Tubal LigationvsSponge

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

Side-by-side comparison

Method	Female Sterilization A permanent surgical procedure that blocks or removes the fallopian tubes to prevent pregnancy.	Sponge A soft foam disc placed deep in the vagina before sex. It covers the cervix and contains spermicide.
Efficacy	99.5% typical use Most effective: over 99 out of 100 people successfully prevent pregnancy per year.	Least effective see details Least effective: under 90 out of 100 people successfully prevent pregnancy per year.
Cost	$0–$6,000 Insurance: Usually	$15–$20 /per package Insurance: No
Duration	Permanent	Single use (can be left in place up to 24 hours and for multiple acts of sex)
Reversibility	Permanent	Reversible
STI Protection	No	No
How it works	Surgical disruption (clipping, banding, cauterization, or complete removal) of the fallopian tubes prevents eggs from reaching the uterus and sperm from reaching the egg.	A polyurethane foam disc impregnated with spermicide is placed over the cervix before sex. The spermicide kills or disables sperm and the physical barrier blocks sperm from entering the uterus.
Prescription	Required Prescription required	OTC No prescription / OTC
Side effects	Surgical risks (bleeding, infection, organ damage) Anesthesia side effects Ectopic pregnancy (small but serious risk if failure occurs)	Vaginal irritation or dryness Increased risk of urinary tract infection Rare allergic reaction
Who shouldn't use this	Medical instability for general anesthesia or laparoscopy Uncertainty about future fertility desires	Allergy to nonoxynol-9, benzalkonium chloride, or other spermicide ingredients History of toxic shock syndrome Active vaginal infection Inability to insert or remove reliably High risk of HIV exposure (frequent nonoxynol-9 use may increase vaginal irritation; CDC cautions)

Key differences

Female Sterilization duration: Permanent. Sponge duration: Single use (can be left in place up to 24 hours and for multiple acts of sex). Female Sterilization is permanent; Sponge is reversible. Female Sterilization requires a prescription; Sponge does not. Female Sterilization: costs $0–$6,000. Sponge: costs $15–$20 per package.