Can you get pregnant from pre-cum?

What is pre-cum?

Pre-cum is a small amount of liquid released from the tip of the penis when sexually aroused. It is produced by the Cowper’s glands and the Glands of Littre, which are located along the length of the urethra [1]. It can occur at any time during intimacy, and it’s involuntary — meaning you can’t control it, and you or your partner may not even feel it happening [2]. 

Pre-cum is a different fluid from semen (also known as ejaculate or cum), and is not the same as premature ejaculation. Premature ejaculation refers to the early release of semen, i.e., reaching sexual climax earlier than expected. Pre-cum can happen before ejaculation, but it doesn’t guarantee that ejaculation is going to happen either. Everyone’s body is different, and some people produce more pre-cum than others.

What is pre-cum for?

Pre-cum is produced to help clear the urethra of acidic urine, providing a safe passage for sperm. This is necessary because the urethra transports both semen and urine. But while semen is alkaline, urine is acidic and can be detrimental to sperm quality [3]. Pre-cum also provides lubrication for the tip of the penis during sex [4].

Are there sperm cells in pre-cum?

Yes, there can be sperm cells in pre-cum. Interestingly, when the body produces pre-cum, it contains several enzymes and mucus but no sperm [1]. Yet many studies have found sperm cells in pre-cum fluid as it is released from the tip of the penis. 

More research is needed to determine how common it is for sperm cells to be present in pre-cum. Limited studies vary widely, ranging from 17% to 41% of participants showing sperm in their pre-cum fluid. These studies also report conflicting results on sperm quality, with some reporting lower sperm motility and count in pre-cum compared to ejaculation, and others finding no difference [1, 5, 6].

As for how sperm cells make their way into pre-ejaculate fluid, research suggests that sperm leftover from prior ejaculations are “picked up” in the urethra by pre-cum. However, one study where participants had urinated multiple times after their last ejaculation still found sperm cells in pre-ejaculate, suggesting there are other ways sperm may end up in pre-cum [1].

Can you get pregnant from pre-cum?

Yes, you can get pregnant from pre-cum. Since pre-cum may contain a reduced number of healthy sperm cells, you might think you’re less likely to get pregnant from pre-cum than from climax ejaculation. However, it only takes one sperm cell to fertilize an egg, and unfortunately, without individual analysis, there is no way to know whether sperm cells are present in an individual’s pre-ejaculate. So if you want to avoid pregnancy, it’s best to assume you can get pregnant from pre-cum and use a form of birth control to ensure you’re protected.

What are the chances of getting pregnant from pre-cum while ovulating?

Let’s also look at female fertility and its impact on whether you can get pregnant from pre-cum. Each menstrual cycle, you have a fertile window, when sex can lead to pregnancy. Ovulation — the release of a female egg cell — determines when your fertile window is. The egg cell lives for 12-24 hours, during which time it is available for fertilization by a sperm cell, whether from pre-cum or ejaculate [7]. But sperm can survive for up to five days in the female reproductive system [8]. So your fertile window lasts for six days each cycle, including the five days before ovulation and the 24 hours after ovulation when your egg cell can survive. 

These six days are the only time in each cycle when you can get pregnant. If you know your fertile window and have had sex outside of it, then your chances of getting pregnant from any kind of intercourse (pre-cum or no pre-cum) are extremely low.

It might sound simple enough to calculate your fertile window, but tracking your cycle and knowing when you’re ovulating can be tricky. Fertility awareness methods require extensive practice, and their effectiveness is variable and user-dependent [9]. 

To make things easier for you, Natural Cycles has developed a first-of-its-kind app that uses biomarkers (such as temperature) and our clinically proven algorithm to predict when ovulation occurs and identify your fertile window, so you know when to use protection or abstain to prevent pregnancy. The NC° app is the first FDA-cleared birth control app, and is 98% effective when used as intended and 93% effective with typical use [9]. 

What is the pull-out method?

The main worry with pre-cum is the risk of pregnancy when having unprotected sex or using the pull-out method. The pull-out method (also known as withdrawal) involves removing the penis from the vagina before male orgasm and ejaculation, to prevent pregnancy [10]. 

Arguably, if you are trying to avoid pregnancy, the pull-out method is better than nothing at all. But it is one of the least effective methods of contraception, and around 20 in every 100 women who use this method will get pregnant within a year [9]. 

Risks include not removing the penis in time before ejaculation and the risk of pregnancy from pre-cum, which, as we now know, may also contain sperm cells. There is also a very small risk of a splash pregnancy from semen landing around the vulva area [2]. 

For these reasons, we do not recommend using the pull-out method as a form of birth control, especially if you are actively avoiding pregnancy, as many alternatives are more effective. The pull-out method does not protect against sexually transmitted infections.

When to take emergency contraception

If you want to avoid pregnancy and are worried you may be pregnant after having unprotected sex, you can consider taking emergency contraception. Emergency contraception, also known as emergency birth control, is used to prevent pregnancy after sex has already happened. It is not recommended as a replacement for regular contraception, such as condoms or contraceptive pills, but can be useful as a backup if you did not use contraception or your usual method of birth control failed. 

Depending on the type chosen, you can take emergency contraception up to five days after you have had sex. Like any other birth control, emergency contraception is not 100% effective, but the sooner it is taken, the greater the chances of preventing pregnancy. 

There are two main types of emergency contraception available: 

• Morning-after pill: Also known as emergency contraceptive pills, the morning-after pill stops pregnancy by delaying or preventing ovulation using synthetic hormones [11]. There are two types of morning-after pill. The first contains a synthetic progestin called levonorgestrel. It is often available over the counter at your pharmacy or doctor’s office, and should be taken within three days for optimal efficacy. The second contains ulipristal acetate, a compound that changes how progesterone is used in the body. It is only available with a prescription from your doctor or family planning clinic, and can be taken up to five days after sex [12].

• Copper IUD: An intrauterine device (IUD) is a T-shaped device fitted inside the uterus. There are two types of IUDs, but only the non-hormonal, copper IUD is used as emergency contraception. You’ll need an appointment with a healthcare practitioner to have it fitted, but it is the most effective emergency contraception available and offers additional long-term contraception [13]. 

You may feel apprehensive about taking emergency birth control, but know that you are not alone. Research shows that around one-third of women in the US have taken emergency contraception during their fertile years [14]. Your healthcare provider is there to help, and the sooner you seek advice, the better.

When to see a doctor

Always speak to a doctor, healthcare provider, or family planning clinic if you have any concerns about your sexual health or pregnancy risk, particularly if: 

• You need to use emergency contraception

• You have symptoms of a sexually transmitted infection (STI)

• You have had unprotected sex or used the pull-out method, and think you may be pregnant

• You would like to start or change to a new birth control method

• You are experiencing irregular periods

• You experience pain or bleeding during sex

Remember, you aren’t protected from STIs when having unprotected sex, including using the pull-out method. STIs are passed between individuals through skin-to-skin contact or bodily fluids, including pre-cum, and only barrier methods (such as condoms) can protect you from STIs [15]. 

Know your fertile window with Natural Cycles

Understanding when your fertile window occurs can help you feel more in control of your pregnancy risk. Natural Cycles offers a non-hormonal birth control option that uses a clinically proven algorithm to predict your ovulation and fertile window with precision. Based on your biomarker data, the NC° app will show you which days you are likely to be fertile. On these Red Days, you need to use additional barrier methods or abstain from sex to use the method correctly. On Green Days, the app will show “Not fertile”. The partner view feature lets your partner see your fertility status, too, keeping you both informed.