Pregnancy Risk and Emergency Contraception Effectiveness

Pregnancy Probability and Emergency Contraceptive Pills

The menstrual period is from the 10th to the 15th.
On November 9th, the condom broke, and I took emergency contraception (Plan B) once on November 29th.
After the first time without a condom, there was no leakage, so I rested.
When I woke up, I had intercourse again without a condom, and again there was no leakage.
After resting for almost an hour, I took emergency contraception again.
I was initially trying to test the safe period, and my husband said if I got pregnant, we would have the baby, which is why I did this.
However, I took emergency contraception a second time and am wondering if taking it twice in one month would reduce its effectiveness.

Additionally, since there were two instances of ejaculation inside without immediate leakage, and I took the medication about 12 hours later, what is the likelihood of pregnancy? From the first ejaculation to taking the medication, it was about 12 to 13 hours.
My husband ejaculated directly at the cervix, and there was no immediate leakage; it took about three to four hours for any fluid to come out.
Given that the volume was quite significant and he did not withdraw immediately, does this reduce the effectiveness of contraception? I have already had one child and am not currently planning for a second, but my husband wants one, so I’m asking about the likelihood of pregnancy and the effectiveness of contraception in this situation.

Qin Jie, 20~29 year old female. Ask Date: 2020/12/01

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the effectiveness of emergency contraception varies based on the timing of administration after unprotected intercourse: taking it within 24 hours provides a 95% effectiveness, 24 to 48 hours offers 85%, and 48 to 72 hours results in 58%.
These percentages refer to the protective effect of delaying ovulation.
If you engage in unprotected intercourse after taking emergency contraception, it is advisable to take another dose.
Additionally, if your period is more than a week late, it is important to check for pregnancy.
Thank you! Wishing you safety and health, Dr.
Zhang.

Reply Date: 2020/12/01

More Info

When it comes to understanding pregnancy risk and the effectiveness of emergency contraception, it's essential to consider several factors, including timing, the method of contraception used, and the specific circumstances surrounding the sexual encounter.

In your situation, you mentioned that you had unprotected intercourse on November 9th due to a condom failure and subsequently took emergency contraception (Plan B) within a reasonable time frame. Emergency contraceptive pills (ECPs) like Plan B are most effective when taken as soon as possible after unprotected intercourse, ideally within 72 hours, but they can be taken up to 120 hours (5 days) after the event. However, their effectiveness diminishes the longer you wait. If you took Plan B shortly after the incident, you significantly reduced your chances of becoming pregnant.

You also mentioned that you had another incident where your husband ejaculated inside you again, and you took Plan B again after a few hours. Taking emergency contraception multiple times in a short period is not ideal, but it does not inherently reduce the effectiveness of the pills. However, it is crucial to remember that ECPs are not intended for regular use and should only be used in emergencies. Frequent use can lead to menstrual irregularities and may not be as effective as regular contraceptive methods.

Regarding the timing of your menstrual cycle, if your period typically occurs between the 10th and 15th of the month, and you had unprotected intercourse on the 9th, you were likely close to your ovulation window. Ovulation typically occurs about 14 days before your next expected period, which means there is a possibility of being in your fertile window. If you had unprotected intercourse during this time, the risk of pregnancy could be higher, especially if you did not take emergency contraception promptly.

In terms of the effectiveness of the emergency contraception you took, studies show that when taken within 72 hours of unprotected intercourse, Plan B can reduce the risk of pregnancy by up to 89%. If you took it within 12-13 hours after the first incident, you likely maximized its effectiveness. However, if you had unprotected intercourse again after taking the first dose, the risk of pregnancy would still be present, especially if the second dose was taken later than recommended.

As for your concerns about the timing of taking the emergency contraception and the potential for sperm to remain viable, sperm can live inside the female reproductive tract for up to five days. Therefore, if you had unprotected intercourse and then took Plan B, the sperm could still be present when the egg is released during ovulation, which could lead to pregnancy.

In conclusion, while you have taken steps to mitigate the risk of pregnancy by using emergency contraception, there is still a possibility of becoming pregnant, especially given the timing of your sexual encounters relative to your ovulation cycle. If you are concerned about the possibility of pregnancy, it would be wise to take a pregnancy test if your period is late or if you experience any unusual symptoms. Additionally, for future sexual encounters, consider discussing more reliable and consistent contraceptive methods with your healthcare provider to avoid the need for emergency contraception.

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