Emergency Contraception: Risks of Condom Failure and Pregnancy Concerns

(Emergency) The condom broke during high-risk sexual activity, and it was discovered that ejaculation occurred inside the body?

Hello, doctor.
I am 23 years old, and my menstrual cycle is regular.
I have never taken birth control pills before, but on June 20th, around 1:00 AM on June 21st, I had sexual intercourse with my boyfriend.
He used a condom throughout, but after ejaculation, he pulled out and discovered that the tip of the condom had broken, and approximately half of the semen was inside me.
I immediately rushed to the bathroom to rinse my genital area, and then the next day at 2:00 PM, I took "Levonorgestrel," an emergency contraceptive pill, which I bought from a pharmacy.
The pharmacist mentioned that there is no distinction between first and second generation pills, but I saw on the packaging that it contains Levonorgestrel, so I assume it is a first-generation pill.
I took the pill about 12 hours after the intercourse and did not experience any side effects throughout the day.
I have several questions:
1.
My last menstrual period ended on June 5th, and my app indicates that June 19th was my ovulation day.
Given that I had unprotected intercourse around 1:00 AM on June 20th, and I took the emergency contraceptive the next day at 2:00 PM, is there still a possibility of pregnancy? What is the likelihood? (Considering it was around ovulation and a significant amount of semen was inside...)
2.
On the day of the incident, I am unsure if I was before or after ovulation.
Assuming I had already ovulated, and I took the emergency contraceptive 12 hours later, is there still a chance of pregnancy?
3.
If I experience bleeding three days after taking Levonorgestrel, is there still a possibility of pregnancy?
4.
My app shows that my next period is expected on July 3rd.
If I do get my period on time, can I rule out the possibility of pregnancy?
5.
After getting my period, is there still a chance of becoming pregnant? When can I take a pregnancy test again after my period?
I apologize for having so many questions.
Thank you for your hard work, doctor!

Allie, 20~29 year old female. Ask Date: 2020/06/22

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the effectiveness of emergency contraception is about 90%, so the chance of pregnancy should be low.
Emergency contraception can sometimes cause irregular menstruation.
If you take a pregnancy test 12 days later and it shows negative, then you should be fine.
Wishing you good health.

Reply Date: 2020/06/22

More Info

Emergency contraception is a critical topic for many individuals who may experience contraceptive failures, such as a broken condom. In your case, you have taken proactive steps by using emergency contraception (the "Plan B" pill, which contains Levonorgestrel) after an incident where the condom broke during intercourse. Let's address your questions one by one.

1. Possibility of Pregnancy: Given that you had unprotected intercourse around your ovulation period, there is a risk of pregnancy. However, since you took the emergency contraceptive pill within 12 hours of the incident, it significantly reduces the chance of pregnancy. Levonorgestrel is most effective when taken as soon as possible after unprotected intercourse, ideally within 72 hours. The effectiveness decreases the longer you wait, but taking it within 12 hours is a good decision.

2. Timing of Ovulation: If you were indeed at or near ovulation when you had intercourse, there is still a chance of pregnancy, even after taking the emergency contraceptive. However, since you took the pill shortly after the incident, it should help prevent ovulation or fertilization. If you had already ovulated, the pill may not be as effective, but it still provides a significant chance of preventing pregnancy.

3. Bleeding After Taking the Pill: Experiencing bleeding a few days after taking the emergency contraceptive is common and can be a side effect of the medication. This bleeding does not necessarily indicate that you are pregnant or not pregnant. It is often a sign that your body is responding to the hormonal changes caused by the pill. However, it is not a definitive indicator of pregnancy status.

4. Menstrual Cycle and Pregnancy: If your expected period arrives on time (July 3), it is a strong indication that you are not pregnant. Emergency contraception can cause changes in your menstrual cycle, including earlier or later periods, but a timely period is generally a good sign. If your period is significantly delayed (more than a week), it would be advisable to take a pregnancy test for confirmation.

5. Testing for Pregnancy After Menstruation: If you get your period, the likelihood of being pregnant is very low. However, if you have any doubts or experience unusual symptoms, you can take a pregnancy test about a week after your missed period for a more accurate result.
In summary, while there is a risk of pregnancy due to the timing of your intercourse, taking emergency contraception promptly is a significant protective measure. If your period comes as expected, it is a good sign that you are not pregnant. If you have any further concerns or experience unusual symptoms, consulting with a healthcare provider is always a wise decision. They can provide personalized advice and support based on your specific situation.

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