Science has the answers. Or, anyway, science has a fascinating look at why this particular question cannot be satisfactorily answered.

Also, being 16 weeks pregnant, this is relevant to my interests. I look forward to the subjective debate in the comments.

HCG is a pregnancy hormone. It's produced by the placenta, a temporary organ that only forms in female bodies when an embryo has attached to the uterine lining. And so it was kind of weird when a male friend of a Reddit user known as CappnPoopDeck peed on a home pregnancy test and it came back positive.

Turns out, HCG can show up in men, too. And when it does, bad things are happening. You might have seen this story on Gawker earlier this week, but the science behind it is so crazy that I wanted to discuss it in a little more depth.

First, let's talk about HGC in ladies. The specific cells that produce HCG are called trophoblasts. At the point where a human is quite literally nothing more than a ball of 70-100 cells, trophoblasts form the outer layer. The mochi to our ice cream center, if you will. These cells eventually grow into the placenta, but at the earliest stages of pregnancy, their primary function is to rip through flesh and secure the embryo to uterine wall. Seriously.

I'm going to quote from Jon Cohen's excellent book on miscarriage, Coming to Term, because it has heavily influenced the mental pictures I see when I think "trophoblast".

Successful implantation occurs only if the embryo properly "invades" the lining of the uterus, which requires that the placenta's trophoblast cells penetrate deeply, boring into maternal arteries to shunt blood to the growing baby. If the mother did not stop the trophoblasts' drilling, they might burrow so deeply into her uterus that she could hemorrhage and die. [He goes on to explain how the female body prevents this. Although he notes that, sometimes, it doesn't work.]

Fun!

The outermost cells in a layer of trophoblasts are called syncytiotrophoblasts. These are the cells that actually produce HCG, which plays a huge role in making sure that you actually miss that first missed period. The chain of command works like this: When you ovulate, you release an egg from a follicle on your ovary. But that follicle doesn't just instantly disappear afterwards. Instead, it hangs out, producing progesterone — a chemical that is instrumental in preventing you from shedding your uterine lining and having a period.

On a normal, non-pregnant cycle, progesterone levels will go up for a bit, but then the spent follicle — the corpus luteum — will wither away. Your progesterone levels will drop. And you'll ride the crimson wave.

But, if you're pregnant, the corpus luteum doesn't go away. It keeps on producing progesterone, and no period happens. What keeps the corpus luteum alive and kicking? Human chorionic gonadotropin, that's what.

So why on Earth would HCG end up in a man?

When that pregnancy test came back positive, CappnPoopDeck made a rage comic about it, and posted it to Reddit. The very first response, from a user named goxilo, was this: "If this is true, you should check yourself for testicular cancer. Seriously. Google it."

Yes, HCG in men can be a sign of a rare (and dangerous) form of testicular cancer — choriocarcinoma. This is a cancer made up of syncytiotroblastic cells, said Katherine McGlynn, a senior investigator with the National Cancer Institutes. The tumor secretes HCG because that's what syncytiotroblasts do. They secrete HCG. And they don't particularly care whether they're secreting it into a man or a woman.

But how do they get into a guy, to begin with? That's where things get really weird. The truth is that nobody is entirely certain, McGlynn told me. But there are a couple of theories. One possibility is that these syncytiotroblasts that turn cancerous were leftovers — remnants of the time when that guy was just a ball of 70-100 cells. One way or another, they persisted in his body and then started to grow out of control.

The other theory: Somehow, normal cells in the man's testes just start regressing, reverting to one of the earliest forms of cells in a human's life cycle. Either way, one thing is certain, "It's exactly the same cell as in the placenta," McGlynn said.

The bad news: Choriocarcinomas move really fast. They're more common in men under 30 and the prognosis is usually bad, because most of the time nobody catches them until they've already spread to other parts of the body, especially the lungs. In that, CappnPoopDeck's friend is incredibly lucky. Both that he decided to pee on a stick for LULZ and that his friend posted the news to Reddit. In a follow-up, CappnPoopDeck reported that doctors found a very small tumor in his friend's right testicle. But they found it early enough that it's going to make treatment much easier.

The good news: Men should know that their chances of developing a choriocarcinoma are extremely rare. A 2002 paper in the Canadian Journal of Emergency Medicine reported that only about 2 men in 100,000 will get any kind of testicular cancer. Pure choriocarcinomas — the dangerous kind that I'm talking about here — make up less than 1% of those diagnoses. It's not clear whether CappnPoopDeck's friend has a pure choriocarcinoma, or a much-less-deadly form of testicular cancer that happens to incorporate some syncytiotrophoblasts.

Either way, McGlynn wanted to make it clear that you all shouldn't feel like you need to run out and stock up on home pregnancy tests. In fact, at least twice during our interview, she marveled at how amazing it was that this story even happened. "The actual odds of the man having this particular cancer, and then using a pregnancy test, are sky high. It's kind of amazing that this happened," she said.

Read More:
• Read the Gawker story about this case
• Read the original Reddit thread
• Read a history of home pregnancy tests, which includes a lot of information about HCG
• Read a full research paper about a different case of testicular choriocarcinoma

Photo: Shutterstock]]> http://boingboing.net/2012/11/08/positive-pregnancy-test-diagno.html/feed 52 http://boingboing.net/2012/10/11/babys-first-baby.html http://boingboing.net/2012/10/11/babys-first-baby.html#comments Thu, 11 Oct 2012 17:46:06 +0000 Xeni Jardin http://boingboing.net/?p=186758 "Baby's First Baby," by Darren Cullen (2012). via BB Flickr Pool.]]> http://boingboing.net/2012/10/11/babys-first-baby.html/feed 33 http://boingboing.net/2012/08/21/going-medieval-on-the-female-r.html http://boingboing.net/2012/08/21/going-medieval-on-the-female-r.html#comments Tue, 21 Aug 2012 15:28:36 +0000 Maggie Koerth-Baker http://boingboing.net/?p=177411 Cory posted yesterday about the history of the bogus idea that women who were raped (excuse me, "legitimately" raped) can't get pregnant from it, citing a medical/legal text from 1785. In a story at The Week, we learn that this particular bit of misinformation is, in fact, even older than that, dating back to 1290. So Akin is propagating a belief that has been spread—despite a complete lack of evidence to support it—since the 13th century. Good times. ]]> http://boingboing.net/2012/08/21/going-medieval-on-the-female-r.html/feed 18 http://boingboing.net/2012/08/21/science-rape-and-pregnancy.html http://boingboing.net/2012/08/21/science-rape-and-pregnancy.html#comments Tue, 21 Aug 2012 15:18:23 +0000 Maggie Koerth-Baker http://boingboing.net/?p=177405

Kate Clancy is one of my favorite bloggers. An anthropology professor at the University of Illinois, she studies the evolution of female reproductive anatomy. Her blog covers science I don't see anywhere else—the human evolution, cultural anthropology, and behavioral science behind ladybusiness.

So Clancy's blog was one of the first places I looked yesterday after reading about Missouri Rep. Todd Akin thoughtful commentary on female biology. In a long, well-written, and (fair warning) rather graphic post, Clancy talks about what we know about rape—think of it this way, you know way more people who have been raped than who have a gluten intolerance—and the way that emotional trauma affects conception and pregnancy.

First off, there is absolutely no difference in the rate of conception between women who have been raped and those who had consensual sex. Clancy breaks this down nicely in her blog post, and even offers a surprising tidbit from the research literature that all people should consider—at any given day in a woman's cycle (even days when she is supposedly "infertile") there's about a 3% chance of unprotected sex leading to a pregnancy.

The impact of stress on miscarriage is a lot messier. I've mentioned here before that we know very, very little about miscarriage, relative to a lot of other medical issues. To paraphrase my family practice doc, when you start talking about conception and miscarriage you very quickly wander past the small amount of hard evidence and straight into voodoo. And also into the counter-intuitive nature of reality. For instance, from reading Jon Cohen's excellent book on miscarriage science, Coming to Term, I know that one of the very few miscarriage interventions that's ever performed better than placebo in multiple trials is something called "Tender Loving Care". The idea: For whatever reason, women who have had recurrent miscarriages have a greater chance of carrying the next pregnancy to term if they have regular access to mental health services, stress-relieving practices like meditation, and doctors who listen and respond to their fears. But that's not the same thing as saying that stress, or a scare, or a severe mental trauma will, inevitably, cause a miscarriage. Here's Kate Clancy:

Yes, psychosocial stress is associated with fetal loss in some samples. That is not the same thing as saying that stress causes fetal loss. Some women are more reactive to stress than others, and this seems to be based on genes and early childhood experiences. As I pointed out in my post, it certainly isn’t something women have conscious control over. And so it is irrational to link the stress of rape, while awful and severe, to fetal loss, when we understand the mechanism of the stress response and its relationship to pregnancy so poorly, and when we know next to nothing regarding how variation in stress reactivity is produced.

Basically, while stress (and the associated hormones) are correlated with a higher risk of miscarriage in some (but not all) studies, that seems to have more to do with an individual's biological makeup than it does with the source of the stress. And, frankly, we barely know enough to even say that.

• Read the rest of Kate Clancy's post on the rape and pregnancy

• Read Clancy's earlier (excellent) post on miscarriage

• Read Jon Cohen's book, Coming to Term. (I keep recommending this, but, seriously, it's wonderful. And a hugely sane-making force in my life.)

Is it any solace to sentimental mothers that their babies will always be part of them?

I’m not talking about emotional bonds, which we can only hope will endure. I mean that for any woman that has ever been pregnant, some of her baby’s cells may circulate in her bloodstream for as long as she lives. Those cells often take residence in her lungs, spinal cord, skin, thyroid gland, liver, intestine, cervix, gallbladder, spleen, lymph nodes, and blood vessels. And, yes, the baby’s cells can also live a lifetime in her heart and mind.

Here’s what happens.

During pregnancy, cells sneak across the placenta in both directions. The fetus’s cells enter his mother, and the mother’s cells enter the fetus. A baby’s cells are detectable in his mother’s bloodstream as early as four weeks after conception, and a mother’s cells are detectable in her fetus by week 13. In the first trimester, one out of every fifty thousand cells in her body are from her baby-to-be (this is how some noninvasive prenatal tests check for genetic disorders). In the second and third trimesters, the count is up to one out of every thousand maternal cells. At the end of the pregnancy, up to 6 percent of the DNA in a pregnant woman’s blood plasma comes from the fetus. After birth, the mother’s fetal cell count plummets, but some stick around for the long haul. Those lingerers create their own lineages. Imagine colonies in the motherland.

Moms usually tolerate the invasion. This is why skin, organ, and bone marrow transplants between mother and child have a much higher success rate than between father and child.

Living With Someone Else’s Cells

Of course, we nosy mothers would like to know exactly what our children’s cells are up to while they hang out in us. Are they just biding time in our bodies? Are they mother’s little helpers? Or are they baby rebels, planning an insurgency?

It turns out that when fetal cells are good, they are very, very good. They may protect mothers from some forms of cancer. Fetal cells show up significantly more often in the breast tissue of women who don’t have breast cancer than in women who do (43 versus 14 percent). Why is this? Fetal cells are foreign to the mother because they contain DNA from the baby’s father. One theory is that this “otherness” stimulates the mother’s immune system just enough to help keep malignant cells in check. The more fetal cells there are in a woman’s body, the less active are autoimmune conditions such as rheumatoid arthritis and multiple sclerosis. These conditions improve during pregnancy and for some time afterward — suggesting that the mother’s immune system is more focused on attacking the “other,” not herself. There’s also tantalizing evidence that fetal cells may offer the mother increased resistance to certain diseases, thanks to the presence of the father’s immune system genes. These are new weapons in the war chest.

Some fetal cells have the potential to grow up and be anything. While many of the cells that enter the mother are immune system cells, some are stem cells. Stem cells have magical properties: they can morph into other types of cells (a process called differentiation), like liver, heart, or brain cells, and become part of those organs. Fetal stem cells migrate to injury sites—for instance, they’ve been found in diseased thyroid and liver tissue and have turned themselves into thyroid and liver cells respectively. At the triage sites of wounds they accelerate healing, reducing scars after pregnancy and restoring the normal structure of the skin. It’s striking, the evidence that a fetus’s cells repair and rejuvenate moms. Of course, evolutionarily speaking, the baby has its own interests in mind. It needs a healthy mom.

Then there’s baby on the brain. This is the truly startling stuff. Researchers working with mice have found evidence that cells from the fetus can cross a mother’s brain-blood barrier and generate new neurons. If this happens in humans—and there’s reason to believe it does—then it means, in a very real sense, that our babies integrate themselves into the circuitry of our minds. Could this help explain the remarkable finding that new mothers grow new gray matter in their prefrontal cortex (goals and social control), hypothalamus (hormonal regulation), and other areas of the brain?

Researchers thrill to the possibility of harnessing fetal stem cells to boost the brain, cure cancer and neurodegenerative diseases, and reverse the ravages of age. Fetal cells may be harvested from the blood or organs of mothers and potentially be used as a source of cells with regenerative properties for a mother and her children. They have advantages over other stem cells in that they don’t require the destruction of embryos or require cell cultures and potential contamination. They’re unlikely to be rejected by the mother or child because, from an immune-system perspective, they’re only part “other.”

How we hurt the ones we love

All is well when fetal cells are good, but when they are bad, they are horrid. They have shown up in cancers, and while they may be there to help, there’s also a suspicion that they’re not so innocent. There’s an explanation for this: fetal stem cells may act as cancer stem cells. This isn’t the only potential problem in the relationship. While fetal cells may stimulate the mother’s immune system to be more vigilant, this dynamic can tip into something like violence. A mother’s body may attack the fetal cells within, and in the crossfire her healthy cells get bombarded. The fetal cells themselves may also attack us, the little traitors. What sets off these battles is unknown, but in the fallout, we may suffer autoimmune diseases like scleroderma and lupus.

The maternal cells circulating in a child’s body are no more predictable. Nearly 1 in every 100 cells in a fetus comes from her mom. The population plummets to something like 1 in 100,000 after birth, but enough of a mother’s special agents are still hiding out in her baby’s tissues, and their ranks may be refreshed by refugees in breast milk that slip into the bloodstream.

Maternal cells are busybodies. Some researchers think they train and shape the baby’s immune system and even decrease the risk of allergies. They’re healers too; there’s evidence that maternal stem cells can morph into, for instance, insulin-prod producing cells that proliferate and repair damaged tissue in kids with juvenile diabetes. And, like fetal cells in mothers, maternal cells in children may cause autoimmune problems.

When more than one person’s cells mingle in one individual, the effect is known as microchimerism. The root of microchimerism is the “Chimera,” an animal in Greek mythology. The Chimera is made up of the parts of multiple animals—and so, in a way, are we mothers.

How many people have left their DNA in us? Any baby we’ve ever conceived, even ones we’ve miscarried unknowingly. Sons leave their Y chromosome genes in their mothers. The fetal cells from each pregnancy, flowing in a mother’s bloodstream, can be passed on to her successive kids. If we have an older sibling, that older sibling’s cells may be in us. The baby in a large family may harbor the genes of many brothers and sisters. My mother’s cells are in my body, and so are my daughter’s cells, and half my daughter’s DNA comes from her dad. Some of those cells may be in my brain. This is squirm-worthy.

But there’s something beautiful about this too. Long post postpartum, we mothers continue to carry our children, at least in a sense. Our babies become part of us, just as we are a part of them. The barriers have broken down; the lines are no longer fixed. Moms must be many in one.

Excerpted with permission by Free Press from Do Chocolate Lovers Have Sweeter Babies?: The Surprising Science of Pregnancy