What are the options for permanent birth control?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Feb 20, 2025.

Key Points

Permanent birth control options, also known as sterilization, are highly effective methods for preventing pregnancy. The most common forms of permanent birth control include tubal ligation for women and vasectomy for men. These procedures both involve minimal surgery (minimally invasive surgical techniques) and you can usually go home the same day.

Permanent birth control may be selected for many reasons, including if:

• You choose not to have children.
• You are done having children.
• You decide to adopt.
• You do not want to pass on an inherited, genetic disorder.

Tubal ligation and vasectomy are common, outpatient, surgical procedures that do not usually require an overnight stay in the hospital. They are both considered low risk procedures. Local, regional or general anesthesia may be used for the procedure. 

Most patients are back to their normal routine within a few days, although you may need to avoid strenuous physical work, exercise, and sex for a few days to about a week or two. Your doctor will explain your limitations and time-frame based upon the procedure and your medical condition.

As with any surgical procedure, there are potential risks such as infections, bleeding, organ damage and reactions to the anesthetics. 

Here, we’ll examine some common forms of permanent birth control.

For Women - With Surgery

Tubal Ligation  ("getting your tubes tied")

• Tubal ligation, often referred to as “getting your tubes tied” is a surgical sterilization procedure for women. It usually involves a 30 minute outpatient surgical procedure and the patient usually goes home the same day. 
• The fallopian tubes are found in women and provide the structure for the female egg and male sperm to fertilize. The fertilized egg (embryo) then travels to the uterus. The fallopian tubes are cut, tied, or sealed to prevent eggs from reaching the uterus.
• The procedure is considered low risk for most women and is usually done laparoscopically (using a thin, lighted tube with a camera that is inserted into the abdomen or pelvis through small incisions). May be done after giving birth or at other times.
• It is considered a highly effective and permanent method of birth control. It is 99% effective with less than a 1% failure rate, but rarely reversible.
• Expensive but permanent (insurance may cover). In general  the cost of a tubal ligation can range from $0 to $6,000 or more, depending upon your insurance coverage. You can get a tubal ligation at a doctor’s office, hospital, or health clinic. Some local women’s health centers, like Planned Parenthood, may also do tubal ligations.
• Does not protect against sexually transmitted diseases (STDs) like HIV. Use a condom to help prevent STDs.

Bilateral salpingectomy (complete removal of fallopian tubes)

• In a bilateral salpingectomy, the fallopian tubes from the female reproductive system are completely removed. This is a permanent procedure that prevents pregnancy and may also reduce the risk of ovarian cancer. It may also be performed if an ectopic pregnancy occurs. 
• Consider this option only if you are sure that you don’t want to become pregnant in the future.
• A bilateral salpingectomy can be performed with laparoscopy or an open abdominal surgery. Recovery can take 1 to 2 weeks for laparoscopic surgery and 4 to 6 weeks for open surgery to return to normal activities. 
• In general  the cost of a bilateral salpingectomy can range from $0 to $6,000 or more. Your cost will vary based on your insurance coverage, the type of surgery, and where you have the surgery as an outpatient procedure or need to stay in the hospital overnight (inpatient). Some private insurance plans, Medicaid, and other government programs may cover the costs, but you may still have a deductible or other copay.
• Does not protect against sexually transmitted diseases (STDs) like HIV. Use a condom to help prevent STDs.

Hysterectomy

• A hysterectomy is a major surgical procedure in women. It is usually done for medical reasons beyond contraception, such as for fibroids, endometriosis, or cancer.
• When a hysterectomy is performed, the uterus (the female reproductive organ) is removed, making pregnancy impossible.
• It may be performed through an abdominal incision, laparoscopically or vaginally. It has a longer recovery time than other surgical procedures, usually 4 to 6 weeks to return to normal activities.
• The cost for a hysterectomy can vary widely, ranging from $5,000 to $10,000 or more. Your costs can depend upon your insurance coverage and any deductibles or co-insurance, your location and if it’s performed as an outpatient or inpatient procedure.
• Does not protect against sexually transmitted diseases (STDs) like HIV. Use a condom to help prevent STDs.

For Men - With Surgery

Vasectomy

• A vasectomy is a surgical sterilization procedure for men in which the tubes (vas deferens) that carry sperm to the semen are cut and sealed closed. No sperm are expelled from the penis at the time of ejaculation.
• It is considered a minor outpatient procedure performed in a urologist’s office using local anesthesia. The procedure usually lasts about 15 to 30 minutes, the person can typically go home the same day and has a short recovery time of a few days to one week.
• It is almost 100% effective at preventing pregnancy with a less than a 1% failure rate in the first year. Most vasectomies can be reversed, but reversal does guarantee success in conceiving a child.
• A second form of birth control (such as a condom) is required until testing confirms that no sperm remain in the ejaculate.It takes about 20 ejaculations after a vasectomy to clear the ducts of sperm. At a follow-up medical visit, usually at 3 months, a sperm count is required to confirm success of the procedure.  
• Sexual intercourse can usually resume in one week. After a vasectomy, men can continue to have normal erections and intercourse, but ejaculations are sperm-free and cannot lead to pregnancy.
• The average cost for a vasectomy ranges between $1,000 to $3,000 but it is usually a permanent procedure with no further costs (insurance may cover). It can be more affordable than tubal ligation in many cases. Men may be able to get a vasectomy at a local Planned Parenthood health center, a doctor’s office, hospital, or health clinic. The cost to reverse a vasectomy is not typically covered by insurance.
• Does not protect against sexually transmitted diseases (STDs) like HIV. Use a condom to help prevent STDs.

Why choose permanent birth control?

• Permanent birth control may be an option if you do not want biological children in the future, are finished with having children, or plan to adopt a child.
• You may also choose permanent birth control if you cannot or do not want to use hormonal birth control or other types of birth control methods.
• After discussion with a genetic counselor and your healthcare provider, it could be a choice if a person does not want to pass on an inherited, genetic disorder.

Before you choose permanent methods of birth control, know that reversal may be difficult. Reversal is possible in some circumstances with special surgical procedures, but there is no guarantee of success. Speak to your healthcare provider about the possibility of reversal for any method you select.

You (and your partner, if needed) should discuss the desirability of permanent forms of birth control, think about future plans for biological children, and discuss these options with your healthcare provider before making a final decision.

Is permanent birth control covered by insurance?

Sterilization procedures are usually covered by health insurance but you may still have a copay, deductible, or coinsurance that you must pay out-of-pocket, based on your plan.

You should call your health insurance company prior to the procedure to determine what type of coverage you have and the cost. Your doctor's office may assist you with determining your coverage.

A vasectomy may cost between $1,000 to $3,000, while sterilization procedures for women can cost $6000 or more. The costs may vary widely based on your procedure and location, but your insurance may cover a portion of it.

Is the contraceptive implant Essure still available?

On December 31, 2018, Bayer stopped selling and distributing the Essure device in the U.S. due to serious side effects. Sales of the device had stopped in 2017 in all other countries. Essure was a permanently implanted birth control device for women (female sterilization). The Essure procedure is considered irreversible. 

Learn more: Information for Patients and Health Care Providers: Essure

Some patients implanted with the Essure System for Permanent Birth Control have had serious side effects, including perforation of the uterus and/or fallopian tubes, inserts moving into in the abdominal or pelvic cavity, persistent pain, and suspected allergic reactions. If the device needs to be removed to address such an adverse event, a surgical procedure will be required with the use of general anesthesia. Device removal has its own risks.

According to the FDA, women who have been using Essure successfully to prevent pregnancy can and should continue to do so. You should speak with your doctor or other care provider right away about any safety concerns you may have about the device or if you are experiencing any pain. You may need to have the implant surgically removed.

In addition, the Adiana system for female sterilization is no longer available in the U.S. anymore. The manufacturer stopped producing the Adiana system for financial reasons in 2012.

Bottom Line

• Permanent forms of birth control like tubal ligation (getting your tubes tied) in women or a vasectomy in men are common procedures and typically considered low-risk, minimal surgery (minimally invasive). Most people can go home the same day but may require a few days to a week of rest.
• Other forms of permanent birth control surgery in women include removing both fallopian tubes (bilateral salpingectomy) or a hysterectomy (which is often done for other medical reasons).
• You may decide to choose permanent birth control (often called "sterilization") for several reasons, including that you are finished having biological children, you have decided to adopt instead, or you want to prevent passing a genetic disease on to children.
• Having permanent birth control is a major decision. Always speak to your healthcare provider for further advice. If you or your partner are not sure that permanent birth control is right for you at this time, or you prefer no surgery, you can consider other forms of contraception, such as an IUD, birth control pill or the contraceptive shot.

Related: What are my birth control options and how effective are they? 

This is not all the information you need to know about permanent birth control measures and does not replace your healthcare providers instructions. If you have any questions about birth control options, it is important to review the specific consumer information discuss any questions or concerns with your doctor or healthcare provider.

See also

• Birth Control Pills (Oral Contraceptives)
• Birth Control Pills and Your Period
• Birth Control Pills: Benefits, Risks & Side Effects
• Birth Control Pills: Why do I get breakthrough bleeding?
• Emergency Contraception: What You Need to Know
• Emergency Contraceptives: Morning After Pills & OTC Options
• Grapefruit and Birth Control Pills: Your Questions Answered
• Missed your birth control pill? Here's what to do
• Non-hormonal Methods of Birth Control

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer