Alternatives

Vasectomy, while highly effective, is also relatively final. The following chart is offered as a comparison of the alternatives.

Method Used by Theoretical*
Failure Rate		 Actual**
Failure Rate		 Advantages Disadvantages
Vasectomy Man .02-0.1% .02-0.2% Very high effectiveness; no cumbersome methods to use before or during intercourse
  		Should be considered permanent; some risk of infection
Tubal Ligation ("tying off tubes") Woman 0.2% 0.2-0.4% Comparable in effectiveness to vasectomy More expensive and complicated than vasectomy with higher surgical risk
 
Birth Control Pill (combination) Woman 0.1% .16-3% High success rate; no loss of sensation; other established health benefits
   		Side effects can be significant
Method Used by Theoretical*
Failure Rate		 Actual**
Failure Rate		 Advantages Disadvantages
Condom Man 1-3% 1-33% No side effects; adds protection from sexually transmitted diseases Reduced sensation; risk of pregnancy if not used correctly; application cumbersome
  
Diaphragm Woman 1-6% 1-21% No loss of sensation Prescription required; application cumbersome
 
Spermicidal jelly, foam, cream or suppositories Woman 3% 13-28% No serious side effects or loss of sensation; prescription not required
  		Cumbersome; lower effectiveness
Method Used by Theoretical*
Failure Rate		 Actual**
Failure Rate		 Advantages Disadvantages
Hormonal Implants Woman .2% .2% High effectiveness; one implant lasts up to 5 years Requires surgical insertion and removal; irregular vaginal bleeding
  
Intrauterine device (IUD) Woman 0.6-1.5% 0.5-3% One-time application; high success rate; no loss of sensation
  		Prescription required; some side effects
Natural family planning ("rhythm method") Both partners 1-3% 14-47% Nothing to buy or apply Requires abstention for 5-15 days per month; high risk of pregnancy
  
Withdrawal Man 4% 19% Nothing to buy or apply Reduced satisfaction; high risk of pregnancy
  
No Method Both partners 85% 85% Nothing to buy or apply Play now, pay later
  

*Theoretical Rate signifies rate when method is used correctly over a one year period.

**Actual Rate signifies rate when method is used routinely over a one year period.

Adapted from:
1. Trussell J, Hatcher RA, Cates W, Stewart FH, Kost K. A Guide to Interpreting Contraceptive Efficacy Studies. Obstetrics and Gynecology 1990; 76:558-67.

2. Mishell DR, Jr. Contraception. New England Journal of Medicine 1989; 320: 777-787.

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