Can You Get Pregnant After Taking Emergency Contraception?

Q: Can You Get Pregnant After Taking Emergency Contraception?

Hello： (1) The menstrual cycle is calculated from the first day of menstruation, which includes the menstrual phase, the proliferative phase (also known as the follicular phase in the ovaries), ovulation, and then the secretory phase (also known as the luteal phase in the ovaries

Accidentally ejaculated inside after contraception?

My girlfriend's period ended on August 9, and we had intercourse on August 12.
She took emergency contraception, but we had intercourse again the next day, and I accidentally ejaculated inside her.
Is there still a chance of pregnancy?

Ah Xiang Xiang, 20~29 year old female. Ask Date: 2015/08/14

Dr. Yang Wangjun reply Obstetrics and Gynecology

Hello: (1) The menstrual cycle is calculated from the first day of menstruation, which includes the menstrual phase, the proliferative phase (also known as the follicular phase in the ovaries), ovulation, and then the secretory phase (also known as the luteal phase in the ovaries).
The duration of the luteal phase is usually more fixed, lasting about 14 days, while the duration of the menstrual phase and the follicular phase varies from person to person, resulting in different ovulation days for each individual.
Typically, for a 28-day menstrual cycle, ovulation occurs around day 14.
(2) Emergency contraceptive pills contain high doses of progestin, and their primary mechanism of action is believed to be the alteration of the endometrium, preventing the implantation of a fertilized egg.
Additionally, they may affect the motility of the fallopian tubes, delaying the entry of the fertilized egg into the uterine cavity.
Usually, fertilization occurs in the fallopian tubes, and the fertilized egg moves to the endometrium about 6-7 days after fertilization before implantation.
Therefore, the timing of taking emergency contraceptive pills affects their efficacy; taking them within 12 hours yields a success rate of 92%, with the success rate decreasing the later they are taken.
If taken 24 hours before intercourse, the success rate is lower, as the concentration of progestin in the bloodstream decreases by three-quarters after one day (the half-life of Levonorgestrel is approximately 9-15 hours).
Thank you for your message!

Reply Date: 2015/08/14

More Info

Emergency contraception (EC) is designed to prevent pregnancy after unprotected intercourse or contraceptive failure. The effectiveness of emergency contraception depends on several factors, including the timing of administration relative to ovulation and the type of emergency contraceptive used.

In your case, your girlfriend had her period on August 9 and had unprotected intercourse on August 12, after which she took emergency contraception. If she took the emergency contraceptive pill (like Plan B or Ella) within 72 hours of the unprotected intercourse, it can significantly reduce the risk of pregnancy. However, if she had unprotected intercourse again after taking the emergency contraception, the situation becomes more complex.

1. Timing of Ovulation: The menstrual cycle is typically around 28 days, but it can vary. Ovulation usually occurs about 14 days before the next expected period. If your girlfriend's cycle is regular and she ovulated shortly after August 9, there is a possibility that she could have been fertile during the time of unprotected intercourse on August 12 and again after taking the emergency contraception.

2. Effectiveness of Emergency Contraception: Emergency contraceptive pills are most effective when taken as soon as possible after unprotected intercourse. Plan B (levonorgestrel) is about 89% effective when taken within 72 hours, while Ella (ulipristal acetate) can be effective up to 120 hours after unprotected intercourse. However, if ovulation has already occurred, the effectiveness of these pills decreases.

3. Sperm Viability: Sperm can live inside the female reproductive tract for up to five days. If your girlfriend ovulated shortly after the unprotected intercourse on August 12, there is a chance that the sperm could fertilize an egg, leading to pregnancy.

4. Next Steps: If your girlfriend is concerned about the possibility of pregnancy, she should consider taking a pregnancy test if her next period is late. Pregnancy tests are most accurate when taken after a missed period. Additionally, if she experiences any unusual symptoms or has concerns about her menstrual cycle, she should consult with a healthcare provider for further evaluation and guidance.

5. Consulting a Healthcare Provider: It's always a good idea to discuss any concerns about contraception and reproductive health with a healthcare provider. They can provide personalized advice based on her health history and specific circumstances.

In summary, while emergency contraception can significantly reduce the risk of pregnancy after unprotected intercourse, it is not 100% effective, especially if there is subsequent unprotected intercourse. The timing of ovulation and the type of emergency contraception used are critical factors in determining the likelihood of pregnancy. If there are concerns about potential pregnancy, taking a pregnancy test after a missed period is advisable.

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