Pregnancy Risks After Unprotected Intercourse: Key Insights

Can I get pregnant?

Hello Doctor: I would like to ask, my period started on December 4 and ended on December 9.
On December 13, around 11 PM, I had unprotected intercourse with my boyfriend (withdrawal method).
The next day, around 1:30 PM, I took emergency contraception (two pills), and the second pill at 1:30 AM.
On December 15, I had intercourse with my boyfriend three times within two hours (the first and second times with a condom, the third time without a condom and with withdrawal).
What is the likelihood of pregnancy in this situation? Additionally, I had previously discovered ovarian cysts on both sides, but after recent ultrasounds, the doctor said the cysts have resolved.
Will this have any impact?

Chen, 20~29 year old female. Ask Date: 2015/12/15

Dr. Lü Lizheng reply Obstetrics and Gynecology

1.
There is still a slight possibility of pregnancy.

2.
The ovarian cyst has resolved and does not affect the ability to conceive.

Respectfully, Dr.
Lu Li-Cheng, Taoyuan Hospital.

Reply Date: 2015/12/15

More Info

When assessing the risk of pregnancy after unprotected intercourse, several factors must be considered, including the timing of ovulation, the use of emergency contraception, and any underlying health conditions. In your case, you had unprotected intercourse on December 13, shortly after your menstrual cycle, and took emergency contraception (Plan B) within hours of the encounter. Additionally, you had further sexual encounters on December 15, with mixed protection.

Understanding the Timing of Ovulation
The menstrual cycle typically lasts between 28 to 31 days, with ovulation occurring approximately 14 days before the next expected period. Since your last menstrual period started on December 4 and ended on December 9, ovulation likely occurred around December 18 to 20. Engaging in unprotected intercourse on December 13 places you just a few days before your ovulation window, which can increase the risk of pregnancy since sperm can survive in the female reproductive tract for up to five days.

Emergency Contraception
You mentioned taking two doses of emergency contraception shortly after the unprotected intercourse. Emergency contraceptive pills (ECPs) are most effective when taken as soon as possible after unprotected sex, ideally within 72 hours. The effectiveness decreases the longer you wait, but taking it within 24 hours can reduce the risk of pregnancy by up to 95%. Since you took the ECPs promptly, this significantly lowers your chances of becoming pregnant from the December 13 encounter.

Subsequent Intercourse
On December 15, you had three sexual encounters, two of which were protected with condoms, and one that was unprotected. If the condom was used correctly and did not break, the risk of pregnancy from those encounters is minimal. However, the unprotected intercourse during this time could still pose a risk, especially since it occurred just a few days before your expected ovulation.

Health Considerations
You also mentioned having previously detected ovarian cysts, which have since resolved. Generally, the presence of functional ovarian cysts does not significantly impact fertility or the risk of pregnancy. However, if you have any concerns about your reproductive health or the implications of these cysts, it is advisable to consult with a healthcare provider for personalized advice.

Conclusion
In summary, while there is a risk of pregnancy from the unprotected intercourse on December 13 and 15, the timely use of emergency contraception significantly mitigates this risk. If your period does not arrive as expected, it is recommended to take a home pregnancy test or consult with a healthcare provider for further evaluation. Additionally, maintaining open communication with your partner about contraception and sexual health can help in making informed decisions in the future.
If you experience any unusual symptoms or have concerns about your menstrual cycle or reproductive health, seeking medical advice is always a prudent step.

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