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Doc's Corner: 'Pregnant despite Contraception'

Falling pregnant despite contraception - a dread for some couples. Here's a troubling enquiry from a couple who hit a snag after emergency contraception failed.......

"Hello doc, How on earth is it possible for someone to get pregnant after using a condom during sex and taking Postinor-2 immediately after?"


Doctor's Corner

Well, this is not an unusual enquiry and many couples have become 'caught out' as a result. But let's take a closer look at Neither of these two methods is 100% effective in preventing pregnancy.  

In fact, no method is absolutely effective - except abstinence.


How Could You Get Pregnant Despite Contraception With Condoms?

Condoms (the male version) are reported as being around 82% effective when used properly - and most times they are probably not used properly.

A Condom is essentially a barrier that prevents the sperm in the man's ejaculate (cum) from travelling into the woman's womb.

Generally, condoms are packaged in individual wrappings for protection and to maintain their durability.

They could be torn when being opened (during sexual frenzy) or burst/ripped during use - especially if they are old or not properly stored before use.  

They should be worn early during sexual activity and before vaginal penetration - not just when about to ejaculate.

Some men feel the condom takes the pleasure away from sex and are not keen to use it.

Condoms are excellent for preventing sexually transmitted infections (STIs), which other forms of contraception cannot.

But because a lot of their effectiveness relies on the user, the risk of failure when it comes to preventing pregnancy is high. These are some of the reasons you can get pregnant despite contraception with condoms.


Pregnant Despite Contraception

I Thought The Emergency Contraception Pill is "Failure-proof"

Actually, No.

Postinor-2 is an emergency contraceptive pill that is effective in delaying ovulation (ie the release of a woman's egg).

Postinor-2 contains Levonorgestrel (LNG); a man-made progesterone drug usually meant to be taken as soon as possible following sexual intercourse; with a second dose 12 hours after the first.

Its effectiveness depends on the time of the woman's cycle it is taken.  

For LNG pills, it is most effective usually when taken immediately after sex up to 72 hours after intercourse.

This must be during the time just before the middle of her cycle or the first 11-12 days after she completes her menstrual flow/period.

If the lady has ALREADY ovulated in that cycle - so it's more than 12 days or more after she completed her period - Postinor-2 may not work.

This generally applies to women with a regular 28-day cycle. Many women, however, do not have regular cycles. This means their monthly periods may be less or more often than every 28-days.

Additionally, even if you have a 28-day cycle, ovulation date is usually estimated. Using ovulation apps, or monitoring with ovulation kits will not give you an exact time for ovulation.

Another effect of Postinor-2 is that it can interfere with the movements of the sperm and prevent fertilisation that way. This is a minor effect though, and we do not know how much of the pill's success can be linked to this.

Essentially, the pill may have failed because she's already ovulated; or taken after the 72 hours window period when it is MOST effective.


Pregnant Despite Contraception

Getting Pregnant Despite Contraception With The Emergency Pill.

So if a lady has already ovulated when she has intercourse, taking Postinor-2 could prevent the sperm from fertilizing the egg and prevent pregnancy.

On average, Postinor-2 has an 85% chance of preventing pregnancy.

If taken within 24 hours (recommended), there is a 95% chance of preventing pregnancy.

If taken after 48-72 hours, there is a 58% chance. 

It is not known whether it is effective if taken more than 72 hours after unprotected intercourse.


So Which Contraception Methods Are Most Effective?

The most effective way to prevent pregnancy is the use of regular hormonal contraception - the current methods with the best effectiveness rates (99%) are:

  • the Implant,
  • Intrauterine device or
  • Sterilisation.


Conclusion

In line with your fertility plan, what contraceptive would you rather use: Postinor 2, implant or intrauterine device? If you find this article helpful, also share your comments in the comment box below.

To provide more information in this area - read this e-book: Ten common questions for Preventing Pregnancy Safely.

Have you any questions about emergency contraception? Share in the comments.

Read More

Editing By AskAwayHealth

Disclaimer

All AskAwayHealth articles are written by practising  Medical Practitioners on a wide range of health care conditions to provide evidence-based guidance and to help promote quality health care. The advice in our material is not meant to replace the management of your specific condition by a qualified health care practitioner.
To discuss your condition, please contact a health practitioner or reach us directly through info@askawayhealth.org

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