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Tubal Ligation 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

Female Sterilization A permanent surgical procedure that blocks or removes the fallopian tubes to prevent pregnancy.
Vasectomy A permanent outpatient procedure that blocks the vas deferens so sperm cannot enter the semen.

Method	Female Sterilization A permanent surgical procedure that blocks or removes the fallopian tubes to prevent pregnancy.	Vasectomy A permanent outpatient procedure that blocks the vas deferens so sperm cannot enter the semen.
Efficacy	Female Sterilization 99.5% 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	Female Sterilization $0–$6,000 Insurance: Usually	Vasectomy $0–$1,000 Insurance: Varies
Duration	Female Sterilization Permanent	Vasectomy Permanent
Reversibility	Female Sterilization Permanent	Vasectomy Permanent
STI protection	Female Sterilization No	Vasectomy No
How it works	Female Sterilization Surgical disruption (clipping, banding, cauterization, or complete removal) of the fallopian tubes prevents sperm from reaching the egg.	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	Female Sterilization Required In-Person Procedure	Vasectomy Required In-Person Procedure
Side effects	Female Sterilization Surgical risks (bleeding, infection, organ damage) Anesthesia side effects Ectopic pregnancy (a serious risk if pregnancy occurs after the procedure)	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	Female Sterilization Medical instability for general anesthesia or laparoscopy Uncertainty about future fertility desires Known allergy or hypersensitivity to materials used in the procedure	Vasectomy Uncertainty about future fertility desires Known allergy or hypersensitivity to materials used in the procedure

Key differences

With typical use, 0.5 in 100 people using Female Sterilization get pregnant in a year, vs 0.2 in 100 with Vasectomy (both most effective). Female Sterilization: costs $0–$6,000. Vasectomy: costs $0–$1,000.