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Grimes, David A. MD; Raymond, Elizabeth G. MD, MPH

Clinical Commentary

The recent United States Food and Drug Administration approval of a commercial kit containing the Yuzpe regimen for emergency contraception is a welcome event. Unlike emergency contraceptive pills sold in other countries, however, the United States product has a pregnancy test bundled with the pills. The test could identify existing pregnancies and avoid unnecessary use of the pills, although any protection against lawsuits alleging injury to an embryo is speculative. Conversely, no major medical organization recommends routine pregnancy testing before using emergency contraceptive pills. The test might stigmatize the Yuzpe regimen as being dangerous to an embryo. Difficulty in understanding the pregnancy test instructions could, paradoxically, deter some women from using the pills after having bought them. The bulky size of the pregnancy test reagent stick makes the package indiscreet, and the test adds unnecessary cost to emergency contraception. The greatest usefulness of the test could be to confirm or exclude a pregnancy several weeks after taking the pills, rather than before. If bundling an unnecessary test with emergency contraception is the only way to bring this useful product to the United States market, then the public health benefits could outweigh the disadvantages. However, this approach sets a worrisome precedent and further isolates the United States from the international medical community.

Bundling a pregnancy test with emergency contraceptive pills is medically unnecessary and paradoxically may deter some women from using the pills.

Family Health International, Research Triangle Park, North Carolina.

Address reprint requests to: David A. Grimes, MD, Family Health International, PO Box 13950, Research Triangle Park, NC 27709. E-mail:

Support for this article was provided by Family Health International (FHI) with funds from the U.S. Agency for International Development (USAID), Cooperative Agreement Number AID/CCP-A-00-95-00022-02. The views expressed in this article do not necessarily reflect those of FHI or USAID.

Received November 30, 1998. Received in revised form February 27, 2999. Accepted February 24, 2999.

© 1999 The American College of Obstetricians and Gynecologists