the Risks of Emergency Contraception After Unprotected Sex

I would like to inquire about the risks associated with emergency contraception?

Hello, doctor.
May 15th is my ovulation day (I have not ovulated yet).
On the same day, I had unprotected intercourse with my boyfriend, but there was no ejaculation inside.
About 1 to 2 hours later, I took the emergency contraceptive pill (ella).
Additionally, we had protected intercourse about 4 to 5 days prior (on May 12th).
I would like to know what the risk of pregnancy is in this situation.
When would be the best time to take a pregnancy test? Should I take another emergency contraceptive pill afterward?

Bai Bai, 10~19 year old female. Ask Date: 2023/05/16

Dr. Lin Manying reply Obstetrics and Gynecology

Hello, you are at low risk of pregnancy.
It is best to take a pregnancy test 10-14 days after your last sexual intercourse.
If you are on any contraceptive pills, please continue taking them.
The Ministry of Health and Welfare cares about your health.

Reply Date: 2023/05/16

More Info

When it comes to understanding the risks of emergency contraception after unprotected sex, it's essential to consider several factors, including the timing of ovulation, the type of emergency contraception used, and the timing of any potential pregnancy tests.

In your case, you mentioned that May 15 was your ovulation day, and you had unprotected sex on that day without ejaculation. Since you took the emergency contraceptive pill (ella) within 1-2 hours after the encounter, you have taken a significant step to reduce the risk of pregnancy. Ella is a selective progesterone receptor modulator that can be effective up to 120 hours (5 days) after unprotected intercourse, but its efficacy is highest when taken as soon as possible after the event.
Given that you had unprotected sex on your ovulation day, there is a risk of pregnancy, but since you took the emergency contraceptive pill promptly, it significantly lowers that risk. The effectiveness of ella is around 85% when taken within the recommended time frame. However, it is important to note that no method of contraception is 100% effective, and the risk of pregnancy cannot be entirely eliminated.

Regarding the timing of a pregnancy test, it is generally recommended to wait at least one week after the expected date of your next period to take a home pregnancy test for the most accurate results. If your menstrual cycle is irregular or if you are unsure when your period is due, you may want to wait at least 14 days after the unprotected intercourse to test. This allows enough time for the hormone hCG (human chorionic gonadotropin) to build up in your urine if you are pregnant.

As for whether you need to take another emergency contraceptive pill, it is not necessary since you have already taken ella. Emergency contraception is designed for occasional use and should not be relied upon as a regular form of birth control. If you find yourself needing emergency contraception frequently, it may be beneficial to discuss long-term contraceptive options with your healthcare provider.

In summary, while there is a risk of pregnancy due to the timing of your unprotected sex, taking ella promptly significantly reduces that risk. Monitor for any signs of pregnancy and consider taking a test at the appropriate time. If you have further concerns or experience any unusual symptoms, it is advisable to consult with a healthcare professional for personalized advice and support.

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