Pregnancy Concerns After Unprotected Sex: Your Questions Answered - Obstetrics and Gynecology

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When it comes to concerns about pregnancy after unprotected sex, especially during the ovulation period, it's important to understand the various factors at play. Based on the timeline you've provided, let's break down your questions and concerns regarding the likelihood of pregnancy, the effectiveness of emergency contraception, and the implications for your girlfriend's menstrual cycle.

Firstly, you mentioned that your girlfriend's last menstrual period was from May 13 to May 18, and that her cycle is not very regular. If we assume a typical cycle length of around 28 days, ovulation would likely occur around May 27 to June 1. Since you had unprotected intercourse on June 1, this timing places you right at or just after her ovulation window. Sperm can live inside a woman's reproductive tract for up to five days, so there is a possibility of pregnancy if ovulation occurred shortly after your encounter.

You expressed concern about the possibility of pre-ejaculate fluid containing sperm. While the risk is lower compared to full ejaculation, pre-ejaculate can indeed contain sperm, and even a small amount can lead to pregnancy. The fact that you withdrew quickly and did not ejaculate inside her reduces the risk, but it does not eliminate it entirely.

Regarding the emergency contraceptive pill (ECP) Ella (ulipristal acetate), it is most effective when taken as soon as possible after unprotected intercourse. While it can be taken up to 120 hours (5 days) after the event, its efficacy decreases the longer you wait. Taking it within 24 hours is generally considered effective, but the sooner, the better. Since you took it approximately 24 hours after the incident, you have maximized its potential effectiveness, but there is still a chance of pregnancy, especially given the timing relative to ovulation.

As for your concerns about your girlfriend's menstrual cycle, taking the ECP can indeed cause some irregularities. It may lead to her next period being earlier or later than expected, and the flow may be lighter or heavier than usual. If she is expecting her period around June 11 and it does not arrive, it would be advisable to take a pregnancy test. Home pregnancy tests are generally reliable and can detect pregnancy about a week after a missed period.
If her period is delayed, you can take a test around June 15, as this would give enough time for the hormone hCG (human chorionic gonadotropin) to build up in her system if she is pregnant. If the first test is negative but her period still does not come, it would be wise to test again a few days later or consult a healthcare provider for further evaluation.

In summary, while there is a possibility of pregnancy given the timing of your unprotected intercourse, taking the emergency contraceptive pill within 24 hours significantly reduces that risk. It's important to monitor her menstrual cycle closely and be prepared to take a pregnancy test if her period is late. Remember, open communication with your partner about these concerns is essential, and seeking advice from a healthcare professional can provide additional reassurance and guidance.