Pregnancy Risks After Stopping Birth Control Pills

The possibility of pregnancy from unprotected sexual intercourse?

Hello, doctor.
I previously took oral contraceptives for seven months, and after my last dose on November 18, I have not taken them again until today, December 11.
My last menstrual period was from November 23 to November 29, and before taking the contraceptives, my cycle was consistently 28 days with a duration of 7 days.
Based on my previous medication, I estimated my next period would be from December 21 to December 27, but now that I have stopped taking the pills, I am unsure if my cycle will remain as regular.

I calculated my fertile window online, determining that my ovulation day was December 7, with the fertile window being from December 2 to December 11.
Today, December 11, I had unprotected intercourse for about five minutes, with no ejaculation inside or outside.
My questions are:
1.
Given my previous long-term use of oral contraceptives, will I still ovulate normally this month?
2.
Is my calculation of the fertile window accurate?
3.
Does the described sexual activity pose a risk of pregnancy, and should I consider taking emergency contraception?

keke, 20~29 year old female. Ask Date: 2022/12/11

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the cessation of birth control pills may lead to irregular menstrual cycles and ovulation for a period of time.
Calculating the fertile window can be quite inaccurate, and there is still a chance of conception even if ejaculation does not occur, as pre-ejaculatory fluid may contain sperm.
It is best to use emergency contraception as a remedy, but its effectiveness is not 100%, with a failure rate of about 3%.
It is recommended to check for pregnancy if your period is more than a week late.
Thank you! Wishing you peace and health.
Dr.
Chang

Reply Date: 2022/12/11

More Info

When considering the risks associated with pregnancy after stopping birth control pills, it is essential to understand how hormonal contraceptives affect the menstrual cycle and ovulation.
1. Will I Ovulate Normally After Stopping Birth Control Pills?
After discontinuing birth control pills, it is common for women to experience a temporary disruption in their menstrual cycle. However, many women will resume normal ovulation within a few weeks to a few months. Since you were on the pill for seven months and had a regular cycle prior to that, it is likely that your body will return to its normal ovulatory pattern relatively quickly. Some women may experience a delay in the return of ovulation, while others may ovulate as soon as their next cycle begins. In your case, since you stopped taking the pill on November 18 and had a withdrawal bleed from November 23 to November 29, it is possible that you could have ovulated around December 7, as you calculated.

2. Is My Calculation of the Fertile Window Correct?
Your calculation of the fertile window appears to be reasonable. The typical ovulation occurs about 14 days before the start of your next period, which aligns with your previous cycle length of 28 days. Therefore, if your next expected period is around December 21, ovulation would likely occur around December 7, making the days leading up to that date (December 2 to December 11) your fertile window. However, keep in mind that individual cycles can vary, and factors such as stress, illness, or hormonal fluctuations can affect ovulation timing.

3. Does the Sexual Activity Pose a Risk of Pregnancy?
The sexual activity you described, which involved no ejaculation and was performed without a condom, does carry a risk of pregnancy, albeit a lower one. Pre-ejaculate fluid (pre-cum) can contain sperm, and while the risk is significantly reduced without ejaculation, it is not entirely eliminated. Given that you were in your fertile window, there is a possibility of pregnancy. If you are concerned about the risk of pregnancy, you may consider taking emergency contraception (the "morning-after pill"). Emergency contraception is most effective when taken as soon as possible after unprotected intercourse, ideally within 72 hours, but some types can be effective up to 5 days later.

In summary, after stopping birth control pills, it is possible to ovulate normally, and your calculation of the fertile window seems accurate. The sexual encounter you described does pose a risk of pregnancy, and if you have concerns, it may be prudent to consider emergency contraception. Always consult with a healthcare provider for personalized advice and to discuss any concerns regarding your reproductive health.

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