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Speculative and science fiction writers have often addressed the social, political, technological, and biological consequences of pregnancy and reproduction through the exploration of possible futures or alternative realities.

Inter species reproduction and alien human hybrids frequently occur in science fiction, and women being impregnated by aliens is a common theme in SF horror films, including I Married a Monster from Outer Space, Village of the Damned, Xtro, and Inseminoid. In Octavia E. Butler's Lilith's Brood trilogy (1987, 1988, 1989) alien and human females impregnated with the DNA of males by alien intermediary sex individuals, in "fivesomes".

Speculative fiction in technology of reproduction may involve cloning and ectogenesis, i. e., artificial reproduction).

Fertility and reproduction have been frequent sites for examination of concerns about the impact of the environment and reproduction on the future of humanity or civilization. For example, The Children of Men by P. D. James is just one of many works which have considered the implications of global infertility; Make Room! Make Room! by Harry Harrison is one of many works which have examined the converse, the implications of massive human population surges. Numerous other works, such as Implosion, The First Century after Beatrice, Venus Plus X and More Than Human by Theodore Sturgeon examine the future of humanity as it evolves, or particular breeding programs.

Pregnancy and control of human reproduction have often been used as proxies for treating gender issues or broader themes of social control; works dealing with pregnancy and human reproduction have also been used to closely explore gender politics. For instance, "male pregnancy" has been used to comedic effect in mainstream literature and films such as Junior (1994 film, dir. Ivan Reitman), and has developed a following in fan fiction—the mpreg genre. The genre of feminist science fiction has explored single sex reproduction in depth, particularly parthenogenesis, as well as gendered control over the ability and right to reproduce. See also numerous dystopian stories about state controlled reproduction, abortion, and birth control, such as Atwood's The Handmaid's Tale, or her short story, "Freeforall". These works have often been analyzed as explorations of contemporary political debates about reproduction and pregnancy.