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All birth control methods work the best if used correctly and every time you have sex. Your choice of birth-control method is a personal one and depends on a number of variables, including short or long-term family planning, personal health, associated risks, failure rate and cost.
The vasectomy is one of the lowest failure rates among the birth control methods. The study showed the traditional vasectomy failure rate is 1-3 per 1000 cases; the failure rate would be less than 1 per 20000 in no scalpel vasectomy with the fascia clipping technique.
Birth Control Methods Comparison
| Contraception | Cost | Failure Rate | Duration | Availability | Advantages | Disadvantages |
| Condom | <10 | 18% | one time | OTC | prevent STIs; no hormonal side effects | local reaction & breakage |
| Vasectomy | $700 – $2000 | 0.2% | Permanent | Office procedure | No effect on hormones and sex drive | No protection in the first 3 months, Surgical side effects |
| Female Condom | $2-$4 | 21% | one time | OTC | prevent STIs; use during menstruation | local reaction & breakage |
| Spermicide | $5-$10 | 28% | one time | OTC | Lubricate, use with other BCP forms | local reaction |
| Sponge | $3-$5 | 24% | Up to 24h | OTC | Lasts 24 hours | Local effects and infections |
| Diaphragm | $50-$300 | 5-20% | Reusable | Prescription | Lasts 24 hours, reusable | Insert challenging,local reaction |
| Cervical cap | $50-$75 | 14-30% | 48-72 hours, reusable | Prescription | Protect 48-72 hours | Abnormal Pap smear, local reaction & infection |
| Birth Control Pill | $15-$50/month | 9% | A month | Prescription | Regulate menstruation; reduce cramps and ovarian cysts | Take daily, weight changes, and medical /risks/side effects* |
| Vaginal ring | $15-80/month | 9% | Wear monthly | Prescription | Regulate menstruation; reduce cramps and ovarian cysts | Weight changes and medical risks/side effects* |
| Contraceptive Patch | $15-80/month | 9% | A month, replace weekly | Prescription | Regulate menstruation; reduce cramps and ovarian cysts | Weight changes and medical risks/side effects* |
| Birth Control shot | $35-75/injection | 6% | 3 months | doctor’s visit | 4 shots/year; reduces menstrual cramps and the risk of ovarian cysts/cancer and PID | Take up to 8 months to return; medical risks/side effects* |
| Intrauterine device (IUD) | $500-$1000 | 1% | 5-12 years | Doctor’s visit | immediately effective | Migrates, ovarian cysts, PID, and ectopic pregnancy |
| Hormone Implants | $400-$800 | 1% | 3 yearse | Doctor’s visit | reduce menstrual flow, cramping, and PID | office procedure, local reaction, Medical side effects** |
| Tubal Ligation | $1500-$6000 | 1% | Permanent | Outpatient surgery | Permanent and immediate; does not impact sex drive | More invasive, complicated than vasectomy, surgical side effect |
| Essure | $1500-6000 | 1% | Permanent | Outpatient surgery | Less invasive than tubal ligation | 3 months to take effect; side effects:cramping,irregular menstrual cycle, GI reaction, and infection |
* Medical risks and side effects: may increase risk of blood clots, stroke, breast cancer, heart attack, high blood pressure, depression and anxiety; may decrease sex drive; other side effects include weight gain, breast lumps, and hair loss or excessive growth.
**Medical risks and side effects: can cause loss of bone density and sex drive, and mood swings, weight gain, breast and abdominal pain, and allergic reaction.
References: Birth Control Guide. Food and Drug Administration Office of Women’s Health.
CONTRACEPTION OPTIONS
Abstinence – both the man and the woman choose not to have sex.
Cervical Cap/Diaphragm/ Vaginal Pouch – barrier devices placed over the cervix and vagina and stops sperm from entering.
Condom – the most common form of contraception; it is a thin latex sheath that physically blocks sperm during sex. It also help prevent the transmission of the AIDS as well as other sexually transmitted diseases. Risk of tearing, breaking, slipping or leaking, any of which can lead to conception.
Depo-Provera® – a progesterone injection administered every 12 weeks that stops ovulation, highly effective but may cause significant side effects such as weight gain or depression. No menstruation with Depo-Provera, but it returns after stopping the injection.
Essure — a permanent, non-surgical transcervical sterilization procedure for women; Essue is less invasive and more cost effective than tubal ligation. This procedure uses a catheter passed from the vagina through the cervix and uterus to insert a flexible coil into the fallopian tubes to block them by inducing benign fibrotic reaction and tissue growth in and around the insert. The tissue barrier formed prevents sperm from reaching an egg.
Experimental Male Birth Control — a number of research groups across the globe have tried different alternatives to male birth control. These include injected plugs, heat methods, pharmaceuticals, hormonal therapy, and obstruction of the vas deferens. Despite promising developments, these treatments are experimental, and not approved by FDA.
Reversible inhibition of sperm under guidance (RISUG) got more attention recently; phase III clinical trials are underway in India. RISUG works by injecting the polymer into the vas deferens, the polymer prevents the sperm from fertilizing an egg.
Intrauterine Device (IUD) – a small T-shaped plastic device placed in the uterus that creates a low-grade inflammation, preventing sperm and fertilized egg from settling in uterus.
Implants — a single-rod contraceptive implant that is inserted just under the skin of a woman’s upper arm and contains etonorgestrel. It is a long-acting reversible contraception that provides a three-year protection. Norplant 6 rod system discontinued in 2004, and Nexplanon is the only available single-rod implant in the US.
Oral Contraceptives – estrogen tablet that is fairly effective.
Rhythm Method – couples abstain from having sex for five to 15 days per month in order to avoid the most fertile days in the woman’s menstrual cycle. However, this is not a precise method.
Spermicides – chemical contraceptives, such as foam, cream or jellies that kill sperm on contact in the vagina.
Tubal Ligation – permanent surgical sterilization for women, involves tying, cutting or cauterizing fallopian tubes to permanently block egg passage from the ovaries to the uterus.
Vasectomy – permanent surgical sterilization for men, it surgically blocks the vas deferens, thin tubes carrying sperm from the scrotum, and prevents sperm from becoming part of the seminal fluid that leaves the body at sexual climax. The most popular type of vasectomy is No-Scalpel Vasectomy.
Withdrawal method – the man withdraws from intercourse before ejaculation, not reliable since sperm may enter the vagina before ejaculation.
