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Tubal Ligation vs Spermicide

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

Female Sterilization A permanent surgical procedure that blocks or removes the fallopian tubes to prevent pregnancy.
Spermicide A chemical gel, foam, or film inserted into the vagina before sex to disable sperm, available over the counter.

Method	Female Sterilization A permanent surgical procedure that blocks or removes the fallopian tubes to prevent pregnancy.	Spermicide A chemical gel, foam, or film inserted into the vagina before sex to disable sperm, available over the counter.
Efficacy	Female Sterilization 99.5% typical use Most effective: over 99 out of 100 people successfully prevent pregnancy per year.	Spermicide 79% typical use Least effective: under 90 out of 100 people successfully prevent pregnancy per year.
Cost	Female Sterilization $0–$6,000 Insurance: Usually	Spermicide $16–$18 per package Insurance: Varies
Duration	Female Sterilization Permanent	Spermicide Single use, one dose before each act of sex (gel works for up to 1 hour; film goes in 15 minutes to 3 hours before sex)
Reversibility	Female Sterilization Permanent	Spermicide Reversible
STI protection	Female Sterilization No	Spermicide No
How it works	Female Sterilization Surgical disruption (clipping, banding, cauterization, or complete removal) of the fallopian tubes prevents sperm from reaching the egg.	Spermicide A chemical (usually nonoxynol-9) immobilizes or kills sperm on contact. Inserted into the vagina before sex.
Prescription	Female Sterilization Required In-Person Procedure	Spermicide Not required Over-the-Counter
Side effects	Female Sterilization Surgical risks (bleeding, infection, organ damage) Anesthesia side effects Ectopic pregnancy (a serious risk if pregnancy occurs after the procedure)	Spermicide Vaginal or penile irritation Increased risk of UTI Allergic reaction
Who shouldn't use this	Female Sterilization Medical instability for general anesthesia or laparoscopy Uncertainty about future fertility desires Known allergy or hypersensitivity to materials used in the procedure	Spermicide Sensitivity to nonoxynol-9 High risk of HIV exposure, or HIV in you or a partner (frequent use may increase transmission risk)

Key differences

With typical use, 0.5 in 100 people using Female Sterilization get pregnant in a year, vs 21 in 100 with Spermicide (most effective vs least effective). How long it lasts: Female Sterilization, permanent; Spermicide, single use, one dose before each act of sex (gel works for up to 1 hour; film goes in 15 minutes to 3 hours before sex). Female Sterilization: permanent. Spermicide: reversible. A prescription is needed for Female Sterilization, not for Spermicide. Female Sterilization: costs $0–$6,000. Spermicide: costs $16–$18 per package.