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This episode is brought to you by Claude from Anthropic. Some of the greatest innovations we have today came from someone just wanting to help. The same is true for the scientists who founded Anthropic. They wanted to build an AI that's safe, harmless, and benefits humanity. And one thing they just committed to no ads in Claude, because once AI is optimized to keep you engaged and scrolling instead of helping you think, it stops being a tool and you become the product. See why problem solvers choose Claude as their thinking partner at Claude AI Scienceverses.
Wendy Zuckerman
Hi, I'm Wendy Zuckerman, and you're listening to Science Verses. Today on the show, a new segment that we're calling Case Files. And this is where we take case
Joel Werner
reports, which are basically stories from academic literature where really weird things have happened to patients that are often so out of the norm that doctors have to write them down for posterity.
Wendy Zuckerman
So think about the kid who went
Joel Werner
to the hospital with a case of blue balls. Classic case report.
Wendy Zuckerman
But today we have a case report
Joel Werner
for you that could perhaps top all case reports. And to process it all, we've got friend of the show and science journalist Joel Werner.
Wendy Zuckerman
Hello, Joel.
Joel Werner
Hey, Wendy. Oh, boy.
Boy, boy.
The case report to top all case reports. Like, you're coming in hot. Let's do it.
Wendy Zuckerman
Let's do it.
Joel Werner
Okay. This story was published in the British Journal of Obstetrics and gynecology in 1988. It begins with a lover's quarrel and ends with what might be one of the unlikeliest events in scientific history. But it's so unlikely that we're wondering if perhaps it is indeed a fairy tale with some nightmarish elements. One doctor told us. It reads like Jerry Springer, quote, you don't see much in medicine that's published in this way.
Wow, that is some hype. All I have to say is, Wendy, Wendy, Wendy, get to it.
Wendy Zuckerman
All right, we're in Lesotho, which is a very small country within the borders of South Africa, and the case report
Joel Werner
starts off like this. I'm just going to read it to you verbatim, the first few sentences.
Wendy Zuckerman
Quote, the patient was a 15 year old girl employed in a local bar. She was admitted to hospital after a knife fight involving her, a former lover and a new boyfriend. Who exactly stabbed whom was not quite clear. But all three participants in the small
Joel Werner
war were admitted with knife injuries.
Wow. Shit got out of control there, didn't it?
It sure did.
Wendy Zuckerman
So this young woman comes into the hospital with a stab wound to the upper part of her stomach. They have a look and it's actually sort of punctured two holes into her stomach. The doctors operate on her, close up the wounds, keep her for observation, but ultimately she gets to go home after about a week and a half, and she's fully recovered. But of course, our story can't end there. Months later, she returns to the hospital with a very different issue. It's about nine months later, actually, and she's complaining of serious stomach pain. It's coming in these very intense waves where the pain gets really bad and then it goes away and then it comes back again. Doctors examine her. What do you think's going on, Joel?
Joel Werner
Like, I got two kids and that sounds like contractions.
Dr. Neil Shah
Yes.
Joel Werner
Yes. Okay.
Wendy Zuckerman
Yes, she is pregnant.
Joel Werner
Wow.
Wendy Zuckerman
Fully in labor. She didn't know she was pregnant.
Joel Werner
She did suspect something was up because her belly was getting bigger.
Wendy Zuckerman
Now again, you might be thinking, okay, this happens. 15 year olds, they get pregnant sometimes. But here's where things get strange. As the doctors started to get her ready to have this baby, they realized something a little bit different about this woman. She has no vagina.
Joel Werner
What?
Dr. Neil Shah
Yeah.
Wendy Zuckerman
So she's pregnant, she's not into sex, she's not trans, but she has no vagina.
Dr. Neil Shah
So.
Joel Werner
So what is down there? It's like as a Barbie doll situation.
Yeah, we're gonna get to that just after the break.
Wendy Zuckerman
Welcome back. Before the break, we told you about a 15 year old who is pregnant
Joel Werner
and in labor, but has no vagina.
Wendy Zuckerman
Okay, so let's just talk about this
Joel Werner
no vagina for a moment.
Wendy Zuckerman
So basically, when this woman was in
Joel Werner
the womb, the lower part of her
Wendy Zuckerman
vagina didn't develop properly. And this can sometimes be caused by a condition called vaginal agenesis.
Dr. Neil Shah
Right. Okay. Yeah.
Wendy Zuckerman
It happens to about 1 in 5,000 people. And this case report said that where her vagina was supposed to be, only a shallow skin dimple was present. So it wasn't like a Barbie situation. We think she had a urethra, the inner and outer lips of the vulva. So all of that looked typical. But then instead of an opening where the vagina was supposed to be, there was skin with a little dent in it. So think about it, like kind of pressing your cheek a little, like a little dimple, so no hole. And this condition is usually brought on by a syndrome with a very long name.
Dr. Neil Shah
Mayer Rokatansky Kuster Hauser syndrome. It's a mouthful.
Joel Werner
Sounds like a law firm, to be honest.
Wendy Zuckerman
Right.
Joel Werner
Well, this mouthful was said by Dr. Neil Shah.
Wendy Zuckerman
He's an OBGYN and the chief medical officer at Maven Clinic. He's based in Massachusetts. Massachusetts. And he's treated people who have this condition before.
Dr. Neil Shah
When I was in residency, I took care of people at Boston Children's Hospital that would fly in from all over the world who had this syndrome.
Wendy Zuckerman
Now, Neil told us that on top of the vagina that hadn't properly formed, people with this condition can also have a uterus that is not fully developed. But in this case, with the pregnant hero of our story, her uterus was fully formed, working perfectly, and could support
Joel Werner
a fetus soon to be a baby.
Wendy Zuckerman
It just seems there was no vagina. So the big question is, of course,
Joel Werner
how did the sperm get in? And I guess part two, how does the baby get out?
Okay, so the baby got out by C section. That's the quick one.
Okay.
Wendy Zuckerman
Now back at the hospital, doctors and nurses were curious themselves about how the sperm got in there. And actually the case report says that, get this. As they were still closing her up from surgery, from the surgery of the C section, quote, curiosity could not be
Joel Werner
contained any longer and the patient was interviewed with the help of a sympathetic nursing sister. End quote. Here's what they found out.
Wendy Zuckerman
The young woman had apparently tried multiple times to have sort of garden variety penis vagina sex, but was obviously unsuccessful due to the aforementioned lack of vagina. And so turn to oral sex, which ends up being key here. So, Joel, do you remember that fight that broke out at the start of this story?
Joel Werner
Oh, yeah. I can't stop thinking about it. The knife has to be. It's Chekhov's knife.
Dr. Neil Shah
Right?
Joel Werner
It's Chekhov's knife.
Wendy Zuckerman
Okay. So it seems that that fight all started because her ex lover caught her going down on her new partner. Ah. And doctors think that wild combination of giving fellatio, swallowing the sperm and the fight might have led to this pregnancy.
Joel Werner
What this is like, I'm imagining the cum going on some sort of, like, Hot Wheels roller coaster ride where it, like, shoots out of one hole and dives into a different hole.
And, I mean, so that is the adventure we are about to go on.
Dr. Neil Shah
Wow. Okay. All right.
Joel Werner
So the first thing we need is some way for the sperm to get to the egg. And normally the sperm has a pretty direct route through the vagina. Sneaky way up the cervix, yada, yada, yada, basically home free. But in this case, when she swallowed the sperm, it would have been stuck in her stomach.
Wendy Zuckerman
And our producer, Katie Foster Keys asked
Producer/Additional Contributor
Neil, are the stomach and the uterus connected in any sort of way?
Dr. Neil Shah
Not without a knife,
Wendy Zuckerman
but we had a knife.
Joel Werner
Right. But maybe we should start our Hot Wheels journey with the sperm inside the stomach. Because she's just swallowed it.
Dr. Neil Shah
Right.
Joel Werner
Because Neil actually told us that at that point, it should have been game over.
Dr. Neil Shah
Wow.
Joel Werner
Okay.
Dr. Neil Shah
The most extraordinary thing is that sperm does not survive acid. Gastric acid in the stomach is basically as acidic as it gets.
Wendy Zuckerman
Yeah. So he's just shocked. And other doctors we reached out to as well. Shocked that it would have survived the stomach at all.
Joel Werner
Other science journalists as well. Like, I'm just perpetually shocked at the moment.
So those stomach acids are so toxic to sperm.
Wendy Zuckerman
In one study, researchers actually looked into
Joel Werner
how different acids would affect sperm, whether it would immobilize or kill human sperm.
Wendy Zuckerman
And so they mixed semen with stuff that is generally less acidic than the contents of our stomach. And what they found was that within
Joel Werner
a minute, the sperm could no longer move.
Wendy Zuckerman
And within 10 minutes, all the sperm were dead. So based on that study, the odds
Joel Werner
of the sperm surviving the stomach were perhaps even less than the odds of this woman not having a vagina. Here's Neil.
Dr. Neil Shah
I've never seen sperm survive in the stomach in my whole career.
Joel Werner
So do they know what length of time there was between her going down on her new lover and her getting stabbed in? Was she caught in the actual. And so the sperm could, like, maybe have just been freshly in the stomach.
Wendy Zuckerman
Yeah, it appears she was caught in the act. All of this must have happened quickly. It couldn't have just been sitting in the stomach because then sperm would have been dead.
Joel Werner
Absolutely.
Wendy Zuckerman
It has to have happened very fast, the swallow. And then. So we know saliva is a. Is a nicer ph for Sperm. We also know that seminal fluid is not. Is not acidic.
Dr. Neil Shah
Okay.
Wendy Zuckerman
It's actually a little bit basic. So maybe the two of them acted like a coating to protect the sperm. On top of that, eating food can lower the acidity in your stomach.
Joel Werner
So maybe if she'd had a big meal before all this happened, it's this
perfect storm of, like, eating and swallowing the cum and getting stabbed in the
stomach and that somehow the sperm survives.
Wendy Zuckerman
And one thing that Neil read in the case report made him think that maybe this did all happen quickly.
Dr. Neil Shah
What they say in the case report is that she vomits.
Wendy Zuckerman
So what the case report actually says is that her stomach was empty when she had surgery. But Neil, knowing what he knows about medicine, reckons that that could be from vomiting.
Joel Werner
So maybe what happens is she swallows the sperm and it's somehow protected in
Wendy Zuckerman
the saliva and the seminal fluid. And then maybe she vom. And that act of vomiting propels a
Joel Werner
tiny bit of sperm out into the little hole in the stomach that the stab wound created. So here's Neil.
Dr. Neil Shah
So it basically has to be, like, perfectly positioned anatomically to be near the place where it would exit based on where the stab was, which, you know,
Joel Werner
explains our exit from the stomach. But there's still. This is just the first step of a long journey I'm imagining.
Wendy Zuckerman
Right.
Dr. Neil Shah
And then it gets even wilder.
Wendy Zuckerman
Right. Because when it exits the stomach, like
Joel Werner
you say, it's not as if the egg is just hanging around saying, hello, I'm right here. The egg, it should be in the pelvis and the hole was in the stomach. So we still have a hot wheels ride to go down.
Absolutely, yeah.
Wendy Zuckerman
Now, once the sperm gets out of the stomach, it moves into this liquidy space that's between the organs in the abdomen. It's called the per cavity. And this peritoneal cavity is actually a
Joel Werner
nicer place, we think, for the little fragile spermies to survive and thrive, because
Wendy Zuckerman
the ph in the peritoneal cavity is about the same as vaginal fluid.
Joel Werner
Ah, okay.
Wendy Zuckerman
Which is the stuff that protects the sperm as it travels through the vagina.
Dr. Neil Shah
Right.
Wendy Zuckerman
For those who have a vagina. Now, there have been two other case reports that we found where sperm was found in. In the peritoneal fluid of men, suggesting that maybe it can survive there.
Joel Werner
And so from this peritoneal cavity, the
Wendy Zuckerman
sperm then would have had to have
Joel Werner
swum past the intestine into the pelvis and ultimately to reach the egg.
Look, this is. Do you know those guys who, like, overanalyze the zapruder film of JFK's assassination. And they're like rewinding it and going, oh, the bullet had to have come. Like, Neil reminds me of one of those guys. He's just gone. No, look, it sounds far fetched, but maybe there's this like magic sperm that can like roller coaster its way through the abdomen and then. Magic fertilizer.
Yeah, exactly. So that is one way. Maybe. After the break, the final unbelievable chapter. Welcome back. Today on the show, how the teenager with no vagina got pregnant. Here's where we're at. Based on the facts on the ground, it looks like the only way to this could have happened was that the sperm that she swallowed after giving oral to her boyfriend somehow survived the acids in her stomach, escaped the stomach through a stab wound, and then swam down the obstacle course that is her body and merged with the egg.
Unbelievable.
Unbelievable. And by the way, we looked into this.
Wendy Zuckerman
There are a bunch of ways that the sperm is guided towards the egg because of things that the egg is doing. Like it releases certain ch that sort of say, come hither to the sperm. And there's changes to temperature and the flow of fluid in the body that can help guide sperm to the egg. But all of that stuff tends to happen when you're already pretty close to the target. It's not kicking in up in the stomach.
Joel Werner
And I imagine that we haven't evolved to help sperm from. Was it the peritoneal?
Wendy Zuckerman
Yes, cavity.
Joel Werner
The cavity to then find its way. It's not like we usually get sperm, no body.
No, no, no, no. Which takes us to the final, rather unbelievable part of the story, which is the egg.
Wendy Zuckerman
What's very curious about what happened here is that we don't think that this young woman ever had a menstrual period before because without a vagina, there'd be no hole for the blood to escape into. And so if she had released an egg and this blood was coming down, the body really doesn't like blood in
Joel Werner
places it shouldn't be, sort of.
Wendy Zuckerman
And so if it was pooling there, it would have caused her a lot of pain and she would have had to go to probably the hospital to deal with it. And plus, when they opened her up to deliver the baby, they would have seen blood from past periods and. And they didn't. He's Neil now.
Dr. Neil Shah
When they deliver her, her cervix is completely dilated and it empties into nowhere and there's no blood anywhere. And apparently she's never menstruated before. So the other extraordinary timing is this is the first time she's ever ovulated in her entire life. She's 15, and she ovulates at the exact perfect time for fertilization to happen.
Joel Werner
What?
Producer/Additional Contributor
What?
Joel Werner
The series of coincidences are stacking up.
Yes.
So the first time she's ever. Her body has ever released an egg, there just happens to be sperm that's made its way from oral sex out a wound in her stomach, from a stab fight on a magical journey through her abdominal cavity. And then it fertilizes the only egg that's ever been there to be fertilized.
And by the way, the baby was born healthy. Here's Diel.
Wendy Zuckerman
Amazing.
Dr. Neil Shah
This is. This baby is born at the expected weight and nothing apparently wrong with it because there's a lot of other things that can happen. She doesn't miscarry. So then you're like, in all of human existence, what are the odds that this happened once?
Producer/Additional Contributor
So this is like the unicorn of all unicorns of all of medical cases?
Dr. Neil Shah
Yeah, yeah, I would say so. You know, the odds are lower than the odds of one person being struck by lightning a hundred times.
Joel Werner
Wow. It's sort of. I mean, often when we're talking about these unbelievable stories in science, I think about that amazing documentary Jurassic park and its famous line, life finds a way. But this is like the perfect example of life finding a way. The odds have been completely stacked against this fertilization event ever occurring. And somehow there's a healthy child at the end of it.
It's. Yeah.
Dr. Neil Shah
And we.
Joel Werner
Look, we reached out to the doctor who wrote the case report several times, but we didn't hear back. He's now retired. We also asked a bunch of other doctors what they made of this report because it is so wild. And a couple of doctors said they just didn't believe it too unlikely.
Wendy Zuckerman
Others were like, maybe. One told us, quote, sperm are persistent little guys. And that doctor actually described a patient that they had had who had no obvious vaginal opening, who had apparently never had penetrative sex, and also got pregnant and given birth to a kid with C section as well.
Joel Werner
Wow.
Wendy Zuckerman
So, yeah, she was. She was like, you know, it's unlikely, but stuff happens. Some of the doctors that we heard from also said that there might be another explanation for what's going on here and that maybe that dimple where her vagina sort of should have been wasn't totally closed off. Maybe there was a tiny hole in there that was missed and sperm somehow got in that way. Just sort of the More regular way. And the fact that all of this happened, you know, some 40 years ago, one doctor told us that they didn't have the technology on hand that we use today to diagnose someone with vaginal
Joel Werner
agenesis, but still, they took a pretty good look in there and couldn't see a vagina.
Producer/Additional Contributor
So.
Joel Werner
Well, this is the thing, you know, from the very first time you start studying science, you're told the simplest solution is often the accurate solution. And if this story we're being told is the simplest solution, like, it makes you think, like, are there other mechanisms by which this could have occurred?
Wendy Zuckerman
Yeah.
Joel Werner
And, you know, but on the other hand, doctors pointed out, you know, this was a case report written in a legit, peer reviewed medical journal. As for Neil, he said, you know, it was extremely unlikely to have happened, but who knows?
Dr. Neil Shah
Nothing is impossible. Like, as a physician also, you have to, you know, you see all kinds of extraordinary things.
Joel Werner
Wow. Now do we know what happened? Is there any resolution to the love story?
Wendy Zuckerman
Yeah. Case report says that about two and a half years later, baby is still perfectly healthy. And in fact, it says, quote, by that time, the son looked very much like the legal father, the new boyfriend. In the story, it says, quote, the young mother, her family, and the likely father adapted themselves rapidly to the new situation, and some cattle changed hands to prove that there were no hard feelings.
Joel Werner
I love these stories where they're just completely almost impossible coincidences that lead to an event. And it sort of challenges our notion of kind of like what is likely. You know, like, if this can be true, if this somehow is the way that that sperm and that egg found each other, then, you know, it gives you a sort of sense of like, I kind of like want to believe. Like, I want to lean in and just like, believe that life, we'll find a way.
Thanks, Joel.
Thanks, Wendy.
Wendy Zuckerman
And Joel Werner has a brand new podcast out. It's a historical thriller called Assassins. It's from the abc, the Australian Broadcasting Corporation, and it's hosted by Aslan Pahari,
Joel Werner
who maybe you know as the hello, my friend guy from TikTok. He's really great.
Wendy Zuckerman
And each episode of Assassins tells the story of one of history's most shocking assassinations, from Abraham Lincoln to Tupac. And there's some science in some of the episodes too. Like, for 3,000 years, the death of Pharaoh Ramses III was a mystery until some scientists came along and solved the riddle. You can find Assassins wherever you get your podcasts.
Producer/Additional Contributor
This episode was produced by Ekedi Foster Keys with help from Wendy Zuckerman, Michelle Dang, Rose Rimmeler and Meryl Horne were edited by Blythe Terrell. Fact checking by Diane Kelly. Mix and sound design by Bobby Lord. Music written by Emma Munger. So Wiley, Peter Leonard, Bumi Hidaka and Bobby Lord. Thank you to all the scientists we spoke to for this episode, including Dr. Sarah Ackroyd, Dr. Sarah Collins, Professor Adam Taylor and Dr. Kathy Flood. Special thanks to Joseph Lavelle Wilson and the Zuckerman family.
Original Air Date: February 26, 2026
Host: Wendy Zuckerman
Guest/Contributor: Joel Werner, Dr. Neil Shah
This episode of Science Vs launches a new segment called "Case Files," exploring bizarre, boundary-pushing stories from medical literature. Today's central question: How could a 15-year-old girl with no vagina become pregnant and give birth? Through a headline-grabbing 1988 case report, host Wendy Zuckerman and science journalist Joel Werner (with OB/GYN Dr. Neil Shah) unravel an extraordinary medical mystery involving anatomy, improbable odds, and the tenacity of life itself.
(Starts at 01:33)
The episode is structured around a real case published in the British Journal of Obstetrics and Gynaecology (1988): a 15-year-old girl in Lesotho, Africa.
Incident: She was injured in a knife fight involving her, an ex, and a new boyfriend (03:09).
“Who exactly stabbed whom was not quite clear. But all three participants in the small war were admitted with knife injuries.” — Joel Werner (03:41)
Doctors operate on her stomach and she recovers—but returns about nine months later, in labor.
(04:44-05:54)
On examination, doctors discover she has no vagina. The lower part of her vagina never developed—a condition called vaginal agenesis (Mayer-Rokitansky-Kuster-Hauser syndrome, or MRKH).
Dr. Shah explains: although the rest of her external genitalia appeared typical, there was only a shallow dimple where her vaginal opening should have been (06:13).
“It wasn’t like a Barbie situation ... there was skin with a little dent in it. No hole.” — Wendy Zuckerman (06:13)
Her uterus was fully formed and functional. She'd never menstruated—likely due to lack of an outflow tract.
(07:49-10:45)
Vaginal intercourse was impossible for her. Doctors interview her post-cesarean: she describes only attempting oral sex (“going down”) on her partner before the altercation.
The fight ensues mid-act, leading to her being stabbed in the abdomen.
“It's Chekhov’s knife.” — Joel Werner (08:55)*
Doctors posit: sperm was swallowed, entered her stomach, then—possibly due to vomiting post-stabbing—it escaped her stomach through the knife wound into her abdominal cavity.
(10:45-15:18)
Challenge 1: Stomach acid kills sperm.
Challenge 2: Sperm must exit from the stomach into the peritoneal cavity.
"So it basically has to be, like, perfectly positioned anatomically to be near the place where it would exit based on where the stab was ..." — Dr. Neil Shah (13:38)
Challenge 3: Sperm must travel through the peritoneal cavity to the egg.
"Maybe there's this magic sperm that can ... roller coaster its way through the abdomen and then—magic fertilizer." — Joel Werner (15:18)
(17:37-18:51)
The young woman had never had a period; thus, this was her first ovulation, perfectly timed with the unlikely sperm journey.
"The other extraordinary timing is this is the first time she's ever ovulated in her entire life... and she ovulates at the exact perfect time for fertilization to happen." — Dr. Neil Shah (18:24)
The baby, delivered by C-section, was healthy and of expected weight.
"The odds are lower than the odds of one person being struck by lightning a hundred times." — Dr. Neil Shah (19:42)
(20:18-22:35)
(22:35-23:36)
This mind-boggling episode blurs the line between medical miracle and scientific near-impossibility, challenging our understanding of human biology. Whether wholly accurate or slightly flawed, the story is a testament to the strangeness and tenacity of life, and to the value of skepticism—even when the facts seem too wild to be true.
If you seek stories where fact outpaces fiction, this “Case Files” debut delivers in true Science Vs style: curious, cheeky, and always scientific.