Vasectomy is a surgical form of male sterilization that involves severing and sealing the vasa deferentia, preventing sperm from mixing with semen during ejaculation. Because a vasectomy does not impact the testes' ability to produce testosterone, hormone levels, libido, and sexual function generally remain unchanged. While vasectomy is highly effective in preventing pregnancy, with a success rate near 99.85%, rare cases of recanalization (spontaneous reconnection) can occur. Although vasectomy reversal is possible, only about 30–40% of men successfully regain fertility. Female sterilization commonly involves tubal ligation, a procedure in which fallopian tubes are closed off and severed, preventing eggs from traveling for fertilization. Tubal ligation can be done via several methods, such as using clips or clamps, tying and cutting, or burning the tubes. The Essure® procedure was an alternative method of non-surgical sterilization involving the placement of metallic coils into the fallopian tubes to promote scar tissue formation, obstructing the tubes. However, due to reports of complications such as chronic pain, device migration, and other health issues, Essure® has been discontinued in many countries.

Hormonal birth control methods are highly effective for pregnancy prevention next to abstinence or surgery. Oral contraceptives, or birth control pills, come in various forms like COCs, which combine estrogen and progestin to suppress ovulation, and progestin-only pills, which mainly thicken cervical mucus to hinder sperm mobility. Alternatives to pills include the transderOral contraceptives also offer benefits beyond contraception, including cycle regulation and reduced risks of certain cancers. Still, they may not suit smokers due to higher cardiovascular risk. Mal patch, the vaginal ring, and emergency contraception pills, which should be used shortly after unprotected intercourse. Another long-term method is the Depo-Provera® injection, which lasts for three months.

Intrauterine devices (IUDs), available in copper or hormonal forms, are highly effective long-term contraceptive options inserted into the uterus. Copper IUDs create an inflammatory response within the uterine lining, which is toxic to sperm and eggs, thereby preventing fertilization. Hormonal IUDs release progestin, which thickens cervical mucus to block sperm, thins the uterine lining, and may suppress ovulation. However, IUDs may not be suitable for all women due to potential side effects, such as discomfort, expulsion, or irregular bleeding.

For those who prefer barrier methods, products such as male condoms, female condoms, diaphragms, and cervical caps prevent sperm from reaching the egg, with condoms also offering protection against STDs. These methods are often combined with spermicides, substances designed to neutralize sperm on contact.

Lastly, periodic abstinence strategies, like the rhythm or sympto-thermal method, depend on tracking the menstrual cycle to determine the window of fertility. Abstaining from sex during fertile days can prevent pregnancy, though the success rate varies due to cycle irregularity. The sympto-thermal method relies on tracking additional signs of ovulation, such as basal body temperature and cervical mucus characteristics, to identify fertile periods more accurately.