Pregnancy Risks and Emergency Contraception Effectiveness

Can I get pregnant?

Hello doctor, at the end of last month, I had unprotected intercourse with my girlfriend and, fearing pregnancy, I bought a single emergency contraceptive pill (Ella) from the pharmacy.
The pharmacist said the effectiveness rate is as high as 99%.
Recently, my girlfriend's period started on the 17th and ended on the 22nd.
On the 17th, I used a pregnancy test and it showed negative.
On the 23rd, during sexual activity, I initially penetrated 1 or 2 times but then stopped due to fear of pregnancy (the penis was dry at the time of initial penetration).
My girlfriend, worried about pregnancy, took another Ella pill that same day.

1: What is the likelihood of pregnancy in this situation?
2: Is the emergency contraceptive still effective under these circumstances?
3: Should we take another pregnancy test?

Mr. Zeng, 10~19 year old female. Ask Date: 2017/12/27

Dr. Huang Jianzhong reply Obstetrics and Gynecology

At the end of last month, I had unprotected intercourse with my girlfriend and was worried about pregnancy, so I bought an emergency contraceptive pill (Ella) from the pharmacy.
The doctor said the effectiveness is as high as 99%.
Recently, my girlfriend's period started on the 17th and ended on the 22nd.
On the 17th, I used a pregnancy test and it showed negative.
On the 23rd, during sexual activity, I initially penetrated 1 or 2 times but then stopped due to fear of pregnancy (the penis was dry at the time of initial penetration).
My girlfriend, worried about pregnancy, took another Ella pill that same day.

1: What is the likelihood of pregnancy in this situation?
Answer: The likelihood of pregnancy is low.
2: Is the emergency contraceptive still effective in this case?
Answer: Yes, it is effective.
3: Should we take another pregnancy test?
Answer: It is advisable to take another pregnancy test.

Reply Date: 2017/12/27

More Info

When it comes to understanding pregnancy risks and the effectiveness of emergency contraception, it's essential to consider several factors, including the timing of intercourse, the type of emergency contraceptive used, and the menstrual cycle of the individual involved.

1. Pregnancy Risk: Based on the timeline you've provided, your girlfriend's last menstrual period began on the 17th, and she had sexual intercourse shortly after that. The menstrual cycle typically involves ovulation occurring about 14 days before the next period, which means ovulation would likely occur around the 14th day of her cycle. If her cycle is regular, the risk of pregnancy from intercourse on the 23rd, especially if it was brief and without ejaculation, is relatively low. However, sperm can survive in the female reproductive tract for up to five days, so if ovulation were to occur shortly after the 23rd, there could still be a risk of pregnancy.

2. Effectiveness of Emergency Contraceptive (Ella): Ella (ulipristal acetate) is a highly effective emergency contraceptive that can prevent pregnancy when taken within 120 hours (5 days) after unprotected intercourse. It works by delaying ovulation and is most effective when taken as soon as possible after the unprotected intercourse. Since your girlfriend took Ella after the sexual encounter on the 23rd, it should still be effective in reducing the risk of pregnancy. However, it’s important to note that no emergency contraceptive is 100% effective, and factors such as timing and individual hormonal responses can influence its effectiveness.

3. Need for Pregnancy Testing: Given that your girlfriend has already taken Ella and had a negative pregnancy test on the 17th, it may not be necessary to test again immediately. However, if her next period is delayed by more than a week, it would be prudent to take another pregnancy test. Emergency contraception can cause changes in the menstrual cycle, including delays or irregular bleeding, so a missed period could be due to the hormonal effects of the medication rather than an indication of pregnancy.

In summary, while the risk of pregnancy appears low given the circumstances, the use of Ella should provide additional reassurance. It’s always a good idea to consult with a healthcare provider for personalized advice, especially if there are any concerns about menstrual irregularities or the effectiveness of the contraception used. Additionally, if your girlfriend experiences any unusual symptoms or has concerns about her reproductive health, seeking medical advice is recommended.

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