Ovulation and Withdrawal: Pregnancy Chances Explained

Probability of Pregnancy

My menstrual cycle is about 28-30 days, with a period lasting six days.
My previous menstrual periods were from May 4 to May 9 and from June 1 to June 6.
I had sexual intercourse with my boyfriend on June 9 and took emergency contraception within 12 hours.
Five days later, on June 15, I experienced bleeding.
The explanation I received was that it could be either ovulation bleeding or withdrawal bleeding, which lasted for about four days.
After the bleeding ended, I had sexual intercourse with my boyfriend for 3-4 consecutive days, and he withdrew before ejaculation each time.

I would like to know the difference between ovulation bleeding and withdrawal bleeding.
Based on my situation, was the bleeding I experienced ovulation bleeding or withdrawal bleeding? After the bleeding ended, I had multiple sexual encounters with my boyfriend from June 19 to June 22, with the male partner withdrawing before ejaculation.
According to my app, the predicted ovulation days were June 19 and June 20, which are the third and fourth days after ovulation on June 16.
This should still be considered a fertile window.
What is the likelihood of pregnancy in this scenario? Thank you.

Niming, 20~29 year old female. Ask Date: 2019/06/29

Dr. Huang Jianzhong reply Obstetrics and Gynecology

The menstrual cycle is approximately 28-30 days, with a menstrual period lasting six days.
The previous menstrual periods were from May 4-9 and June 1-6.
On June 9, I had sexual intercourse with my boyfriend and took emergency contraception within 12 hours.
Five days later, on June 15, I experienced bleeding.
The explanation I received at that time was that it could be either ovulation bleeding or withdrawal bleeding, which lasted for about four days.
After the bleeding ended, I had sexual relations with my boyfriend for 3-4 consecutive days, and he withdrew before ejaculation each time.

I would like to know: What is the difference between ovulation bleeding and withdrawal bleeding?
Answer: The mechanisms are different.
Based on my situation, is the bleeding I experienced ovulation bleeding or withdrawal bleeding?
Answer: It is difficult to determine.
After the bleeding ended, I had multiple sexual encounters with my boyfriend (June 19-22), during which he withdrew before ejaculation.
According to my app, the predicted ovulation days were June 19 and June 20, which are the third and fourth days after ovulation on June 16.
Logically, this should still be considered a fertile window.
I would like to ask about the likelihood of pregnancy in this scenario.

Answer: The likelihood of pregnancy is low.

Reply Date: 2019/06/29

More Info

Understanding ovulation and the implications of withdrawal as a contraceptive method is crucial for anyone trying to conceive or avoid pregnancy. Based on your menstrual cycle, which typically lasts 28-30 days, and the details you've provided, let's break down your situation.

Ovulation and Withdrawal
1. Ovulation Timing: In a regular 28-30 day cycle, ovulation generally occurs around 14 days before the start of your next period. For your cycle, if your last period started on June 1, ovulation likely occurred around June 15. This is when the egg is released and is the most fertile time in your cycle.

2. Withdrawal Method: The withdrawal method, also known as "pulling out," involves the male partner withdrawing his penis before ejaculation to prevent sperm from entering the vagina. While this method can reduce the chance of pregnancy, it is not foolproof. Pre-ejaculate fluid can contain sperm, and timing can be difficult to manage, especially during the fertile window.

Types of Bleeding
- Ovulation Bleeding: This can occur around the time of ovulation and is typically light spotting. It happens due to hormonal changes and is usually not accompanied by significant pain or discomfort.

- Withdrawal Bleeding: This refers to bleeding that occurs after stopping hormonal contraception, such as the emergency contraceptive pill (ECP) you took. This bleeding can mimic a menstrual period and is often lighter than a regular period. It can occur a few days after taking the ECP and is a result of hormonal fluctuations.

In your case, the bleeding you experienced on June 15, five days after taking the emergency contraceptive pill, is likely withdrawal bleeding. This is a common response to hormonal changes induced by the pill, rather than ovulation bleeding.

Pregnancy Chances
Given that you had unprotected intercourse during your fertile window (June 19-22), there is a possibility of pregnancy. The timing of your ovulation and the subsequent sexual activity falls within the fertile window, which typically spans a few days before and after ovulation.
However, since you took the emergency contraceptive pill shortly after unprotected intercourse on June 9, it is designed to prevent ovulation or fertilization. If taken within 72 hours of unprotected intercourse, it can significantly reduce the chances of pregnancy. The effectiveness decreases the longer you wait to take it after unprotected sex.

Conclusion
To summarize, the bleeding you experienced after taking the emergency contraceptive pill is likely withdrawal bleeding rather than ovulation bleeding. The chances of pregnancy from the sexual activity that occurred after the bleeding depend on whether ovulation had already occurred and the effectiveness of the emergency contraceptive pill.
If you are concerned about the possibility of pregnancy, consider taking a home pregnancy test a week after your expected period. If you have further questions or concerns, consulting with a healthcare provider can provide personalized guidance and support.

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