Effectiveness of Ella After Ovulation and Sperm Count in Withdrawal Method

Taking Ella after ovulation, withdrawal method contraception, and sperm count?

Is Ella effective if taken after ovulation? Since Ella is known to inhibit ovulation, does it become ineffective after ovulation has occurred, or is it still useful even if ovulation has already taken place? Will it affect the contraceptive effectiveness? Additionally, if withdrawal method is used and it is confirmed that no ejaculation occurred inside, how high is the risk of pregnancy from pre-ejaculatory fluid? If ejaculation has occurred multiple times, will the sperm count be lower during subsequent ejaculations?

Niming, 20~29 year old female. Ask Date: 2022/06/01

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, during the ovulation period, having sexual intercourse with ejaculation can lead to pregnancy.
Ella is an emergency contraceptive pill, and its effectiveness is not superior to that of pre-coital contraceptives.
It should be effective; however, if your period is late, it is advisable to consult a gynecologist.
Wishing you good health.

Reply Date: 2022/06/01

More Info

Ella (ulipristal acetate) is a type of emergency contraceptive pill that is primarily designed to prevent ovulation. It is most effective when taken before ovulation occurs, but its effectiveness after ovulation is a topic of interest and concern for many.
To address your first question, Ella can still be effective after ovulation, although its primary mechanism is to inhibit or delay ovulation. If ovulation has already occurred, Ella may still work by altering the endometrial lining, making it less suitable for implantation. Studies suggest that Ella can reduce the risk of pregnancy even when taken during the luteal phase (after ovulation), but the effectiveness is not as high as when taken before ovulation. The effectiveness of Ella decreases as time passes after ovulation, but it is still a viable option within the 120-hour window post-unprotected intercourse.

Regarding the risk of pregnancy from the withdrawal method (coitus interruptus), it is important to note that pre-ejaculate fluid (pre-cum) can contain sperm. While the concentration of sperm in pre-ejaculate is generally lower than in ejaculate, there is still a risk of pregnancy if sperm are present. The likelihood of pregnancy from pre-ejaculate is not negligible, especially during the fertile window when a woman is ovulating. Therefore, even if ejaculation does not occur inside the vagina, there is still a potential risk of pregnancy.

As for the question about sperm count after multiple ejaculations, it is true that the volume and concentration of sperm can decrease with successive ejaculations. After ejaculation, the body needs time to replenish sperm levels. If a male ejaculates multiple times in a short period, the subsequent ejaculations may contain fewer sperm, which could reduce the likelihood of pregnancy. However, even a small number of sperm can lead to pregnancy if they are viable and reach an egg.

In summary, Ella can still be effective after ovulation, but its efficacy diminishes. The withdrawal method carries a risk of pregnancy due to the presence of sperm in pre-ejaculate, and repeated ejaculations can lead to a decrease in sperm count. If there is any concern about potential pregnancy, it is advisable to take a pregnancy test if menstruation is delayed or consult a healthcare provider for further guidance.

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