Pregnancy Chances After Condom Failure and Emergency Contraception

Probability of Pregnancy

The last menstrual period started on June 23, with a stable cycle of approximately 28 days and lasting 7 days.
On the morning of July 10, I used a condom throughout intercourse, but after ejaculation, I checked and found a hole in the condom.
I immediately went to the pharmacy and took Ella.
The app indicates that there is currently a moderate chance of pregnancy, and I am very worried since I may have already ovulated.
I am unsure if the medication will still be effective and how high the likelihood of pregnancy is.
Thank you.

Lin, 20~29 year old female. Ask Date: 2020/07/10

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the chances of pregnancy should be low.
Wishing you good health.

Reply Date: 2020/07/10

More Info

When it comes to understanding pregnancy chances after a condom failure and the use of emergency contraception like Ella, there are several important factors to consider.
First, let's break down the timeline you've provided. Your last menstrual period (LMP) was on June 23, and you have a regular cycle of about 28 days, lasting 7 days. This means that you likely ovulated around July 7, which is typically about 14 days after the start of your last period. If you had unprotected intercourse on July 10, this would have been just a few days after your ovulation window, which could increase the chances of pregnancy since sperm can survive in the female reproductive tract for up to five days.

You mentioned that the condom broke during intercourse, and you took Ella (ulipristal acetate) shortly after. Ella is an effective form of emergency contraception that works primarily by delaying or inhibiting ovulation. It is most effective when taken as soon as possible after unprotected intercourse, and it can be taken up to 120 hours (5 days) after the event. However, its effectiveness decreases the closer you are to ovulation when taken.

Given that you took Ella after the condom failure, it is important to note that while it can significantly reduce the chances of pregnancy, it is not 100% effective, especially if ovulation has already occurred. Studies suggest that Ella can reduce the risk of pregnancy by about 85% when taken within the recommended time frame, but this effectiveness can vary based on the timing of ovulation.

As for your concern about the likelihood of pregnancy after taking Ella, it is difficult to provide an exact percentage. If you are already in the luteal phase of your cycle (after ovulation), the chances of pregnancy are lower than if you had taken Ella before ovulation. However, since you are worried about the effectiveness of the emergency contraception, it is advisable to monitor for any signs of pregnancy, such as a missed period or unusual symptoms.

If your period does not arrive on time, it would be wise to take a home pregnancy test. These tests are generally reliable and can provide you with a quick answer. If the test is positive, or if you have any concerns about your health or the possibility of pregnancy, it is important to consult with a healthcare provider for further evaluation and guidance.

In summary, while Ella is a highly effective emergency contraceptive, its effectiveness can be influenced by the timing of ovulation. Given your cycle and the timing of events, there is a possibility of pregnancy, but taking Ella does reduce that risk. Monitoring your menstrual cycle and being aware of any changes will be key in determining your next steps. If you have further concerns or questions, don't hesitate to reach out to a healthcare professional for personalized advice.

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