Can Taking Emergency Contraceptive During Ovulation Prevent Pregnancy?

What is the likelihood of pregnancy if taking emergency contraception during the ovulation period?

Hello, Doctor: I am very grateful and will never forget your kindness.
I would like to share my menstrual cycle over the past few months: 8/17-8/24, 9/15-9/21, and 10/19-10/24.
I have always had sexual intercourse with my boyfriend using condoms.
However, on 11/3, during intercourse, the condom slipped off, and when he pulled out, my vaginal opening was filled with his semen.
I was very anxious and almost cried.
I rinsed the condom with water, but after squeezing it with my hand, there were no holes or leaks, so I suspect it might have been that he pulled out too late, causing possible semen backflow.
It was already late at night, and no pharmacies were open.
I checked my menstrual cycle tracking app, which indicated that 11/3 was during my fertile window, with a high chance of pregnancy.
11/6 was my ovulation day, so on the morning of 11/4 at 8:30 AM, I urgently bought and took the emergency contraceptive pill.
I was really nervous and worried, especially since I have always insisted on using condoms, and this time it slipped off.
I would like to ask the doctor if taking emergency contraception during the fertile window still carries a risk of pregnancy? What is the likelihood?

Miss Zhang in Panic, 20~29 year old female. Ask Date: 2019/11/15

Dr. Huang Jianzhong reply Obstetrics and Gynecology

In the past few months, my menstrual cycles were from 8/17 to 8/24, 9/15 to 9/21, and 10/19 to 10/24.
I have always had sexual intercourse with my boyfriend using condoms.
However, on 11/3, during intercourse, the condom slipped off, and when he pulled out, my vaginal opening was filled with his semen.
I was very anxious and almost cried.
I rinsed the condom with water, but it was intact and showed no signs of leakage, so I suspect that he may have pulled out too late, causing possible semen backflow.
At that time, it was already late at night, and there were no pharmacies open.
I checked my menstrual cycle tracking app, which indicated that 11/3 was during my fertile window, with a high chance of pregnancy, and 11/6 was my ovulation day.
Therefore, on the morning of 11/4 at 8:30 AM, I urgently bought and took the emergency contraceptive pill.
I was really nervous and worried, especially since I had always insisted on using condoms, and this time it slipped off.
I would like to ask the doctor if taking the emergency contraceptive pill during the fertile period still carries a risk of pregnancy? Is the risk significant?
Answer: Yes, there is a risk of pregnancy, but after taking the emergency contraceptive pill, the likelihood of becoming pregnant is low.

Reply Date: 2019/11/15

More Info

Taking emergency contraceptive pills (ECPs) during the ovulation period can significantly reduce the risk of pregnancy, but it is not 100% effective. The effectiveness of ECPs, such as Plan B or Ella, depends on several factors, including the timing of administration relative to ovulation and the individual's unique physiology.

Emergency contraceptive pills work primarily by delaying or inhibiting ovulation. If taken before ovulation, they can prevent the release of an egg, thereby reducing the chance of fertilization. However, if ovulation has already occurred, ECPs may not be effective in preventing pregnancy. In your case, since you mentioned that November 3 was close to your ovulation day (November 6), the timing of taking the ECP is crucial. If ovulation has already happened, the ECP may not prevent pregnancy.

Research indicates that ECPs are most effective when taken as soon as possible after unprotected intercourse, ideally within 72 hours, although some formulations can be effective up to 120 hours after. The sooner you take the pill after the incident, the better the chances of preventing pregnancy. Given that you took the ECP on November 4, just one day after the incident, you maximized your chances of preventing ovulation.

It's also important to note that while ECPs are effective, they do not guarantee that pregnancy will not occur. The failure rate is relatively low, but it is not zero. Factors such as body weight, hormonal fluctuations, and the specific type of ECP can influence effectiveness.
In addition to the hormonal mechanisms, ECPs may also alter the uterine lining, making it less suitable for implantation if fertilization were to occur. However, this mechanism is less understood and is not the primary action of these medications.

If you are concerned about the possibility of pregnancy after taking ECPs, it is advisable to take a pregnancy test about two weeks after the incident or after your next expected period. If your period is late or if you experience any unusual symptoms, consulting a healthcare provider would be prudent.

In summary, while taking emergency contraceptive pills during the ovulation period can reduce the risk of pregnancy, it is not foolproof. The effectiveness is highest when taken promptly after unprotected intercourse, and individual factors can influence the outcome. If you have further concerns or questions about your reproductive health, it is always best to consult with a healthcare professional who can provide personalized advice based on your specific situation.

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