Once a month, Dr. Joe DeOrio, a urologist in Chicago, answers your questions on male sexual health. To ask him your own question, click here.
Dear Dr. Joe,
Can pre-ejaculate get a woman pregnant?
Pre-ejaculate, or “pre-cum,” as it is commonly known, is the predominantly clear fluid that leaks from a man’s penis during sexual stimulation prior to orgasm. And, yes, it can get a woman pregnant.
Pre-ejaculate arises primarily from the periurethral glands (glands of Littre) and the bulbourethral glands (Cowper’s glands). This fluid prepares the urethra for ejaculation, and, to some extent, may provide some lubrication during sexual intercourse. Despite the fact that these glands do not produce or secrete sperm, the pre-ejaculate fluid may still contain sperm.
How does that happen? Though it is not perfectly clear, the general consensus is that some sperm remain in the penile urethra after a previous ejaculation. The pre-ejaculate fluid “picks up” some of these sperm as it traverses the urethra and escapes from the penile meatus (opening). This theory is supported by the fact that pre-ejaculate from men who have recently urinated (thereby flushing the urethra) or who have not ejaculated for a period of time often does not contain sperm.
Unfortunately, there is no way to know if your or your partner’s pre-ejaculate contains sperm, barring a full microscopic examination, which isn’t very romantic. Normal ejaculate contains tens of millions of sperm (normal is greater than 20 million per milliliter). Pre-ejaculate is significantly less, but may still contain a few million sperm. Since it only takes one sperm (and a few helper sperm) to get pregnant, there are clearly enough little guys to fertilize an egg.
The withdrawal method — or coitus interruptus, as my high school Latin teacher referred to it — is a form of birth control in which the man withdraws his penis from the vagina prior to ejaculation. Based on the information above, it is not surprising that this technique is one of the least effective forms of birth control. If perfectly practiced, the annual failure rate is 4%. But, honestly, very few people are perfect, and the annual failure rate can be as high as 28%! In comparison, perfect-use failure rates for the pill, the I.U.D., and condoms are 0.3%, 0.6%, and 2%, respectively.
So, in conclusion, pre-ejaculate certainly can get a woman pregnant. If you plan to practice the withdrawal method as a means of birth control, the male partner should always urinate before intercourse and after each ejaculation. In this scenario, though pregnancy is possible, it is far less likely (provided the male withdraws in time!). Finally, it should go without saying, withdrawal provides no protection from STD’s. Be safe!
— Dr. Joe
Dr. Joe earned his undergraduate degree in Molecular Biology from Princeton University. After attending the Loyola University Stritch School of Medicine, he completed his residency training in urological surgery at the Los Angeles County Medical Center. He lives and works in Chicago, IL. Keep an eye out for his upcoming blog at docjoe.net.