Birth Control Options – Surgical Methods

How do I choose a birth control or contraception option?

Many factors go into choosing a birth control option, ranging from personal comfort, life goals, health conditions, and the thoughts and opinions of your sexual partner(s). Thinking about your lifestyle and speaking with a health care provider may help provide you with more information so you can make a more informed decision. 

Some questions to consider before choosing a birth control option may include: 

  • What are your goals with starting birth control? Is it to prevent pregnancy, STIs, both, or maybe something else entirely? 
  • Do you have health conditions that may be affected by any of the birth control options? 
  • What are the potential side effects of each option? 
  • How much effort is involved in using specific options? How much effort are you willing to put in to prevent pregnancy or STIs? 
  • What is the effectiveness of the birth control option in preventing pregnancy? In preventing STIs? 
  • If it’s pregnancy you’re trying to prevent, how often do you engage in penile-vaginal sex? 
  • If you would like to become pregnant now or in the future, how soon would you like that to occur? 
  • What are you most comfortable with? 
  • How many sex partners do you have? What are your sex partners comfortable with? 

The various birth control methods have their benefits and disadvantages, and often these depend on peoples’ different perspectives and lifestyles. What works for someone else may not work for you and vice versa. That said, some trial and error may be involved in finding the best fit for you.

How do the surgical contraceptive options work?

These methods are considered permanent birth control or voluntary sterilization options because they involve a surgical procedure that’s generally difficult or expensive to reverse. Additionally, reversing this procedure does not ensure that your fertility will return to pre-procedure levels. And it’s important to note that these options do not protect against STIs.

What are the surgical options?


  • A surgical procedure on external reproductive anatomy 
  • In this procedure, the tubes that carry sperm to the urethra (the vas deferens) are sealed. This prevents sperm from getting into semen, which is ejaculated during sex 
    • After a vasectomy, the sperm concentration in semen decreases to zero over a few weeks or months 
    • Getting a sperm count from your health care provider will ensure that the sperm concentration has truly reached zero 
  • The two types of vasectomy are incision vasectomy or no-scalpel vasectomy 
  • Conventional or Incision vasectomy 
    • A health care provider makes one to two small cuts in the skin of the scrotum and the vas deferens are blocked off through these cuts or a small portion is removed 
    • Then the tubes are either tied, clipped off, or cauterized before the skin is restitched 
    • The procedure takes about 20 minutes 
  • No-scalpel vasectomy 
    • A small hole is made to reach the vas deferens without a cut to the skin of the scrotum 
    • Then, the tubes are closed off in the same manner as an incision vasectomy 
    • No stitches or scarring will occur 
    • This method may lower the risk of infection as no incision is made 
  • Research has not found any significant differences in effectiveness between conventional and no-scalpel methods 
  • This procedure is becoming more common in couples that can get pregnant, likely due to cheaper costs, convenience, and the changing landscape of abortion regulations 
  • Some potential side effects: discomfort or pain after procedure, risk of infection after procedure 
  • Effectiveness rate: 99.9 percent in the first year 

Tubal ligation 

  • A surgical procedure on internal reproductive anatomy, often known as getting your “tubes tied” 
  • In this method, the fallopian tubes are tied or closed, preventing eggs from encountering sperm for fertilization 
  • Some potential side effects: risk of infection after procedure, increased risk of ectopic pregnancy if tubal ligation fails 
  • Effectiveness rate: 97 to 99.8 percent 

Last reviewed/updated: February 14, 2024

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