What is the likelihood of pregnancy with the use of a condom (contraceptive device) and the coital withdrawal (pull-out) method?

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Last updated: April 29, 2025View editorial policy

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From the Guidelines

Using a condom and the pull-out method together can significantly reduce the risk of pregnancy, with an estimated failure rate of less than 2% when used perfectly, as the condom has a 2% failure rate with perfect use and the pull-out method has a 4% failure rate with perfect use 1. When considering the use of both a condom and the pull-out method, it's essential to understand the effectiveness of each method individually. According to the data, condoms have a 2% failure rate with perfect use and an 18% failure rate with typical use, while the pull-out method has a 4% failure rate with perfect use and a 27% failure rate with typical use 1.

Key Considerations for Effective Use

  • The condom should be put on before any genital contact to prevent sperm from escaping.
  • Check the condom for damage before use to ensure it is intact.
  • Leave space at the tip of the condom to collect semen.
  • Withdraw before ejaculation, even when using a condom, to minimize the risk of sperm entering the vagina.

Additional Protection

While using a condom and the pull-out method together can provide effective protection against pregnancy, it's crucial to remember that neither method offers perfect protection against STIs, although condoms do provide good protection 1.

Alternative Options

If you're concerned about pregnancy, consider adding a hormonal method like the pill, patch, or IUD for even greater protection. These methods can be used in conjunction with a condom and the pull-out method to provide multiple layers of protection against pregnancy.

Summary of Effectiveness

  • Condom: 2% failure rate with perfect use, 18% with typical use
  • Pull-out method: 4% failure rate with perfect use, 27% with typical use
  • Combination of condom and pull-out method: less than 2% failure rate with perfect use 1

From the FDA Drug Label

Condoms, sponge, withdrawal, spermicides, diaphragm: Use correctly every time you have sex Tier 3 Less Effective More than 13 pregnancies per 100 women in one year

The chance of pregnancy with a condom and pull-out method is more than 13 pregnancies per 100 women in one year if used correctly every time. However, the effectiveness of these methods can vary depending on proper use. 2

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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