Pregnancy Risks and Test Accuracy After Unprotected Intercourse

Pregnancy test questions?

Hello Doctor, my menstrual dates for the past six months are 6/19, 7/19, 8/15, 9/13, and 10/16, with a cycle length of approximately 26 to 32 days (mostly around 30).
On the evening of 11/13 at 10 PM, I accidentally had my boyfriend's genitalia slide against mine while we were helping each other, and the contact lasted less than 10 seconds.
Both of us had secretions (he had not ejaculated and was still 5 to 10 minutes away from ejaculation).
I took an emergency contraceptive pill on the evening of 11/14 (within 24 hours).
My period, which was originally due on 11/15, has not arrived yet and is delayed until today.
On the evening of 11/22, I noticed brown discharge.
I had a blood test for pregnancy on 11/21 (eight days after the sexual encounter), which showed a value of less than 1.2.
On the morning of 11/23 (ten days after the sexual encounter), I took a home pregnancy test using first-morning urine, which was negative.
I would like to ask: (1) What is the nature of the secretions? (2) Do the secretions contain a sufficient amount of sperm to cause pregnancy? Should I be concerned about the risk of pregnancy? (3) Are the results of these two pregnancy tests reliable? Thank you.

Niming, 10~19 year old female. Ask Date: 2022/11/23

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, I have already responded to your question earlier.
Wishing you good health.

Reply Date: 2022/11/23

More Info

When assessing the risk of pregnancy after unprotected intercourse, it is essential to consider several factors, including the timing of the menstrual cycle, the nature of the sexual activity, and the effectiveness of emergency contraception. In your case, you had a close encounter with your boyfriend on November 13, where there was no ejaculation, but there was contact with pre-ejaculatory fluid. You took emergency contraception within 24 hours, which is a crucial step in reducing the risk of pregnancy.

1. Understanding Pre-ejaculatory Fluid: Pre-ejaculatory fluid, often referred to as "pre-cum," is produced by the Cowper's glands and can contain sperm. While the concentration of sperm in this fluid is generally lower than in ejaculate, it is still possible for it to contain enough sperm to result in pregnancy, especially if there was a recent ejaculation prior to the encounter. However, since there was no ejaculation during your encounter, the risk of pregnancy is significantly reduced.

2. Pregnancy Risk Assessment: Given that you took emergency contraception (the "morning-after pill") shortly after the incident, this further decreases the likelihood of pregnancy. Emergency contraceptive pills are most effective when taken as soon as possible after unprotected intercourse, ideally within 72 hours, but they can be effective up to 5 days after. Since you took it within 24 hours, you maximized its effectiveness.

3. Menstrual Cycle Considerations: Your menstrual cycle appears to be somewhat irregular, ranging from 26 to 32 days. If your period was expected on November 15 and has not arrived by November 22, this could be attributed to several factors, including the stress of the situation, hormonal fluctuations, or the effects of the emergency contraception itself, which can sometimes cause temporary changes in the menstrual cycle.

4. Testing for Pregnancy: You mentioned that you had a blood test on November 21, which returned a result of less than 1.2, indicating a negative result for pregnancy. Additionally, you performed a home urine pregnancy test on November 23, which was also negative. Both tests are reliable methods for determining pregnancy. Blood tests can detect pregnancy earlier than urine tests, and a result of less than 5 mIU/mL is generally considered negative. Since both tests were negative, it is unlikely that you are pregnant.

5. Brown Discharge: The brown discharge you observed on November 22 could be old blood, which is not uncommon when a period is delayed. It may also be a side effect of the emergency contraception, as hormonal changes can lead to spotting or changes in menstrual flow.

In conclusion, based on the information provided, the risk of pregnancy appears low due to the absence of ejaculation, the timely use of emergency contraception, and the negative results from both the blood and urine pregnancy tests. If your period does not arrive within a week or if you have any further concerns, it would be advisable to consult with a healthcare professional for further evaluation and guidance.

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