*Range of estimates comes from a small number of moderate-quality studies and may not apply to all populations; higher-quality data are needed (Peragallo Urrutia et al., 2018). Notes: Typical-use failure rates express effectiveness among all women who use the method, including those who use it inconsistently and incorrectly. Perfect-use failure rates express effectiveness among only those women who use the method both consistently and correctly. IUD=intrauterine device.
Notes: Perfect-use failure rates are not available for Natural Cycles, Bioself, French single check and Thyma double check methods because it was not possible to calculate accurate rates during a systematic review (Peragallo Urrutia et al., 2018). Perfect-use failure rates for Natural Cycles (Berglund Scherwitzl et al., 2017) and the DOT fertility app (Jennings et al., 2019) were published after the systematic review was conducted, and have not yet been rigorously evaluated. This figure excludes information on the modified mucus method (data were available only for experienced users), and methods with no moderate-quality data available at the time of the systematic review (e.g., rhythm and Creighton).
| CONTRACEPTIVE FAILURE RATES | ||
|---|---|---|
| % of women who will become pregnant during the first year of use, by method | ||
| Method | Typical use | Perfect use |
| Implant | 0.1 | 0.1 |
| Vasectomy (male sterilization) | 0.15 | 0.1 |
| IUD (hormone-releasing) | 0.1–0.4 | 0.1–0.3 |
| Tubal surgery (female sterilization) | 0.5 | 0.5 |
| IUD (copper T) | 0.8 | 0.6 |
| Injectable | 4 | 0.2 |
| Combined and progestin-only pill | 7 | 0.3 |
| Vaginal ring | 7 | 0.3 |
| Patch | 7 | 0.3 | Male condom | 13 | 2 |
| Sponge (when used by women who have not given birth) | 14 | 9 |
| Fertility awareness–based methods* | 2–34 | <1–12 |
| Diaphragm (with spermicidal cream or jelly) | 17 | 16 |
| Withdrawal | 20 | 4 |
| Internal (female) condom | 21 | 5 |
| Spermicides | 21 | 16 |
| Sponge (when used by women who have given birth) | 27 | 20 |
| No method | 85 | 85 |
*Range of estimates comes from a small number of moderate-quality studies and may not apply to all populations; higher-quality data are needed (Peragallo Urrutia et al., 2018). Notes: Typical-use failure rates express effectiveness among all women who use the method, including those who use it inconsistently and incorrectly. Perfect-use failure rates express effectiveness among only those women who use the method both consistently and correctly. IUD=intrauterine device. |
||
| Failure rates for IUDs | ||
|---|---|---|
| Paragard (copper T) | 0.8 | 0.6 |
| Skyla (13.5 mg LNG) | 0.4 | 0.3 |
| Kyleena (19.5 mg LNG) | 0.2 | 0.2 |
| Liletta (52 mg LNG) | 0.1 | 0.1 |
| Mirena (52 mg LNG) | 0.1 | 0.1 |
| Failure rates for fertility awareness–based methods | |||
|---|---|---|---|
| Method type | Methods with moderate-quality data available | % of women experiencing pregnancy in first year of use | |
| Typical use | Perfect use | Calendar | Standard Days Method | 11–14 | 5 |
| Mucus-only | TwoDay Method | 14 | 4 |
| Billings Ovulation Method | 11–34 | 1–3 | |
| Basal body temperature plus | Natural Cycles | 10 | na |
| Bioself | 9 | na | |
| Symptothermal | French single check | 13 | na |
| Thyma double check | 11–33 | na | |
| Sensiplan double check | 2 | 0.4 | |
| Urinary hormone–based or symptohormonal | Persona contraception monitor | 26 | 12 |
| Marquette monitor–based methods | 2–7 | <1 | |
| Notes: Perfect-use failure rates are not available for Natural Cycles, Bioself, French single check and Thyma double check methods because it was not possible to calculate accurate rates during a systematic review (Peragallo Urrutia et al., 2018). Perfect-use failure rates for Natural Cycles (Berglund Scherwitzl et al., 2017) and the DOT fertility app (Jennings et al., 2019) were published after the systematic review was conducted, and have not yet been rigorously evaluated. This table excludes information on the modified mucus method (data were available only for experienced users) and methods with no moderate-quality data available at the time of the systematic review (e.g., rhythm and Creighton). na=not available. | |||
Figure sources:
Hatcher RA et al., Contraceptive Technology, 21st ed., New York: Maging Contraception, 2018.
Sundaram A et al., Contraceptive failure in the United States: estimates from the 2006–2010 National Survey of Family Growth, Perspectives on Sexual and Reproductive Health, 2017, 49(1):7−16, doi:10.1363/psrh.12017, https://www.guttmacher.org/journals/psrh/2017/02/øcontraceptive-failure-united-states-estimates-2006-2010-national-survey-family.
Peragallo Urrutia R et al., Effectiveness of fertility awareness–based methods for pregnancy prevention: a systematic review, Obstetrics & Gynecology, 2018, 132(3):591−604, doi:10.1097/AOG.0000000000002784.
Urrutia RP and Polis CB, Fertility awareness based methods for pregnancy prevention, BMJ, 2019, 366:l4245, doi:10.1136/bmj.l4245.
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