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Copper IUD vs Vasectomy

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.
Vasectomy A permanent outpatient procedure that blocks the vas deferens so sperm cannot enter the semen.

Method	Copper IUD A small copper device placed in the uterus that works for up to 10 years and is over 99% effective.	Vasectomy A permanent outpatient procedure that blocks the vas deferens so sperm cannot enter the semen.
Efficacy	Copper IUD 99.2% typical use Most effective: over 99 out of 100 people successfully prevent pregnancy per year.	Vasectomy 99.85% typical use Most effective: over 99 out of 100 people successfully prevent pregnancy per year.
Cost	Copper IUD $0–$1,167 Insurance: Usually	Vasectomy $0–$1,000 Insurance: Varies
Duration	Copper IUD Up to 10 years	Vasectomy Permanent
Reversibility	Copper IUD Reversible	Vasectomy Permanent
STI protection	Copper IUD No	Vasectomy No
How it works	Copper IUD Releases copper into the uterus, which interferes with sperm movement and fertilization and may prevent implantation.	Vasectomy A clinician cuts, seals, or blocks the vas deferens so sperm cannot mix with semen during ejaculation. The body absorbs the sperm, and the semen remains normal in appearance and volume.
Prescription	Copper IUD Required In-Person Procedure	Vasectomy 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	Vasectomy Mild pain or swelling for a few days Bruising or bleeding at the site Sperm granuloma (swelling from leaked sperm that usually goes away on its own) Chronic post-vasectomy pain syndrome (5% in a 2020 meta-analysis)
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)	Vasectomy 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 0.2 in 100 with Vasectomy (both most effective). How long it lasts: Copper IUD, up to 10 years; Vasectomy, permanent. Copper IUD: reversible. Vasectomy: permanent. Copper IUD: costs $0–$1,167. Vasectomy: costs $0–$1,000.