Medication Abortion Self-Confirmation (MASC): Comparison of two home pregnancy tests as an alternative to office follow-up
Awarded 2017
Complex Family Planning Fellowship Research
Wing Kay Fok, MD
Stanford University

Objectives: We sought to evaluate the ability of women to independently perform and interpret the results of the low sensitivity and multilevel urine pregnancy tests for medication abortion follow up.
Study design: We conducted a randomized trial of women seeking medication abortion, with intrauterine pregnancies through 63-days gestation. Women were randomized to use either a 1000 mIU/mL low sensitivity pregnancy test (LSPT) or a 5-level multilevel pregnancy test (MLPT). On day 7, all participants were asked to perform their assigned UPT at home and to complete an electronic questionnaire to document the result. On day 14, participants were instructed to perform another UPT, if indicated, based on day 7 test result. The primary outcome was comprehension of abortion status, which was determined based on women’s interpretation of their final UPT.
Results: We enrolled 88 women, and randomized 43 to use the LSPT and 45 to use the MLPT. Comprehension on day of final UPT was 97% in the LSPT arm and 91% in the MLPT arm (p=0.37). When the urine pregnancy test indicated an ongoing pregnancy, all 3 LSPT users and 2 of 3 MLPT users accurately comprehended their results. On a 100-point VAS with 0 being very easy to use and 100 being very difficult to use, the median score for LSPT was 7.5 (range 0-68), and the median score for MLPT was 9.0 (range 0-52) (p=0.24). Eighty-nine percent of LSPT participants and 95% of MLPT participants were either likely or very likely to recommend use of their test (p=0.66).
Conclusions: This study did not find a statistically significant difference in the ability of women to comprehend the results of the LSPT versus the MLPT, though trends towards lower comprehension of the MLPT and more phone calls by users of the MLPT due to uncertainty were seen.
Implications: Women are able to use both the LSPT and MLPT for medication abortion follow up, but if the MLPT is made available, additional support for women choosing this option may be beneficial.