Pregnancy Chances After Unprotected Intercourse and Emergency Contraception

Probability of Pregnancy

Hello, doctor.
According to the app, my girlfriend's ovulation period is from November 27 to December 6.
We had unprotected intercourse on December 4, and there was no ejaculation, but there was pre-ejaculatory fluid.
About 44 hours later, she took the emergency contraceptive pill (Ella 30 mg).

1.
Does this emergency contraceptive pill have contraceptive effects both before and after ovulation?
2.
What is the approximate chance of pregnancy in this situation?
3.
Should we be concerned about the possibility of unintended pregnancy?
4.
After taking the pill, she experienced abdominal pain.
How long is this likely to last?
5.
Will her menstrual cycle be affected by the emergency contraceptive pill, causing it to come early or late?
6.
If a fertilized egg were to implant unexpectedly, what symptoms might she experience?

66, 10~19 year old female. Ask Date: 2020/12/11

Dr. Chen Zhiyu reply Obstetrics and Gynecology

Regarding your concerns, here are the responses to your questions 1-3: According to the manufacturer's insert for the medication, this is a second-generation emergency contraceptive pill.
Based on the timing of your intake, the chance of pregnancy is approximately 2.1%.
In other words, there is nearly a 97% chance of successful contraception.

For questions 4-5, experiencing slight abdominal pain after taking the medication is expected.
It is advisable to continue monitoring the situation.
Theoretically, if contraception is successful, your next menstrual period should arrive as scheduled.
For question 6, implantation does not cause any noticeable sensations in women.
However, if your period is overdue and has not arrived, it may lead to some unexplained anxiety.
Thank you for your questions, and I wish you health and happiness.

Reply Date: 2020/12/11

More Info

When it comes to understanding pregnancy chances after unprotected intercourse and the use of emergency contraception, several factors need to be considered. Let's break down your questions one by one.

1. Effectiveness of Emergency Contraceptive Pills (ECPs): The emergency contraceptive pill you mentioned, Ella (ulipristal acetate), is effective at preventing pregnancy when taken within 120 hours (5 days) after unprotected intercourse. It works primarily by delaying or inhibiting ovulation. If taken before ovulation, it can prevent the release of an egg. If taken after ovulation, its effectiveness diminishes, but it may still prevent fertilization or implantation. Therefore, taking it 44 hours after intercourse during your girlfriend's fertile window is a proactive measure and should provide a good chance of preventing pregnancy.

2. Probability of Pregnancy: The likelihood of pregnancy after unprotected intercourse depends on various factors, including the timing of the menstrual cycle and the presence of sperm in pre-ejaculatory fluid (pre-cum). While pre-cum can contain sperm, the risk of pregnancy is lower compared to full ejaculation. Given that you took the emergency contraceptive pill shortly after intercourse, the chances of pregnancy are significantly reduced, but not entirely eliminated. Studies suggest that ECPs can reduce the risk of pregnancy by up to 89% when taken within the recommended time frame.

3. Concerns About Unintended Pregnancy: While the emergency contraceptive pill is effective, no method is 100% foolproof. If your girlfriend experiences a missed period or unusual symptoms, it would be wise to take a pregnancy test. However, given the timing of the pill and the nature of the intercourse, the risk of unintended pregnancy is relatively low.

4. Post-Pill Symptoms: It is common for women to experience side effects after taking emergency contraception, including abdominal pain, nausea, fatigue, and changes in menstrual bleeding. These symptoms can vary in duration but typically resolve within a few days. If the abdominal pain is severe or persists, it is advisable to consult a healthcare provider.

5. Menstrual Cycle Changes: Emergency contraceptive pills can affect the menstrual cycle. Your girlfriend may experience her next period earlier or later than expected, and the flow may be lighter or heavier than usual. This is a normal response to the hormonal changes induced by the pill.

6. Signs of Implantation: If fertilization occurs and the embryo implants in the uterine lining, some women may experience early signs of pregnancy, such as light spotting (implantation bleeding), cramping, or changes in breast tenderness. However, these symptoms can also be similar to premenstrual symptoms, making it difficult to distinguish between the two without a pregnancy test.

In summary, while the use of emergency contraception significantly reduces the risk of pregnancy after unprotected intercourse, it is not infallible. Monitoring for any unusual symptoms and being aware of changes in the menstrual cycle is essential. If there are any concerns or if your girlfriend experiences severe symptoms, seeking medical advice is always a prudent step.

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