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Copper IUD vs Tubal Ligation

A side-by-side comparison of two birth control methods — efficacy, cost, how they work, and who shouldn't use them.

Last verified October 11, 2026Updated October 11, 2026

Side-by-side comparison

Copper IUD A small copper device placed in the uterus that works for up to 10 years and is over 99% effective.
Female Sterilization A permanent surgical procedure that blocks or removes the fallopian tubes to prevent pregnancy.

Method	Copper IUD A small copper device placed in the uterus that works for up to 10 years and is over 99% effective.	Female Sterilization A permanent surgical procedure that blocks or removes the fallopian tubes to prevent pregnancy.
Efficacy	Copper IUD 99.2% typical use Most effective: over 99 out of 100 people successfully prevent pregnancy per year.	Female Sterilization 99.5% typical use Most effective: over 99 out of 100 people successfully prevent pregnancy per year.
Cost	Copper IUD $0–$1,167 Insurance: Usually	Female Sterilization $0–$6,000 Insurance: Usually
Duration	Copper IUD Up to 10 years	Female Sterilization Permanent
Reversibility	Copper IUD Reversible	Female Sterilization Permanent
STI protection	Copper IUD No	Female Sterilization No
How it works	Copper IUD Releases copper into the uterus, which interferes with sperm movement and fertilization and may prevent implantation.	Female Sterilization Surgical disruption (clipping, banding, cauterization, or complete removal) of the fallopian tubes prevents sperm from reaching the egg.
Prescription	Copper IUD Required In-Person Procedure	Female Sterilization Required In-Person Procedure
Side effects	Copper IUD Heavier or longer periods (especially first few months) Increased cramping Spotting between periods Small risk of uterine perforation at insertion	Female Sterilization Surgical risks (bleeding, infection, organ damage) Anesthesia side effects Ectopic pregnancy (a serious risk if pregnancy occurs after the procedure)
Who shouldn't use this	Copper IUD Active pelvic infection or PID (FDA label) Uterine abnormality that distorts the uterine cavity (FDA label) Wilson's disease (copper metabolism disorder) (FDA label) Known copper allergy (FDA label) Current pregnancy (FDA label)	Female Sterilization Medical instability for general anesthesia or laparoscopy Uncertainty about future fertility desires Known allergy or hypersensitivity to materials used in the procedure

Key differences

With typical use, 0.8 in 100 people using Copper IUD get pregnant in a year, vs 0.5 in 100 with Female Sterilization (both most effective). How long it lasts: Copper IUD, up to 10 years; Female Sterilization, permanent. Copper IUD: reversible. Female Sterilization: permanent. Copper IUD: costs $0–$1,167. Female Sterilization: costs $0–$6,000.