Emergency Contraception After Ovulation: What Are Your Chances?

Emergency contraception during ovulation period?

Hello, doctor.
I had intercourse with my boyfriend one day after ovulation, around 3 or 4 PM.
I had never calculated my fertile days before, but feeling anxious, I looked it up online.
That night, I bought emergency contraception (Ella) and took it around 11 PM.
We used a condom at first, but after a few minutes, we had unprotected intercourse without cleaning up, only wiping with tissue, but there was no ejaculation inside.
Is there still a significant chance of pregnancy?

1T, 10~19 year old female. Ask Date: 2021/01/21

Dr. Huang Zifei reply Obstetrics and Gynecology

Dear 1ㄊ,
Emergency contraception is effective when taken within 72 hours after sexual intercourse.
If you engage in sexual activity after taking the pill, it may not be effective.
Even if there is no ejaculation, pre-ejaculatory fluid can still contain sperm.
If condoms were not used consistently, there is a possibility of pregnancy.
If your period is delayed by a week, it is advisable to take a pregnancy test.
For any other concerns, it is recommended to consult a gynecologist.

Dr.
Huang Zifei, Department of Obstetrics and Gynecology, Nantou Hospital

Reply Date: 2021/01/21

More Info

When it comes to emergency contraception (EC) after ovulation, understanding the timing and effectiveness is crucial. Based on your description, you had unprotected intercourse the day after your estimated ovulation date and took the emergency contraceptive pill (ECP) within a few hours. This is an important factor to consider when evaluating your chances of pregnancy.

Emergency contraceptive pills, such as Plan B (Levonorgestrel) and Ella (Ulipristal acetate), work primarily by delaying or inhibiting ovulation. If ovulation has already occurred, the effectiveness of these pills can be reduced. However, Ella is known to be more effective than Plan B in this scenario, as it can delay ovulation even after ovulation has occurred, but its effectiveness diminishes the longer you wait to take it after unprotected intercourse.

In your case, since you had intercourse the day after ovulation, the chances of becoming pregnant are higher than if you had taken the ECP before ovulation. However, because you took the ECP shortly after the encounter, you still have a chance to prevent pregnancy. The effectiveness of Levonorgestrel is around 89% when taken within 72 hours after unprotected intercourse, while Ella can be effective up to 120 hours (5 days) after the event, with studies suggesting it maintains a higher efficacy rate compared to Levonorgestrel in the same timeframe.

It's also important to note that pre-ejaculate fluid (pre-cum) can contain sperm, which means that even without ejaculation, there is still a risk of pregnancy. The fact that you did not wash after intercourse and only used tissue to wipe could potentially increase the risk of sperm being present.

In terms of your chances of pregnancy, while there is a risk, the use of emergency contraception significantly reduces that risk. If your period is delayed by more than a week from when you expect it, it would be advisable to take a pregnancy test to confirm whether or not you are pregnant.

In summary, while the risk of pregnancy exists due to the timing of intercourse relative to ovulation, taking the emergency contraceptive pill shortly after the incident does provide a significant level of protection. If you have any concerns or experience unusual symptoms, consulting with a healthcare provider is always a good step to ensure your reproductive health is managed appropriately.

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