Necrofriggians have an ability to asexually reproduce once every 80 years, building a large nest made of digested metal where their eggs will hatch and their offspring will feed on the metal, first eating from the nest before they instinctively feed on solar plasma until they mature and starts their own separate lives. Due to the Necrofriggian reproduction cycle, Big Chill overtook Ben's personality to carry out the process, but Ben did not remember anything he did as Big Chill during this cycle, like eating metal and having 14 babies, and he felt very embarrassed when Gwen, Kevin and Julie explained, and Kevin's teasing and calling him "mommy" did not help. In The Three Stooges episode "Even as IOU" Curly accidentally swallows a Vitamin Z pill meant for a horse. However, the error allows Curly to give birth to an Equidae, which the Stooges crown as a winning race horse.

Virgil Wong, a performance artist, created a hoax site[12][29] featuring a fictitious male pregnancy, claiming to detail the pregnancy of his friend Lee Mingwei.[30][31][32]

Male pregnancy is also commonly explored in slash (homosexual) fan fiction, usually based upon fantasy series such as Supernatural or Harry Potter.[33][32]

gollark: “If you're trying to stop me, I outnumber you 1 to 6.” “Never trust an unstable asymptotic giant branch star. Stick with main sequences and dwarfs.” “You know, fire is the leading cause of fire.”“if you can’t find time to write, destroy the concept of time itself”“Strength is a strength just like other strengths.”
gollark: “In yet another sentence of mine that will in no way be taken out of context later: the answer is always murder”
gollark: “If you want to have your cake and eat it too, steal two cakes.”
gollark: “The laws of Australia prevail in Australia, I can assure you of that. The laws of mathematics are very commendable, but the only law that applies in Australia is the law of Australia.”This one is pretty stupid, an Australian prime minister said it.
gollark: I have a bunch of quotes on my notes thing, maybe there are stupid ones in that.

See also

References
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  4. Wilson, A. B.; I. Ahnesjo; A. Vincent; A. Meyer (2003). "The dynamics of male brooding, mating patterns, and sex roles in pipefishes and seahorses (family syngnathidae)". Evolution. 57 (6): 1374–1386. doi:10.1111/j.0014-3820.2003.tb00345.x. PMID 12894945.
  5. Berglund, A; G. Rosenqvist (2003). Sex role reversal in pipefish. Advances in the Study of Behavior. 32. pp. 131–167. doi:10.1016/s0065-3454(03)01003-9. ISBN 9780120045327.
  6. Sagebakken, Gry; Ingrid Ahnesjo; Kenyon B. Mobley; Ines Braga Goncalves; Charlotta Kvarnemo (2009-11-25). "Brooding fathers, not siblings, take up nutrients from embryos". Proceedings of the Royal Society B. 277 (1683): 971–977. doi:10.1098/rspb.2009.1767. PMC 2842728. PMID 19939847.
  7. William Leith (2008-04-10). "Pregnant men: hard to stomach?". The Daily Telegraph. London.
  8. Dick Teresi (1994-11-27). "How to Get a Man Pregnant". The New York Times Magazine.
  9. "Babies borne by men 'possible'". The Independent. 1999-02-22.
  10. Meryl Rothstein (2005-07-31). "Male Pregnancy: A Dangerous Proposition". Popular Science. Archived from the original on 2007-10-15.
  11. Men can have babies; Study still in infancy though: Expert Archived 2009-03-09 at the Wayback Machine
  12. "A Womb of His Own". Snopes.com. 2008-05-09.
  13. Kaplan-Gordon, Lisa (November 17, 2015). "Surgery Could Give Men Wombs of Their Own Within 5 Years". Yahoo! Health. Yahoo!.
  14. Rowe, Aaron (April 27, 2009). "The Future of Reproduction: Male Pregnancy". Upstart Business Journal. The Business Journals.
  15. Nair, Anjana; Stega, Jeanetta; Smith, J. Richard; Del Priore, Giuseppe (2008). "Uterus Transplant". Annals of the New York Academy of Sciences. 1127: 83–91. doi:10.1196/annals.1434.003. PMID 18443334.
  16. Stein, Rob (January 15, 2007). "First U.S. Uterus Transplant Planned". The Washington Post.
  17. Schoenhaus, S. A.; Lentz, S. E.; Saber, P; Munro, M. G.; Kivnick, S (2008). "Pregnancy in a hermaphrodite with a male-predominant mosaic karyotype". Fertility and Sterility. 90 (5): 2016.e7–10. doi:10.1016/j.fertnstert.2008.01.104. PMID 18394621.
  18. Dumic, Miroslav; Lin-Su, Karen; Leibel, Natasha I.; Ciglar, Srecko; Vinci, Giovanna; Lasan, Ruzica; Nimkarn, Saroj; Wilson, Jean D.; McElreavey, Ken; New, Maria I. (1 January 2008). "Report of fertility in a woman with a predominantly 46,XY karyotype in a family with multiple disorders of sexual development". The Journal of Clinical Endocrinology and Metabolism. 93 (1): 182–189. doi:10.1210/jc.2007-2155. ISSN 0021-972X. PMC 2190741. PMID 18000096. A 46,XY mother who developed as a normal woman underwent spontaneous puberty, reached menarche, menstruated regularly, experienced two unassisted pregnancies, and gave birth to a 46,XY daughter with complete gonadal dysgenesis.
  19. FTM Transgender. - FAMILY/Hormone guide for FTM, "Question 2" (geocities) last accessed 2008-07-02
  20. Labor of Love website Archived 2010-01-23 at the Wayback Machine.
  21. Thomas Beatie, "Labor of Love: Is society ready for this pregnant husband?", The Advocate, April 8, 2008, p. 24.
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  23. Grant P, Pearn JH Foetus-in-foetu. Med J Aust. 1969; 1:1016-1020 — source not consulted; cited here following Hoeffel, CC; Nguyen, KQ; Phan, HT; Truong, NH; Nguyen, TS; Tran, TT; Fornes, P (2000). "Fetus in fetu: A case report and literature review". Pediatrics. 105 (6): 1335–44. doi:10.1542/peds.105.6.1335. PMID 10835078.
  24. Mohini, Gaurav Dutt. "PREGNANT MAN WHO GAVE BIRTH TO HIS BROTHER AFTER 36 YEARS". Archived from the original on 2014-12-22.
  25. "Man With Twin Living Inside Him -- A Medical Mystery Classic". ABC News. 23 August 2006. Retrieved 2008-03-27.
  26. Mahesh, Roshni (October 3, 2013). "2-Year-Old Chinese Boy 'Gives Birth' to Parasitic Twin". International Business Times. Retrieved 2014-01-10.
  27. Piercy, Marge (1985-11-12). Woman on the Edge of Time. Fawcett. ISBN 978-0-449-21082-6.
  28. "Frankenstein's Baby". BFI. Archived from the original on 2009-01-29.
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  30. Hoax website: "POP! The First Human Male Pregnancy". Retrieved 2008-03-27.
  31. Lee Mingwei. Mingwei Archived 2008-06-19 at the Wayback Machine Refers to hoax as "Male Pregnancy Project, Centre d’Art Santa Monica, Barcelona, Spain"
  32. Ingram-Waters, Mary C. (2008). Unnatural Babies: Cultural Conceptions of Deviant Procreations. ProQuest. ISBN 9780549700333.
  33. Astrom, Berit (2010). "Transformative Works and Cultures". Transformative Works and Cultures. 4 (4). doi:10.3983/twc.2010.0135.
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