Pregnancy Risks: Do I Need Emergency Contraception?

What is the likelihood of pregnancy in this situation? Is emergency contraception needed?

I have polycystic ovary syndrome (PCOS) and recently took oral contraceptives to regulate my menstrual cycle and for contraception for about three months.
My last menstrual period was from February 21 to February 25.
Since my cycles have been irregular, it was normal for me to be a week late in March.
I stopped taking the medication in March, and my period started on March 27 and ended on March 31.
On April 4, I had intercourse with my boyfriend using a condom twice.
During the last time, he used his hand, and I am unsure if there was any contact, but he said his hand was dry and did not touch anything.
On April 6, we had intercourse again, but he initially penetrated without a condom; however, I stopped him, so he only went in and out a few times.
I have been using ovulation test strips over the past few days, and they all indicate that I am not in my ovulation period.
I would like to know what the chances of pregnancy are in this situation.
Thank you, doctor.

Ms. Chen, 10~19 year old female. Ask Date: 2021/04/07

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the chances of pregnancy should be low; it's advisable to observe for now.
Wishing you good health.

Reply Date: 2021/04/07

More Info

When considering the risk of pregnancy after engaging in sexual activity, especially when there are concerns about potential ovulation and the use of contraception, it is essential to understand the factors at play. In your case, you have a history of polycystic ovary syndrome (PCOS) and have recently stopped taking birth control pills, which can affect your menstrual cycle and ovulation patterns.

Firstly, it's important to note that with PCOS, menstrual cycles can be irregular, and ovulation may not occur consistently. This irregularity can make it challenging to predict fertile windows accurately. The fact that you have been using ovulation test strips and they have not indicated ovulation is a good sign that you may not be in your fertile window. However, these tests are not infallible, and there is still a possibility of ovulation occurring outside the expected timeframe.

Regarding the sexual encounters you described, the use of condoms is a reliable method of contraception when used correctly. However, you mentioned a concern about your boyfriend's hands potentially having contact with semen. While the risk of pregnancy from pre-ejaculate fluid (pre-cum) is generally low, it is not zero. If there was any sperm present on his hands and it made contact with your vaginal area, there is a slight chance of pregnancy, although this is considered unlikely.

The encounter where your boyfriend briefly penetrated without a condom poses a higher risk, even if it was for a short duration. The withdrawal method (pulling out) is not a reliable form of contraception, as pre-ejaculate can contain sperm. However, since he did not ejaculate inside you, the risk is reduced, but again, it is not eliminated.

Given your situation, if you are concerned about the possibility of pregnancy, you may want to consider emergency contraception (EC). EC is most effective when taken as soon as possible after unprotected intercourse, ideally within 72 hours, but some forms can be effective up to 5 days after. It is important to consult with a healthcare provider to discuss your options and determine the best course of action based on your specific circumstances.

In summary, while the likelihood of pregnancy in your case seems low due to the use of condoms and the timing of your cycle, there is still a possibility. If you have any doubts or if your period is delayed, taking a pregnancy test or consulting with a healthcare professional would be prudent. They can provide personalized advice and support based on your health history and current situation. Remember, understanding your body and its signals is crucial, especially when managing conditions like PCOS.

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Hello, the chances of pregnancy are low, so there is no need to take emergency contraception. It is best to use preventive measures beforehand. If your period is more than a week late, it is advisable to see a gynecologist. Wishing you good health.