Concerns About Pregnancy: Risks and Emergency Contraception

Concerned about pregnancy?

Hello, doctor! My period started on October 19 and ended around the 23rd.
I had sexual intercourse with my boyfriend from the 24th to the 26th, once each day, and we used condoms throughout.
However, during the last encounter, he did not pull out immediately after ejaculation; he said he pulled out a few seconds later, but I feel like it might have been longer.
He assured me that he checked the condom for any breaks, and it was still firm after pulling out, making it difficult to remove.
Since this was my first time, I am quite anxious.
I took an emergency contraceptive pill within 120 hours on the 28th.
I would like to know if there is still a chance of pregnancy.
I am very worried! Were we in a safe period? (My menstrual cycle is usually irregular, ranging from 30 to 35 days.) Most of the time, my period is delayed.
The dates of my period in the last few months were: July 12, August 16, September 19, and October 19, lasting about 5 days, sometimes a bit longer.
What is the likelihood that I could be pregnant?

Niming, 30~39 year old female. Ask Date: 2015/10/29

Dr. Lü Lizheng reply Obstetrics and Gynecology

1.
The use of condoms throughout the entire intercourse results in a pregnancy probability of less than one percent.
2.
Engaging in sexual activity during the safe period further reduces the likelihood of pregnancy.
3.
Additionally, taking emergency contraception decreases the chance of pregnancy even more.
Sincerely, Dr.
Li-Cheng Lu, Taoyuan Hospital.

Reply Date: 2015/10/29

More Info

When it comes to concerns about pregnancy, especially regarding the use of emergency contraception and the risks of unintended pregnancy, it's important to understand the various factors at play. Based on the details you've provided, let's break down your situation and address your concerns.

Firstly, you mentioned that you had unprotected intercourse during your fertile window, which can increase the risk of pregnancy. However, you also used a condom, which is a reliable form of contraception when used correctly. The fact that your boyfriend checked the condom for any breaks and found it intact is reassuring. Condoms, when used properly, have a failure rate of about 2% with perfect use, but this can increase to about 18% with typical use due to human error.

You took emergency contraception (EC) within 120 hours (5 days) after the unprotected intercourse, which is a crucial step in reducing the risk of pregnancy. Emergency contraceptive pills (ECPs) are most effective when taken as soon as possible after unprotected sex. The sooner you take it, the better the efficacy. For instance, levonorgestrel (Plan B) is about 89% effective when taken within 72 hours, while ulipristal acetate (Ella) can be effective up to 120 hours after intercourse.

Given your menstrual cycle history, it appears that you have irregular cycles, which can complicate the prediction of ovulation. Your cycle length ranges from 30 to 35 days, and since you had intercourse shortly after your last period, you might have been approaching your fertile window. However, without precise tracking of ovulation, it's difficult to determine the exact risk of pregnancy.

As for your anxiety about the possibility of being pregnant, it's completely normal to feel concerned, especially if this is your first experience with sexual intercourse. The best course of action is to wait until your next expected period. If your period is late by a week or more, you should take a home pregnancy test for confirmation. These tests are quite accurate and can provide peace of mind.

In terms of your question about the likelihood of pregnancy, while it's impossible to give an exact percentage without knowing the specifics of your ovulation, the combination of using a condom and taking emergency contraception significantly reduces the risk. If the condom was intact and you took the EC promptly, your chances of pregnancy are relatively low.

It's also worth noting that if you find yourself frequently anxious about pregnancy or contraception, consider discussing these concerns with a healthcare provider. They can provide personalized advice, help you understand your cycle better, and discuss regular contraceptive options that might suit you and your partner better in the future.

In conclusion, while there is always a possibility of pregnancy when engaging in sexual activity, the steps you've taken—using a condom and taking emergency contraception—are effective measures to mitigate that risk. Monitor your body for any signs of pregnancy, and don't hesitate to reach out to a healthcare professional for further guidance and support.

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