Pregnancy Risks: Unprotected Intercourse and Pre-Ejaculate - Obstetrics and Gynecology

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When assessing the risk of pregnancy following unprotected intercourse, it is essential to consider several factors, including the timing of the menstrual cycle, the nature of the sexual activity, and the presence of pre-ejaculate fluid.

1. Timing of Intercourse: In your case, your girlfriend's last menstrual period started on February 17. Typically, ovulation occurs approximately 14 days before the next expected period. If her cycle is regular, ovulation would likely occur around March 3. The sexual activity on February 20 occurred shortly after her period, which is generally considered a safer time for unprotected intercourse, as it is less likely to coincide with ovulation. However, if her cycle is irregular, this could complicate predictions about ovulation.

2. Nature of Sexual Activity: You mentioned that during the first instance of intercourse on February 20, there was no ejaculation inside, and you withdrew before ejaculation. This method, known as the withdrawal method, can reduce the risk of pregnancy, but it is not foolproof. Even without ejaculation, pre-ejaculate fluid (pre-cum) can contain sperm, which poses a risk of pregnancy.

3. Pre-Ejaculate Fluid: Pre-ejaculate fluid is produced by the Cowper's glands and can sometimes contain sperm from previous ejaculations. While the concentration of sperm in pre-ejaculate is generally lower than in ejaculate, it is still possible for pregnancy to occur if viable sperm are present. The risk of pregnancy from pre-ejaculate fluid is not negligible, especially if there is any chance that sperm could be present.

4. Second Instance of Intercourse: In the second instance of intercourse on March 5, you used a condom, which is a reliable method of contraception when used correctly. Since you did not ejaculate inside the condom, this further reduces the risk of pregnancy.

Conclusion: Given the timing of the sexual activities relative to your girlfriend's menstrual cycle and the precautions taken (withdrawal method and condom use), the overall risk of pregnancy appears to be low. However, it is crucial to remember that no contraceptive method is 100% effective, and the withdrawal method is particularly unreliable due to the potential presence of sperm in pre-ejaculate fluid.

If your girlfriend experiences a missed period or any unusual symptoms, it would be advisable for her to take a home pregnancy test or consult with a healthcare provider for further evaluation. Additionally, if you are concerned about the risk of pregnancy in the future, consider discussing more reliable contraceptive options, such as hormonal birth control or long-acting reversible contraceptives (LARCs), with a healthcare professional.