Postinor/pregnancy

Dear Dr,
I recently had sex with my partner, the condom slipped off and (not knowing this) I ejaculated inside her. She is currently taking the COCP. She is certain that she didn't miss any pills, however, we were paranoid (both medical students) at the possibility of pregnancy so she decided to take postinor (single dose). She took it within 12 hrs of the episode. She was most likely in the fertile period of her cycle. My questions are as follows:
1. assuming she hadn't missed taking any of her COCPs, was taking postinor "just to be safe" a good decision?
2. does being in the fertile period reduce the efficacy of emergency contraception? (i understand the drug company claims it prevents implantation, however, I have read data which suggest a lack of efficacy in the post-ovulatory fertile period)
3. risk of pregnancy?
4. would you advise a pregnancy test and if so when?

thankyou in advance

[Minoo Bhagia, MD]

Dear operation1,

Thanks for the query.

As she was already taking OCPs (oral contraceptive pills) and she has not missed the dose of these pills, there is no chance of pregnancy and there was no need to take the emergency contraception.

Since she has taken it, there is no need to worry. Being in the fertile period doesn't reduce its efficacy.

Her next period can be irregular, heavy or normal. She may have delayed periods.

You can do pregnancy test to be extra sure, if she misses her next period. The test can be done 4-5 days after the missed period.

Hope that this information helps and hope that you will get better soon.

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Best Regards,
Dr. Minoo Bhagia.