When Sperm Is Released During Anal Sex, Can It Result in a Pregnancy?

A February 2022 article published in Culture, Health & Sexuality found that individuals saw having anal sex as one way to reduce the probability of pregnancy. However, even though the research said the likelihood of pregnancy after anal sex is very, very small, naturally, people want to know for sure. So, in the interest of clearing up sexual health confusion, we decided to delve into the facts. Can you get pregnant from anal sex? Also, what are the risks involved in having anal sex?

Can Anal Sex Lead to Pregnancy?

If you're careful about where your partner's sperm ends up after anal sex, the answer is definitely no—you won't get pregnant. The act itself cannot directly cause a pregnancy.

When it comes to pregnancy, the general process entails the fusion of eggs and sperm. If fertility treatments like intrauterine insemination (IUI)—where sperm is placed directly into the uterus—or in vitro fertilization (IVF) are not used to facilitate pregnancy, it can happen naturally when semen makes its way through your vagina to your uterus and fertilizes an egg. This is likely why there have not been many reports—if any reports at all—of anal sex resulting in pregnancy.

"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, a physician in residence for the men's health service, Roman, told Health.

When Is Pregnancy More Likely?

There are, however, a few very unlikely exceptions for getting pregnant from this sexual position.

For example, consider if semen released during anal sex makes its way into the vagina via your or your partner's hand or a sex toy. Another possibility is that "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," Dr. Reitano said.

Another exception would be if a person 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. Oftentimes, surgery is needed to repair the fistula but not always.

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 explained.

Other Concerns Regarding Anal Sex

Being careful during anal sex can help you bypass the chances of pregnancy. This could include using contraceptive methods such as condoms or hormonal birth control. Furthermore, as long as you don't have any rare complications that involve your pelvic area as well, you shouldn't worry about getting pregnant from anal sex.

However, though pregnancy from anal sex is highly improbable, that doesn't mean that there aren't other things to be concerned with if you engage in anal sex.

You should also take care to protect yourself from sexually transmitted infections (STIs), as they can be transmitted through anal sex. Symptoms of STIs can vary (e.g., painful urination, sores, or abdominal pain), but seek medical attention if you experience any signs of STIs.

Ultimately, we can't stress enough how slim the chances of pregnancy from anal sex happening are, but it's still important to know what having anal sex means for you and your health.