From the Guidelines
The chances of getting pregnant in your situation are relatively low, but not zero, and to minimize this risk, consider taking emergency contraception like Plan B (levonorgestrel) within 72 hours or ella (ulipristal acetate) within 5 days of unprotected sex for maximum effectiveness. Pre-ejaculate can contain sperm, which means pregnancy is possible even without full ejaculation [ 1 ]. Since you just finished your period, you're likely not in your most fertile window, which typically occurs around 12-14 days before your next period starts. However, sperm can survive in the female reproductive tract for up to 5 days, and ovulation timing can vary, especially if you have irregular cycles.
According to the U.S. Selected Practice Recommendations for Contraceptive Use, 2013, emergency contraception methods have varying ranges of effectiveness depending on the method and timing of administration [ 1 ]. The Cu-IUD and three types of ECPs, including levonorgestrel and ulipristal acetate, are available options in the United States. Studies have shown that ulipristal acetate (UPA) is more effective than levonorgestrel 3-5 days after unprotected sexual intercourse [ 1 ].
To minimize the risk of pregnancy, it's essential to take emergency contraception as soon as possible. Plan B is available over-the-counter without a prescription, and ella requires a prescription. For future protection, consider more reliable contraception methods, such as hormonal birth control or an intrauterine device (IUD), and ensure proper condom use, including holding the base during withdrawal to prevent slippage. A pregnancy test can be taken about 14-21 days after the incident for accurate results.
Some key points to consider:
- Pre-ejaculate can contain sperm, which can lead to pregnancy
- Emergency contraception is available and effective in preventing pregnancy
- The Cu-IUD and ECPs, including levonorgestrel and ulipristal acetate, are available options
- UPA is more effective than levonorgestrel 3-5 days after unprotected sexual intercourse
- Proper condom use and more reliable contraception methods can help prevent pregnancy in the future.
From the Research
Pregnancy Risk After Condom Failure
- The risk of pregnancy after condom failure, even with pre-ejaculate, is present but can be mitigated with emergency contraception 2, 3, 4.
- Emergency contraception methods include oral pills like levonorgestrel and ulipristal acetate, as well as the copper intrauterine device (IUD) 3, 4.
- The effectiveness of these methods can depend on factors such as the time since unprotected sex and the individual's body mass index 4.
- For emergency contraception, ulipristal acetate is considered more effective than levonorgestrel and can be used up to five days after intercourse 4.
- The copper IUD is the most effective method for emergency contraception and also provides ongoing contraception for up to 10 years 4, 5.
Emergency Contraception Options
- Levonorgestrel and ulipristal acetate pills are available for emergency contraception, with ulipristal acetate being more effective, especially for women who are overweight or obese 3, 4.
- The copper IUD is highly effective for emergency contraception and can be used regardless of the time of ovulation or the woman's weight 5.
- A study comparing levonorgestrel IUDs to copper IUDs for emergency contraception found that levonorgestrel IUDs are noninferior to copper IUDs for this purpose 5.
Considerations for Emergency Contraception
- Any woman requesting emergency contraception should be offered treatment within 120 hours of intercourse, along with information and services for ongoing contraception 3.
- Factors such as time since unprotected sex, body mass index, and use of enzyme-inducing medicines should be considered when recommending an emergency contraception method 4.