Ovarian function and regulation of the hypothalamic-pituitary-ovarian axis after tubal sterilization

OBJECTIVE: To assess the effects of laparoscopic tubal sterilization with Hulka or Filshie clip on ovarian function and regulation of the hypothalamic-pituitary-ovarian axis. STUDY DESIGN: Hormonal changes were evaluated in 33 women undergoing sterilization with Hulka (n = 16) or Filshie clips (n = 17). All participants were healthy, with regular menstrual cycles. The levels of estradiol, follicle-stimulating hormone, luteinizing hormone, sex hormone binding globulin, prolactin, testosterone and androstenedione were measured in one cycle immediately before mid 3 mid 12 months after sterilization on cycle days 3-7 ami 20-24. Repeated measures analysis of of variance, paired t test and nonparametric Friedman two-way analysis of variance were used for statistical analysis. RESULTS: The follicular phase estradiol values in creased after sterilization. The highest values were observed three months after the procedure (204.8 +/- 119.1 pmol/L vs. 170.3 +/- 111.7 pmol/L) (P = .04017). The values declined to the presterilization level by 12 months (150.3 +/- 71.3 pmol/L). The luteal phase estradiol values did not change significantly No change in any of the other hormones studied took place, with the exception of a slight increase by follicular phase luteinizing hormone levels (4.4 +/- 1.4 U/L in the first cycle, 5.1 +/- 1.3 U/L in the second cycle mid 5.2 +/- 1.8 U/L in the third cycle) (P = .0553). CONCLUSION: Laparoscopic tubal sterilization increases follicular phase estradiol levels, but the change seems to be only temporary.