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IUD vs Vasectomy: Which is More Effective?

In this blog, we will take a close look at two popular forms of contraception: Intrauterine Devices (IUDs) and Vasectomies. We will explore their mechanisms, effectiveness, and the pros and cons of each method. This comprehensive guide will provide valuable insights for anyone considering these contraceptive options.

Greta Daniskova

Author - Greta Daniskova

Greta is a BSc Biomedical Science student at the University of Westminster, London.

Greta used MediSearch to find sources for this blog.
MediSearch gives instant answers to medical questions based on 30 million scientific articles.

What is An IUD?

An infertility device (IUD) is a small T-shaped device that is introduced into the uterus of a woman to prevent pregnancy [1, 2, 3, 4, 5]. It is one of the most effective and only easily reversible forms of birth control, with fewer than 1 in 100 IUD-utilising women becoming pregnant each year [1]. IUDs may also contain either copper [1, 2, 4] or hormones [2, 4]. Worldwide, IUDs are one of the most widely utilised reversible contraceptive methods [6].

What Does An IUD Do?

The IUD creates an unwelcome environment in the uterus for a fertilised egg. The copper IUD releases copper into the uterus for up to 10 years and makes it inhospitable for sperm to reach an egg (ParaGard) [1, 4]. The hormonal IUDs, like Mirena, Liletta and Skyla, release progestin in the uterus to prevent pregnancy. Progestin coats the cervical mucus so tightly that sperm cannot wiggle through to reach and fertilise an egg. Progestin can also prevent eggs from being released to be fertilised and thins the lining of the uterus, so a fertilised egg cannot be implanted there [1].

Most IUDs work immediately after insertion, but a few take seven days to become effective [2]. None of them prevents sexually transmitted infections (STIs), and all should be accompanied by a condom [3].

What Is A Vasectomy?

A vasectomy is a surgical method of men’s permanent birth control. It is an invention applied to permanently prevent the release of sperm from the testicles during male ejaculation, which consequently reduces the risk of pregnancy [7, 8].

They cut or block a tube, the vas deferens, that carries sperm from the testicles into the urethra [7], leading to permanent sterilisation [8].

What Does A Vasectomy Do?

A vasectomy stops sperm from mixing with the fluid – semen – that is ejaculated from the penis [9]. The testicles continue to create sperm, but rather than being discharged, they are reabsorbed into the body [10].

Crucially, vasectomy is one of the most reliable forms of birth control: pregnancy will occur in about 1 in 2,000 couples where the penis-possessing partner had a vasectomy, according to the American Urological Association [7].

However, it takes two to three months for the procedure to be effective, and alternative forms of birth control should be used during that period until a health-care provider confirms that there are no more sperm in the ejaculate [11].

Similarities and Differences Between IUD and Vasectomy?

Intrauterine devices (IUDs) and vasectomies are both methods of contraception, but they differ significantly in their approach, procedure, and reversibility.

IUDs refer to a small intrauterine device inserted into your womb to prevent you from being pregnant. IUDs can be classified into two categories: hormonal and non-hormonal IUDs.

Hormonal IUDs will leak hormones, thicken cervical mucus, thin the uterine lining, and prevent ovulation. Non-hormonal IUDs will not leak hormones [12]. IUDs are chosen for their low maintenance and because they are easy to remove by a doctor if a woman decides that she wants a pregnancy [13].

Meanwhile, the surgical removal of fertility is known as a vasectomy and involves cutting or blocking the vas deferens or sperm-carrying tubes that exit the testicles. Semen that is ejaculated through the penis no longer contains sperm and will not result in pregnancy. Vasectomies are nearly 100% effective and do not affect sexual function or desire. However, they are meant to be permanent, and reversals are expensive and often effective only a portion of the time [13].

But both methods are highly effective modes of contraception. And while the fertility of a woman who had an IUD removed could return relatively quickly, vasectomies are almost always considered permanent. Because of their reliability, vasectomies have significantly lower rates of failure and lower rates of postoperative complications than their gynecologic counterparts [14].

Which is More Effective, An IUD Or A Vasectomy?

The choice between an Intrauterine Device (IUD) and a vasectomy depends on various factors, including long-term plans, health concerns, and financial considerations.

A vasectomy is close to 100% effective for birth control, rarely interferes with sexual function or desire, and is considered permanent – both advantages and disadvantages. It is a little more expensive to reverse and potentially ineffective. It is also surgical and carries a 1 to 2 per cent risk of chronic pain [13].

By contrast, an IUD is a small, practically effortless device that can be removed by your doctor at any time if you decide you’d like to get pregnant. Although rare, it can slip out of place. If that happens, your doctor must insert and remove it for you [13].

In terms of efficacy, they both work reasonably well: vasectomy is at least 99.9% effective (with less than 2% risk of complications) [15], and IUDs are also among the most effective birth-control methods with fewer than 1 in 100 women becoming pregnant while using them [16].

Vasectomy is considered more affordable compared with IUDs in general [17]. Nevertheless, costs associated with IUD insertion also vary, depending on whether or not you have insurance, and can cost as little as $0 or as much as $1,300 [16].

In a nutshell, IUDs and Vasectomy both have their advantages and disadvantages. Using one of these measures to contraceptive your birth should be your choice, and your doctor should advise you about it.

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