Going on a long rant here, but I've really been analyzing Lawrence and Adam's roles in Saw, how the movie shows they aren't exactly what they're presented as and how the bathroom trap shifts what would the obvious power dynamic in our society in the opposite direction when their true selves have to be shown. During the movie, Lawrence's place in society is the competent doctor with it all together and Adam is the whiny lowlife barely afloat, but whole point of the trap is to subvert and pervert those roles and how how they may not be as fitting as they seem, they are liars and fakes, they don't really fit the boxes society says they do.
The whole point of Lawrence being put in that trap, petty Jigsaw revenge aside, is because he's trying too hard to look like he's the perfect average man, rich and white with a loving family, the man of the house with a well-paying job, when it's obvious he's only doing this for show and nobody in his family is happy. He's trying to play strong and capable and sane, he's surrounding himself in dupes and illusions and everything fake because he's desperate to seem normal, when in reality he isn't. Lawrence isn't happy being average, he's not happy playing the role society has assigned him, he wants to be this pillar of strength and rationality and the American dream, but he's trapped because he isn't, he isn't and he's lying by saying he is, which is hurting the people around him. Lawrence cuts his foot off in the end because he cannot save his family, he wasn't able to fake it until he made it and he that desperate to be the one that is able to be there for them when he never could be, there is no pretending that he is strong and powerful, and once he's footless and bleeding, he's pretty much of no use until the door is opened and he's able to leave. He shoots Adam in the end, but cannot kill him, Lawrence tries to exert power over Adam through the shooting, but it being intentional or not, Lawrence cannot kill him, he does not truly have it in him to do so, he doesn't have the power. Lawrence says he'll come back for Adam, save him, but we all know he doesn't, he makes another promise in an attempt to be strong, to be the provider, to be the man in power, but ultimately he cannot fulfill this role, not to his family, not to Adam.
Speaking of Adam, throughout the movie, he is trying to lie and play innocent when he just isn't. He hides the picture of Lawrence's family and acts as if all is well, Adam doesn't tell Lawrence about the fact that he's been stalking him, he omits both facts to try to make it seem like has nothing over Lawrence, no power when in reality, he does, his life decides whether Lawrence's family lives or dies, he has evidence of Lawrence's cheating. When Adam finally reveals he's stalking Lawrence, he ends up being able to corner Lawrence better that he could ever corner Adam, Adam is able to call out Lawrence and make him lash out, when Lawrence insults and lashes out at Adam when he calls him out, he doesn't scream or try to bullshit his way out of it, he takes it and deals it back in a way that cracks Lawrence's facade of strength. In the end, when Lawrence has cut his foot off and Zep is about to kill him, it is Adam that gets up and kills Zep for Lawrence, Lawrence spent his bullet trying and failing to kill Adam, and made himself defenseless when he was put in danger, and Adam was the one who despite being shot, was strong enough and had the power to save him. Lawrence could not save Adam, he could not get him out of there, but Adam was the reason Lawrence was able to crawl out of that bathroom alive. Also, may it be said, Adam was supposed to be able to move, his key went down the drain so he couldn't, but he was supposed to be the one able to move around, the point of that being that he was apathetic and supposed to be active, making decisions and taking charge, being the one with the power to do things, Adam died because he was put in a position where he couldn't do anything, he died because the trap was not perfect and he did not have the power he was supposed to, he was failed in that way, Lawrence and Adam are not happy together in canon because Adam was forced to sit out and stay put and not given the agency that could have saved them both. My final message in all this is that it is thematically accurate to say Adam would be the one getting Lawrence pregnant.