When I think of hermaphrodite I think of a person being born with sex organs of both male and female, in the case of the pregnant man, this is a woman that had breasts removed, male organs attached, and given hormones. Concerning hermaphrodites born naturally.

I think it is theoretically possible, If it did work, in vitro fertilization would be necessary. This is based on gut reaction and my (pretty good but probably incomplete) knowledge of reproductive physiology. I also found a very useful and interesting paper to back up some of this stuff.

The Pregnant Man

First you’d need two viable gametes. The primordial germ cells, precursors to sperm or eggs, start off the same on both sexes and develop into the correct type of gamete under the influence of hormones etc from the gonad they are developing in (it’s the environment in the gonad that determines the sex of the resulting gamete).

So a pgc in a testicle becomes sperm and one in an ovary becomes an egg. Some hermaphrodites have a functioning version of each gonad (one on each side), so having both gametes form is theoretically possible.

The main problem would be cross contamination of hormones, as they circulate in the bloodstream. The balance of male hormones in the testicle vs female in the ovary would need to be just right so as not to disrupt the environment provided to the pgc, and I’m not sure if that’s possible.

Note in the rabbit paper above the testis were infertile when the animal was pregnant. However the animal had fathered children previously, so it may be that only one set can work at a time. This would fit with the hormone problem. Gametes could be harvested at different times though, avoiding this issue.

Spermatogenesis is rare in true hermaphrodites so getting functioning, mature sperm would probably be the largest problem. You’d need to find someone who was not only producing sperm, but had a functioning ovary also. Then the sperm needs to mature, which needs the prostate and epididymis and vas deferens, etc.

The paper I linked above indicates that these generally do develop next to testes so this might not be an issue. Even if it was, immature/damaged sperm can be taken direct from the testes and used in in vitro fertilization (intracytoplasmic sperm injection or ICSI), so full sperm development may not be necessary.

Some true hermaphrodites have been shown to ovulate (more common than spermatogenesis) and there have been at least three cases of pregnancy (from the article I linked, one of them was also mentioned in previous comments).

For in vitro fertilization eggs need to be matured and harvested artificially which involves large injections of female hormones etc. This could screw up sperm production quite a lot reinforcing the harvesting at different times.

At the very least artificial insemination would be needed as self fertilization is not physically possible (particularly given that external genitalia of hermaphrodites are usually under developed).

Lastly the zygote needs somewhere to developed. Most hermaphrodites don’t have functioning wombs (the article I linked found 10% with ‘normal’ uteruses). This is because the testes secretes a substance during development that actively inhibits development of the female parts (uterus, fallopian tubes etc) and this messes up uterine development.

The three pregnancy cases outlined above were unable to bring their children to term because of uterus problems, and it’s not unreasonable to expect that a true hermaphrodite with a fully functioning male side will not also have fully developed female ducts because of this secretion (although I haven’t found anything confirming this).

We also need to assume that the hermaphroditism wasn’t caused by some underlying totally messed up genetics. Sometimes it is and sometimes it isn’t. So while this doesn’t kill the idea, it does further reduce the possibility of finding an individual with all the right characteristics.

So in summary, you’d need a true hermaphrodite with one of each gonad, fully developed, producing gametes and with the associated plumbing, you’d need hormone balance between the two sides to be somehow maintained despite the circulating nature of these compounds and you’d need no underlying genetic disorders that precludes fertility.

Then you’d need to find a practitioner willing to perform in vitro fertilization with this person and have everything go perfectly, hormone levels kept in check etc, so the child could develop. All this is possible but the vanishingly small probabilities of finding such a combination lead me to expect it will never happen.