Can You Get Pregnant From Anal Sex? The Answer Might Surprise You

Can you get pregnant from anal sex? We know, it sounds like a ridiculous question at first. But people do wonder, even if the likelihood of pregnancy is very, very small. So in the interest of clearing up sexual health confusion, we decided to delve into the facts.

Okay, so is it ever possible for a woman get pregnant this way? If you don’t have a certain rare medical complication and you’re careful about where your partner’s sperm ends up after anal sex, the answer is definitely no.

“There’s no connection between the rectal canal and the vaginal pouch. Semen must enter the vaginal pouch [for you to get pregnant],” Michael Reitano, MD, physician in residence for the men's health service Roman, tells Health.

Still, there are a few very unlikely exceptions to this rule—for example, if semen released during anal sex makes its way into the vagina via your or your partner's hand. 

"Here’s how it can happen: If you have unprotected anal sex and semen does leak out of the anus, the semen can possibly enter the vaginal pouch and result in a pregnancy," says Dr. Reitano. That said, being a little careful and also using a condom during anal sex can help you get that under control. And we can’t stress enough how slim the chances of this happening are.

Another exception would be if a woman has a very rare medical condition called a rectovaginal fistula, according to Dr. Reitano. A rectovaginal fistula is an opening between the vagina and the rectum. It can be caused by Crohn’s disease, an injury that occurs during childbirth, cancer found in the pelvic area, or radiation treatment. Surgery is needed to repair the fistula.

If you have anal sex while suffering from a rectovaginal fistula, it could result in pregnancy, since the condition creates an opening between the rectum and the vagina through which sperm can theoretically travel. But anal and vaginal sex both would probably be out of the question if you had a rectovaginal fistula.

“Gas and feces and secretions can go from the rectum to the vaginal pouch. The person generally has such difficult hygiene issues that any form of anal or vaginal intercourse is not feasible,” Dr. Reitano says. 

So once and for all, here's the bottom line: If you use a condom during anal sex and don’t suffer from any rare complications that involve your pelvic area, you shouldn’t worry about getting pregnant from anal.

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