Around the same time that menstrual extraction was first used in the United States, a method utilizing nearly identical technology was beginning to be used internationally. This method, another type of manual vacuum aspiration, is most often called menstrual regulation. As with ME, menstrual regulation, when desired as a method of controlling fertility, is performed very early in the menstrual cycle, earlier than a pregnancy test can be performed. One main difference between these two methods is the equipment used. While the Del Em was created such that one is able to put it together from individual pieces and it consists of three parts: the cannula with a one-way valve, a collection jar and the syringe, which are connected by plastic tubing; menstrual regulation is performed with a commercially produced kit which consists of two parts, the cannula with a one-way valve and a directly connected syringe. With this kit, the contents of the uterus are sucked directly into the syringe. ME is performed by a group; menstrual regulation is performed by an individual practitioner.