Luteal function after tubal sterilization

The luteal function in women after tubal sterilization was evaluated and compared with a control group of women of a similar average age. Progesterone measurements and endometrial biopsies were obtained in the midluteal phase (5 to 10 days before the next menstrual period). The group of women who had been sterilized by tubal ligation or electrocoagulation had a significantly lower (P less than or equal to .001) mean midluteal progesterone level (8.5 +/- 6.0 ng/ml) than the group of women who had been sterilized by Hulka-Clemens clips (15.4 +/0 6.3 ng/ml) and the control group (17.2 +/- 4.8 ng/ml). The comparison between these 3 groups on days 19 and 20 and on days 21 and 22 gave the same statistical results. Progesterone levels were lower than 10 ng/ml in 54% of women after tubal ligation or electrocoagulation, whereas such low values were found in only 20% of women after sterilization by Hulka-Clemens clips and in 12% of the women in the control group. A retarded endometrium was observed more frequently in the women who underwent tubal ligation or electrocoagulation than in those who were sterilized by Hulka-Clemens clips. The most likely hypothesis to explain these differences is that sterilization using Hulda-Clemens clips preserves the continuity of the uteroovarian artery.