Globally, withdrawal is the most commonly used form of contraception, by a large margin.

Also known as “coitus interruptus,” or “pulling out,” the penis is withdrawn from the vagina just before ejaculation. Orgasm is usually completed by manual stimulation.

Withdrawal has some significant advantages:

• It is reasonably effective (80-90%).
• It involves no mechanical devices, medications, or chemicals
• It is always available and requires no preparation

However, withdrawal as a contraceptive method has some problems:

It’s effectiveness is very dependent upon the male sense of timing. Some men are more skilled at this than others.

It requires mental resolve on the part of the male at the precise moment when the power of passion and instinct is formidable.
During the few minutes after ejaculation, the initially thick, globular semen liquefies. In this more liquid form, it is relatively easy for some of the semen to come into contact with the vulva, particularly if there is continuing intimate contact. Pregnancies have occurred under these circumstances, even without vaginal penetration, although they are not common.

Some men and women find withdrawal to be psychologically and physically less satisfying for a variety of reasons. The sensations are not identical to orgasm at full penetration, and the sense of completion is different.

In the past, it was felt that this method would sometimes fail because of a few sperm being found in pre-ejaculatory fluid released prior to orgasm inside the vagina. Most pre-ejaculatory fluid is without any identifiable sperm, although occasionally a few sperm are seen. But these few sperm cannot be responsible for this method’s failure.

Millions of sperm are normally required to achieve a pregnancy through intercourse. The normal male has about 60 million sperm per cc. If a male has fewer than 10 million sperm per cc, he is considered sterile. While it is true that at the end of a lengthy and complex process, a single sperm joins with a single egg, it takes millions of sperm along the way to get to that last single sperm. In the event the withdrawal method fails, it’s not because of a few sperm in some pre-ejaculatory fluid.