Pregnancy Chances After Contraceptive Failure: Key Insights

Probability of Pregnancy

Hello doctor, my last menstrual period was from March 17 to March 22, the one before that was from February 17 to February 22, and the one before that was from January 19 to January 24.
On March 23, I had sexual intercourse with my boyfriend, and the condom broke, resulting in ejaculation inside.
I took emergency contraception within four hours.
From March 28 to March 30, I experienced continuous bleeding, which was similar in volume to my menstrual flow.
I tested for pregnancy using a home pregnancy test on the 7th, 10th, and 14th days, and all results were negative.
However, I read online that testing is more accurate after 18 days or if my period is late.
I would like to know if the chance of pregnancy is high in this situation, or should I wait until my expected period to test again? Since the bleeding, I have been experiencing dull pain in my lower abdomen, similar to premenstrual symptoms, and I feel easily fatigued with lower back pain.
If I want to confirm quickly, can I pay out of pocket for a blood test for pregnancy?

HuiHui, 20~29 year old female. Ask Date: 2022/04/08

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the effectiveness of emergency contraceptive pills is not 100%, with a failure rate of about 3%.
Additionally, early pregnancy may not present specific symptoms, and subjective symptoms cannot be used to make a determination.
It is recommended that if your period is more than a week late, you should still check for pregnancy.
Thank you! Wishing you peace and health.
Dr.
Chang

Reply Date: 2022/04/08

More Info

When it comes to understanding pregnancy chances after a contraceptive failure, such as a broken condom, there are several factors to consider. Based on your timeline and the actions you've taken, let's break down the situation.

You mentioned that your last menstrual period (LMP) was from March 17 to March 22, and you had unprotected intercourse on March 23, followed by taking emergency contraception (the morning-after pill) within four hours. This is a crucial step, as emergency contraception is most effective when taken as soon as possible after unprotected intercourse. The effectiveness of these pills can decrease the longer you wait, but taking it within the recommended time frame significantly reduces the chances of pregnancy.

Following the use of emergency contraception, you experienced bleeding from March 28 to March 30, which you noted was similar in volume to your regular menstrual flow. This bleeding could be a side effect of the emergency contraceptive, as it can cause changes in your menstrual cycle, including early or delayed periods. It's not uncommon for women to experience irregular bleeding after taking emergency contraception, which can sometimes be mistaken for a menstrual period.

You also mentioned that you took home pregnancy tests on days 7, 10, and 14 after the incident, all of which returned negative results. Home pregnancy tests are generally reliable, especially when taken after a missed period. However, it's important to note that the sensitivity of these tests can vary, and they are most accurate when taken after a missed period. Since your expected period would be around mid-April, waiting until then to test again could provide a more definitive answer.

Regarding the abdominal discomfort and fatigue you are experiencing, these symptoms can be related to hormonal changes from the emergency contraception, premenstrual syndrome (PMS), or other factors. If your symptoms persist or worsen, it may be wise to consult a healthcare provider.

If you want to confirm your pregnancy status sooner, you can opt for a blood test, which is more sensitive than home urine tests and can detect pregnancy earlier. Many clinics offer this service, and it can provide peace of mind.

In summary, while the chances of pregnancy after using emergency contraception are relatively low, they are not zero. Given your negative home pregnancy tests and the timing of your menstrual cycle, it is advisable to wait until your expected period date to test again. If your period does not arrive or if you have concerns about your symptoms, seeking medical advice would be beneficial. A healthcare provider can offer further insights and support tailored to your specific situation.

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