Science Vs

How Do You Get Pregnant With No Vagina?

February 26, 2026

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  • The episode introduces a case report concerning a 15-year-old girl in Lesotho who became pregnant and went into labor despite having vaginal agenesis (no vagina), presenting a medical mystery. 
  • The leading hypothesis for conception involves sperm from oral sex surviving stomach acid, escaping through a stab wound sustained during a fight, navigating the abdominal cavity, and fertilizing an egg during the patient's first-ever ovulation. 
  • The patient had Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, which typically involves an underdeveloped uterus, but in this unique case, her uterus was fully functional, allowing for a healthy pregnancy delivered via C-section. 

Segments

Pharmaceutical and AI Sponsorships
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(00:00:00)
  • Key Takeaway: Tremfya is a prescription medicine for Crohn’s disease and ulcerative colitis, requiring physician consultation regarding risks like serious allergic reactions and infections.
  • Summary: Tremfya offers self-injection or intravenous infusion for adults with moderately to severely active Crohn’s disease and ulcerative colitis. Serious risks include allergic reactions, infections, and liver problems, necessitating prior checks for infections and tuberculosis. Listeners are directed to ask their doctor about Tremfya or call a specific number for more information.
Introducing the Case File
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(00:01:01)
  • Key Takeaway: Science Vs introduces a new segment, ‘Case Files,’ focusing on extremely unusual medical case reports from academic literature.
  • Summary: The episode features a new segment called Case Files, dedicated to reviewing rare and bizarre patient stories documented in academic literature. The hosts hype this particular case as potentially topping all previous case reports due to its unbelievable nature. Science Vs is a Spotify Studios Original podcast.
The Lesotho Knife Fight
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(00:03:00)
  • Key Takeaway: The case originated in 1988 Lesotho, involving a 15-year-old bar employee admitted after a knife fight with an ex-lover and a new boyfriend.
  • Summary: The case report, published in the British Journal of Obstetrics and Gynecology, details a young woman who sustained a stab wound to her stomach during a three-person knife fight. Doctors operated, closed the wounds, and she recovered, only to return months later with labor pains. The initial incident involved a lover’s quarrel stemming from the patient giving oral sex to her new partner.
Discovery of Vaginal Agenesis
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(00:05:42)
  • Key Takeaway: Upon preparing the patient for delivery, doctors discovered she was pregnant but lacked a vagina, presenting only a shallow skin dimple where the opening should be.
  • Summary: The patient was fully pregnant and in labor, but examination revealed she had vaginal agenesis, meaning the lower part of her vagina did not develop. This condition, occurring in about one in 5,000 people, is often associated with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Despite the missing vagina, her uterus was fully formed and functional.
Sperm’s Impossible Journey
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(00:08:18)
  • Key Takeaway: The central mystery is how sperm entered the uterus, with the C-section delivery solving the exit problem but leaving the entry route unexplained.
  • Summary: The sperm likely entered the body via the oral sex incident, meaning it was swallowed and entered the stomach. Gastric acid is highly toxic to sperm; studies show sperm are immobilized within a minute and dead within 10 minutes in less acidic environments than the stomach. Experts suggest the sperm needed protection from saliva and seminal fluid, possibly aided by recent eating or vomiting, to survive long enough to exit the stomach through the stab wound.
Abdominal Swim to the Egg
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(00:14:27)
  • Key Takeaway: If sperm exited the stomach wound, it entered the peritoneal cavity, which has a pH similar to vaginal fluid, potentially allowing survival for the swim toward the fallopian tubes.
  • Summary: After leaving the stomach, the sperm would enter the peritoneal cavity, the space between abdominal organs. The pH in this cavity is surprisingly similar to vaginal fluid, offering a more hospitable environment for sperm survival than the stomach. The sperm then needed to navigate past the intestines to reach the pelvis and the egg.
The Coincidence of Ovulation
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(00:18:01)
  • Key Takeaway: The patient had never menstruated due to the lack of an exit, meaning the fertilization occurred during the exact first time she ever ovulated in her life.
  • Summary: The patient had never experienced a menstrual period because the blood had no opening to escape, suggesting she had never ovulated before. The timing of the sperm’s miraculous journey coincided precisely with her first-ever ovulation at age 15. The resulting baby was born healthy, making the entire sequence of events a medical unicorn.
Case Resolution and Skepticism
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(00:20:48)
  • Key Takeaway: While some doctors doubted the report’s extreme unlikelihood, others cited similar rare cases, and the original case report confirmed the child’s health two years later.
  • Summary: The case report noted that two and a half years later, the son was healthy and resembled the new boyfriend, with cattle changing hands suggesting reconciliation among the parties involved. Some consulted doctors found the story too unlikely, while others suggested a small, missed opening in the dimple might be a simpler explanation. The original case was published in a peer-reviewed journal, lending it credibility despite the extraordinary nature of the events.