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Delayed periods. Condom slipped during sex. Pulled immediately. Took Next Choice One Step after 4 hours. Chances of pregnancy?

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Practicing since : 2007
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Hello Doctor -
Question about Next Choice One Dose and ovulation.
My girlfriend and I had sex yesterday (06/22) and the condom slipped off. The condom did not break and the opening of it remained at the opening to her vagina. We were able to pull it out immediately and it appeared intact and did contain what seemed to be a large amount of semen. We were still very concerned some semen may have entered or even leaked out the side of the condom. We purchased the Next Choice One Step and she took it about 3.5 to 4 hours after the event.
Our concerns are about the efficacy of the Next Choice ECP when taken very close to possible ovulation. Earlier this month we had a pregnancy scare when she was 5 days late for her period. At that time, she was supposed to get her period on 06/01. She was under a good deal of stress and ended up receiving it on 06/05. It lasted until 06/08. We have since begun using condoms for contraception; she is not taking any medications and is nearly 30 years old. According to a period app she uses on her phone, she is predicted to be ovulating today. She took levonorgestrel yesterday evening at approximately 9pm.

Our concerns:
1. Are there any issues using Next Choice One Dose, which has levonorgestrel, so close to possible ovulation? Does it lose efficacy when so close to ovulation? ***It is my understanding this medication is less effective when a woman is ovulating. Of course we don't know if she was in fact ovulating today.
2. Since her period was 5 days late the last time, is it reasonable to assume ovulation was delayed for this cycle? Will her period most likely be late again this month given it was late last month?
3. Since it appeared as though most of the semen was left in the condom and she used Next Choice soon after the event, is it reasonable to assume there is a very low chance of pregnancy?
Posted Fri, 12 Jul 2013 in Birth Control
Answered by Dr. Arif N Khan 47 hours later

Thank you for choosing XXXXXXX

Emergency contraceptive pill next choice is very effective (99% effective). Only 1% chance of getting pregnant. Answers to your individual questions are as follows:

1) No, levonorgesteral emergency pills don't loose their effectiveness at the time of ovulation; although their might be some amount of difference, which is not clinically significant. Hence, the overall contraceptive effectiveness in whole of the period is 99%. So kindly don't worry about the date of ovulation as the chances of pregnancy is still reduced with the usage of condom.

2) It is normal to have 2 to 5 days of variation between the periods. It's nothing to do with delayed ovulation. In a female there are many factors which play a role, main thing is STRESS which might delay her periods. If the delay is more than 7 days, then always rule out pregnancy by doing Urine pregnancy test.


I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow-ups. If you like my answers kindly rate it, and write a review as well. Please do not forget to accept it.

Wish you good health.

Dr Arif
Above answer was peer-reviewed by
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