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.


METHODS
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 and 3 and 12 months after sterilization on cycle days 3-7 and 20-24. Repeated measures analysis of variance, paired t test and nonparametric Friedman two-way analysis of variance were used for statistical analysis.


RESULTS
The follicular phase estradiol values increased 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 = .0407). 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 in 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 and 5.2 +/- 1.8 U/L in the third cycle) (P = .0553).


CONCLUSIONS
Laparoscopic tubal sterilization increases follicular phase estradiol levels, but the change seems to be only temporary.
Timonen
Susanna
S
Departments of Obstetrics and Gynecology and of Clinical Chemistry, Turku University Central Hospital, Finland. susanna@sumiala.pp.fi
Tuominen
Juhani
J
Irjala
Kerttu
K
Mäenpää
Juhani
J
D000328:Adult; D000704:Analysis of Variance; D000735:Androstenedione / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005498:Follicular Phase / Q000097:blood; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology*; D008137:Longitudinal Studies; D008183:Luteal Phase / Q000097:blood; D007986:Luteinizing Hormone / Q000097:blood; D010053:Ovary / Q000502:physiology*; D011388:Prolactin / Q000097:blood; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D018709:Statistics, Nonparametric; D013246:Sterilization, Tubal; D013739:Testosterone / Q000097:blood
D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D000735:Androstenedione; D004958:Estradiol; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone