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Recommendations for Contraceptive Use

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Withdrawal (coitus interruptus)

Q.1. Are couples practicing withdrawal at risk of pregnancy from pre-ejaculate fluid?

Recommendations

Rationale

a) Probably not. The risk of pregnancy is potentially low if a man is able to "pull out" before ejaculation and makes sure that semen does not have contact with the woman's genitalia.

a) Some researchers conclude that the number of sperm required for fertilization is not contained in pre-ejaculatory fluid. Failure of the method to prevent pregnancy is usually related to inadequate withdrawal.

  1. Rogow D, Horowitz S. Withdrawal: a review of the literature and an agenda for research. Studies in Family Planning. 1995;26 (3):140-53.
   

b) If a second intercourse is anticipated shortly after a first, the man should urinate prior to re-entry and wash off his penis to remove any seminal fluid which may be on the glans or shaft of the penis.

b) Some evidence suggests that after a recent ejaculation, pre-ejaculatory fluid may contain higher levels of viable spermatozoa, and that men should urinate after ejaculating prior to having intercourse a second time, to "flush" or "void" any semen that remains. Washing off the shaft and glans of the penis would prevent any remaining semen external to the man's urethra from being transported into the vagina during re-entry.

  1. Rogow D, Horowitz S. Withdrawal: a review of the literature and an agenda for research. Studies in Family Planning. 1995;26 (3):140-53.
  2. Hatcher R, Trussell, J Stewart F, Stewart G, Kowal D, Guest F, et al. Coitus Interruptus (Withdrawal). In: Contraceptive Technology. New York: Irvington, 1994: 341-6.


Any part of Recommendations for Updating Selected Practices in Contraceptive Use may be reproduced or adapted to meet local needs without prior permission from the TG/CWG Secretariat, provided the TG/CWG is acknowledged and the material is made available free of charge or at cost.


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