Permanent birth control: Tubal ligation vs. vasectomy

Feb 22, 2013 at 1:00 p.m. ET

Here's what you do know: You are ready to stop having kids. Here's what you don't know: How to decide on which type of permanent birth control is right for you and your husband.

Couple talking to doctor

Explore both sides of the surgical birth control debate to figure out if a vasectomy or tubal ligation is a better fit for you.

Permanent birth control is a serious topic that deserves a significant amount of research and thought. After all, if all goes as planned, "permanent" is, well, permanent. Choosing the right procedure for your family should take some time, but the process doesn’t have to be stressful.

Think about it

Permanent sterilization should not be taken lightly. While a crystal ball may not be practical, it is important to take a serious look into your future before making any decisions. "When thinking about permanent sterilization, a man or woman needs to be sure that they do not want to have any more children no matter what," says Tristi Muir, M.D., associate professor in the Department of Obstetrics and Gynecology and medical director of the Pelvic Health and Continence Center at the University of Texas Medical Branch. "I counsel them to consider worse case scenarios including loss of a partner and remarriage, even loss of a child. Regret is most common in women who undergo permanent sterilization in their 20s and have a change in marital status."

Read more: Why are more women choosing not to have children? >>

Tubal ligation

Tubal ligation is a serious surgery in which the fallopian tubes are essentially closed off through clamping, cutting or burning in order to prevent future pregnancies. Total recovery time varies and risks are consistent with any surgical procedure performed under general anesthesia. "For women undergoing tubal ligation, if they have a failure of the operation, the pregnancy is more likely to implant in the scarred fallopian tube and lead to an ectopic or tubal pregnancy — which can be a serious condition for women," says Dr. Muir.

Could you have pregnancy symptoms after tubal ligation? >>


A vasectomy is an in-office procedure in which a man’s vas deferens tubes are cut and permanently closed, preventing the release of sperm. A local anesthetic is used and recovery is relatively quick. "Vasectomy is safer, effective, less costly and fast[er] recovery time than tubal ligation," says Dr. Muir. "Postoperative semen collection can confirm the absence of sperm and success of the operation." An alternate form of birth control needs to be used for at least three months until operation results are confirmed.

Find out about birth control: Vasectomy facts >>

Other alternatives

If a vasectomy and tubal ligation don’t meet your needs, there are other permanent options available. "Hysteroscopic tubal sterilization is available and does not require general anesthesia," says Dr. Muir. "This method is less expensive, well tolerated and has less postoperative pain than tubal ligation. Hormonal contraception can reduce the pain and bleeding associated with a woman’s period and comes in a pill, patch or vaginal ring. The progesterone-only contraception is available in injections, implants and intrauterine devices." As always, your doctor should be able to walk you through your options before you make any permanent decisions.

More about birth control

Natural family planning: Charting fertility to prevent pregnancy
Finding birth control that’s right for you
Birth control: Natural family planning