Pregnancy

Pregnancy is the process by which a mammalian female carries a live
offspring from conception until it develops to the point where the offspring
is capable of living outside the womb.

It starts from the fertilization of an embryo (conception) to form a zygote,
and ends in birth, miscarriage or abortion.

In humans, pregnancy takes approximately 40 weeks between the time of the
last menstrual cycle and delivery. It is divided into three trimesters of
three months duration each. The first trimester carries the highest risk of
miscarriage, the unintentional abortion of a fetus. It is often a result of
defects in the fetus, its parent, or damage caused after conception.

Fertilization

The first step of pregnancy usually begins with sexual intercourse where
haploid male gametes in the form of sperm cells are deposited into the
vagina. The semen produced by the male contains not only sperm cells but
also sugars, proteins and other substances to help keep the sperm viable -
human sperm generally survive for about 48 hours in the female body. Sperm
have a long flagella, which they use to swim and are the only human cell
with this property. These cells, having divided by meiosis from germ cells
in the male testes, only have one half copy of the chromosomes, making them
haploid. Typically, between 100 million and 300 million of these cells are
released at one orgasm.

Oocytes are the female egg cells, and their role is to fuse with one sperm
cell to form a fertilized zygote which will then grow in the uterus to form
a developing fetus. These cells are produced by meiosis in the ovaries and
stay in a state of suspended animation until they become activated by
hormonal changes in the woman's menstrual cycle. Typically, only one egg
cells is released during each menstrual cycle.

At ovulation, the fimbriae at the end of the fallopian tube move over the
ovary to catch the released egg. If fertilization is to take place, the
sperm usually meet with the egg in the fallopian tube. Note that the sperm
cell would have had to swim from the upper vagina through the cervix and
across the length of the uterus before reaching the fallopian tube (quite a
task considering how small a sperm cell is). Once there, the successful
sperm swim towards the oocyte and each attempt to fertilize it. Each sperm
cell contains a small pouch of enzymes that it uses to break through the
outer layer of the oocyte in order to fuse with it. This can take up to
twenty minutes. Once the oocyte fuses with a single sperm cell, the cell
membrane of the oocyte changes and no other sperm are allowed into the
oocyte. The fusion of the oocyte and sperm nuclei completes the first stage
of pregnancy.

In vitro fertilisation (IVF), an artificial means of fertilization where
sperm and egg cells are mixed in a test tube, has, in recent years, become
an alternative to the traditional way of fertilization for infertile couples.

Pre-implantation

At this point, there exists a single totipotent cell with the potential to
create an entire human being. Mitotic cell division is the next process to
occur, where each cell doubles to produce another diploid cell. The zygote
divides to produce two smaller cells called blastomeres roughly every 20
hours. These cells get progressively smaller until about 4 divisions have
taken place resulting in 16 individual cells. This cluster of 16 cells is
known as a morula and will leave the fallopian tube and make its way to the uterus.

Ectopic pregnancy

If the developing bunch of cells implants anywhere other than the uterus, it
is an ectopic pregnancy. The most common location for ectopic pregnancies is
in one of the fallopian tubes although ectopic pregnancies can potentially
arise in any tissue that the fertilized zygote can get to - this potentially
includes anything within the abdomen.

When the zygote implants itself in an ectopic position, the tissue it
burrows into is not suited to the development of the embryo. This usually
results in complications when the developing embryo grows too big for the
poor blood supply of the ectopic location to sustain it any more. When this
happens, the ectopic pregnancy is at risk of rupture which can lead to life
threatening blood loss.

An ectopic pregnancy can be a life-threatening condition.

Post-implantation

A blastocele is a small cavity on the center of the cells, and the
developing cells will grow around this. There will be a flat layer of cells
on the exterior of this cavity, and the zona pellucida will remain the same
size as before. Cells are growing increasingly smaller to fit in. This new
structure with a cavity in the center and the developing cells around it is
known as a blastocyst. The presence of the blastocyst means that two types
of cells are forming, inner cell mass growing on the interior of the
blastocele and cells growing on the exterior of it. In 24 to 48 hours, the
blastocyst's barrier, the zona pellucida breaches. The cells on the exterior
of the blastocyst begin excreting an enzyme which erodes epithelial uterine
lining and creates a site for implantation. The blastocyst also secretes a
hormone called human chorionic gonadotropin which in turn, stimulates the
corpus luteum in the mother's ovary to continue producing progesterone,
which acts to maintain the lining of the uterus so that the embryo will
continue to be nourished. The glands in the lining of the uterus will swell
in response to the blastocyst, and capillaries will be stimulated to grow in
that region. This allows the blastocyst to receive vital nutrients from the
mother.

The hormone human chorionic gonadotropin is the substance that pregnancy
tests test for the presence of.

Placental Circulation System

The cells surounding the blastocyst will now destroy cells in the uterine
lining forming small pools of blood, which in turn will stimulate the
production of capillaries. This is the first stage in the growth of the
placenta. The inner cell mass of the blastocyst divides rapidly, forming two
layers. The top layer will become the embryo and cells from there will be
used in the amniotic cavity. At the same time, the bottom layer will form a
small sac. If the cells begin developing in an abnormal position, an ectopic
pregnancy may also occur at this point. Several days later, chorionic villi
in the forming placenta anchor the implantation site to the uterus. A system
of blood and blood vessels will now develop at the point of new-forming
placenta, growing near the implantation site. The small sac inside the
blastocyst will begin producing its blood cells. These are small cells with
no nuclei, known as hematopoietic. For the next 24 hours, connective tissue
will develop between the developing placenta and the growing fetus. This
will later develop into the umbilical cord.

Cellular Differentiation

Following this, a narrow line of cells will appear on the surface on the
embryo. Its growth shows the fetus will undergo gastrulation, which is a
process where the three layers of the baby will develop. The ectoderm,
mesoderm and endoderm are the layers which develop. The narrow line of cells
begin to form the audoderm and mesoderm. The ectoderm begins to grow rapidly
as a result of chemicals being produced by the mesoderm. At this point, the
three layers that surround the embryo, the ectoderm, mesoderm and endoderm
will give rise to all the various types of tissue in the body. The endoderm
will later form the lining of the tongue, digestive track, lungs, bladder
and several glands. The mesoderm will form muscle, bone and lymph tissue, as
well as the interior of the lungs, heart, reproductive and excretory system.
It will also give rise to the spleen, and will be used in the production of
blood cells. The ectoderm will form the skin, nails, hair, cornea, lining of
the internal and external ear, nose, sinuses, mouth, anus, tooth enamel,
pituitary gland, mammary glands, and all parts of the nervous system.

Approximately 18 days after fertilisation, the embryo will have divided to
form much of the tissue it will need. It will be shaped like a pear, where
the head region is larger than the tail. The embryos nervous system is one
of the first organs to grow. This system begins growing in a concave area
known as the neural groove. Also, the blood system is continuing to grow
networks which allow the blood to flow around the embryo. Blood cells are
already produced and are flowing through these developing networks.
Secondary blood vessels also begin to develop around the placenta, to supply
it with more nutrients. Blood cells will begin to form on the sac in the
center of the embryo, as well as cells which will begin to differentiate
into blood vessels. Endocardial cells begin to form the musculature which
will become the heart of the embryro.

At about 24 days past fertilisation, there is a primative S-shaped tubule
heart which begins beating. The flow of fluids travelling throughout the
embryo will begin at this stage.

Pregnancy in science fiction

There are numerous science fiction, utopian and dystopian novels revolving
around sexual reproduction, pregnancy and infertility. Some examples:

   * Margaret Atwood: The Handmaid's Tale (1985)
   * Anthony Burgess: The Wanting Seed (1962)
   * Charlotte Perkins Gilman: Herland (1915) (parthenogenesis in an
     all-female society)
   * P.D. James: The Children of Men (1992) (universal infertility)
   * Marge Piercy: Woman on the Edge of Time (1976) (fetuses raised
     externally in breeders rather than in the female womb)
   * John Wyndham: The Midwich Cuckoos (1957)