Defining and diagnosing postpartum clinical endometritis and its impact on reproductive performance in dairy cows

The effect of nutritional management of the dairy cow on reproductive efficiency

The cause of low fertility in dairy cows is multifactorial. Poor nutrition during the dry and early postpartum periods results in reduced glucose, insulin, insulin-like growth factor (IGF-I) and low LH pulse frequency with concomitant increases in beta-hydroxy butyrate, non-esterified fatty acids (NEFA) and triacylglycerol. Cows must mobilize large lipid, but also some protein reserves, with a consequent increased incidence of such metabolic disorders as hypocalcaemia, acidosis, ketosis, fatty liver and displaced abomasums. The occurrence of milk fever and ketosis affects uterine contractions, delays calving and increases the risk of retained foetal membranes (RFM) and endometritis. The nutritional risk factors that cause RFM are hypocalcaemia, high body condition score (BCS) at calving and deficiencies in Vitamin E and selenium. The risk factors for endometritis are hypocalcaemia, RFM, high triacylglycerol and NEFA. Thus, metabolic disorders predispose cows to gynaecological disorders, thereby reducing reproductive efficiency. Cows that are overconditioned at calving or those that lose excess body weight are more likely to have a prolonged interval to first oestrus, thereby prolonging days open. Nutritionally induced postpartum anoestrus is characterized by turnover of dominant follicles incapable of producing sufficient oestradiol to induce ovulation due to reduced LH pulse frequency. High nutrition can also increase metabolic clearance rate of steroid hormones such as progesterone or oestradiol. Lower concentrations of oestradiol on the day of oestrus are highly correlated with the occurrence of suboestrus, thereby making the detection of oestrus in high yielding cows even more difficult. Nutrition also affects conception rate (CR) to AI. Cows that develop hypocalcaemia, ketosis, acidosis or displaced abomasums have lower CRs and take longer to become pregnant. Excessive loss of BCS and excess protein content of the ration can reduce CR while supplemental fats that attenuate the production of F2alpha can improve CR. The increased metabolic clearance rate of progesterone (P4), which decreases blood concentrations during early embryo cleavage up to the blastocyst stage is associated with decreased CRs. In conclusion, poor nutritional management of the dairy cow, particularly before and after calving, is a key driver of infertility.

Defining postpartum uterine disease in cattle

Uterine function is often compromised in cattle by bacterial contamination of the uterine lumen after parturition, and pathogenic bacteria often persist, causing uterine disease, a key cause of infertility in cattle. However, the definition or characterization of uterine disease frequently lacks precision or varies among research groups. The aim of the present paper was to provide clear clinical definitions of uterine disease that researchers could adopt. Puerperal metritis should be defined as an animal with an abnormally enlarged uterus and a fetid watery red-brown uterine discharge, associated with signs of systemic illness (decreased milk yield, dullness or other signs of toxemia) and fever > 39.5 degrees C, within 21 days after parturition. Animals that are not systemically ill, but have an abnormally enlarged uterus and a purulent uterine discharge detectable in the vagina, within 21 days post partum, may be classified as having clinical metritis. Clinical endometritis is characterised by the presence of purulent (> 50% pus) uterine discharge detectable in the vagina 21 days or more after parturition, or mucuopurulent (approximately 50% pus, 50% mucus) discharge detectable in the vagina after 26 days post partum. In the absence of clinical endometritis, a cow with subclinical endometritis is defined by > 18% neutrophils in uterine cytology samples collected 21-33 days post partum, or > 10% neutrophils at 34-47 days. Pyometra is defined as the accumulation of purulent material within the uterine lumen in the presence of a persistent corpus luteum and a closed cervix. In conclusion, we have suggested definitions for common postpartum uterine diseases, which can be readily adopted by researchers and veterinarians.

Association between endometritis diagnosis using a novel intravaginal device and reproductive performance in dairy cattle

Endometritis reduces reproductive performance in dairy cattle. Diagnosis of endometritis is undertaken using a variety of techniques including vaginoscopy, manual examination, cytology and ultrasonography. The current studies compared a novel test device ("metricheck") that is inserted into the vagina with vaginoscopy and then examined the relationship between the metricheck test score at 35 days before the start of the seasonal breeding programme and subsequent reproductive performance. Cows (n = 191; Study 1) with a history of a peripartum disease were examined by both vaginoscopy and the metricheck device and any material viewed within the vagina (using vaginoscopy) or retrieved (by the metricheck device) was scored on a 0 (no material) to 5 (grossly purulent and with an odour) scale. Within each herd the order of examination was randomized with sequentially presented pairs of cows. All cows (n = 2793; Study 2) from nine herds were examined and scored using the metricheck device 35 days before the start of the seasonal breeding programme. All cows were pregnancy tested to determine date of conception. In Study 1, more cows were defined as infected (i.e. score > 1) following metricheck than vaginoscopic examination (60% versus 43%, respectively; P < 0.05) and the level of agreement between the two tests was moderate (kappa = 0.45). The metricheck device had a higher sensitivity, but lower specificity, than vaginoscopy. Endometritis (i.e. score > 1) was detected in 21.2% of cows examined in Study 2. The prevalence of endometritis varied among herds, declined with time postpartum (P < 0.05) and was higher in cows recorded as having a peripartum disease (P < 0.01). Cows diagnosed with endometritis were at higher risk of not being detected in oestrus before the start of breeding (P < 0.01), took longer to be inseminated after the start of the seasonal breeding programme (P < 0.01), had a lower first service conception rate (P < 0.01), had lower 56-day and final pregnancy rates (P < 0.05) and took longer to conceive than cows without endometritis (P < 0.05). It is concluded that examination with the metricheck device is more sensitive in detecting endometritis than vaginoscopy. Diagnosis of endometritis with the metricheck device was associated with poorer subsequent reproductive performance.

Major Advances in Disease Prevention in Dairy Cattle

This paper describes some of the major points of progress and challenges in health management of dairy cattle in the last 25 yr. A selection of the leading contributors in the field is acknowledged. Specific advances in the areas of transition cow management, epidemiology, udder health, applied immunology, housing design, calf health, and health-monitoring tools are described. The greatest advances in dairy health in the last 25 yr have been the shifts to disease prevention, rather than treatment, as well as from focus on individual animals to groups and herds. A fundamental advancement has been recognition of the multifactorial nature of almost all diseases of importance in dairy cattle. Epidemiology has been a critical new tool used to describe and quantify the interconnected risk factors that produce disease. Another major advance has been redefining disease more broadly, to include subclinical conditions (e.g., subclinical mastitis, ketosis, rumen acidosis, and endometritis). This expansion resulted both from improved technology to measure function at the organ level and, just as importantly, from the evolution of the health management paradigm in which any factor that limits animal or herd performance might be considered a component of disease. Links between cattle and people through consideration of environmental or ecosystem health are likely to further expand the concept of disease prevention in the future. Notable successes are decreases in the incidence of milk fever, clinical respiratory disease in adults, contagious mastitis, and clinical parasitism. There has also been improved protection through vaccination against coliform mastitis and bovine virus diarrhea. Since 1980, average herd size and milk production per cow have increased dramatically. Despite these increased demands on cows' metabolism and humans' management skills, the incidence of most common and important diseases has remained stable. Great progress has been made in understanding the biology of energy metabolism and immune function in transition dairy cows, the time at which the majority of disease occurs. Coupled with an emerging understanding of how best to provide for dairy cows' behavioral needs, transition cow management promises to be the foundation for progress in maintenance and enhancement of the health of dairy cows in the next 25 yr.

Serum protein pattern during cow pregnancy: Acute-phase proteins increase in the peripartum period

Serum collected in a time-course mode during the pregnancy of a group of heifers was analyzed by 2-DE under various experimental conditions to optimize resolution of all protein spots. Changes in the levels of some components were detected during the last phase of pregnancy and early postpartum. These included a decrease of alpha2-HS-glycoprotein, an increase of alpha1-antichymotrypsin and, with a much larger and more abrupt variation, of orosomucoid and haptoglobin. These findings associate the weeks preceding calving with an acute-phase reaction. Analysis of individual animal's sera by 1-DE demonstrated a higher level of orosomucoid in the sera of cows developing postpartum endometritis during the 2 wk after calving (i.e., in the course of the infection) but a lower level during the 2 wk before calving. This observation could represent an important tool for the prepartum detection of animals prone to develop postpartum endometritis and lead to a more accurate peripartum management of those animals.

Feeding behavior identifies dairy cows at risk for metritis

Dairy cows experience a high incidence of disease and metabolic disorders in the weeks immediately following calving, but early and accurate diagnosis remains a challenge. Cows suffering from metritis, one common disease following calving, exhibit reduced milk yield and reproductive performance. However, afflicted cows show few overt signs of illness and frequently go unnoticed in the absence of veterinary examination. To determine whether changes in feeding behavior could be used to identify animals at risk for metritis, attendance at the feed alley was monitored continuously for 26 Holstein cows during the transition period, beginning 2 wk before and ending 3 wk after calving. Every 3 +/- 1 d, cows were examined for metritis based on rectal body temperature and condition of vaginal discharge. Over the 3 wk of observations after calving, 69% of cows showed some signs of metritis. These cows spent on average 22 min/d less time at the feed alley during the transition period than did non-metritic cows. For every 10-min decrease in average daily feeding time, cows were twice as likely to be diagnosed with metritis. A threshold of 75 min of average daily feeding time was 89% sensitive and 62% specific for detection of acute metritis. In conclusion, reduced time at the feeder can be used to identify dairy cows at risk for metritis. More research is required to determine how soon before calving at-risk cows can be identified and whether these behavioral differences can also be used in the early diagnosis of other diseases or metabolic disorders.

The management of bovine reproduction in elite herds

The management of bovine reproduction is the cornerstone of health provision in elite herds. Aims and objectives for reproductive performance should be herd specific and data to monitor progress should not only be frequently collected, but also analysed and reported. Strategic monitoring of animals should include a vaginal examination for evidence of uterine disease, as well as transrectal ultrasonography of the genital tract. There has been considerable advancement in our ability to intervene in the reproduction of cattle during the last 50 years. However, it is salutary to note that during this time fertility has consistently declined, despite increasing veterinary intervention. Most elite herds use artificial insemination and success depends on accurate detection of oestrus expression, but this appears to be less overt than 25 years ago. In addition, half the cattle have abnormal oestrous cycles after parturition and conception rates are decreasing by 1% per year. Risk factors for abnormal oestrous cycles include puerperal problems, negative energy balance, which can be evaluated by body condition scoring, and uterine disease. Bacterial contamination of the uterus is ubiquitous after parturition in cattle and disease disrupts ovarian follicle growth and function. Reproduction is also disrupted by stress associated with clinical disease, pain or a sub-optimal environment. The challenge for veterinarians providing reproduction control programmes to elite herds is to transfer our knowledge of the problems underlying subfertility to the farm, in order to provide effective solutions.

Use of the cow as a large animal model of uterine infection and immunity

For most of the reproductive cycle in both humans and animals, the uterus is clear of pathogenic bacteria. However, it is readily contaminated with pathogens, such as Escherichia and Tritichomonas species, during sexual intercourse and after parturition. Uterine infection is particularly common after parturition in cattle (Bos taurus), causing clinical disease and infertility. The endocrine and immune responses to uterine infection in cattle have been investigated in vivo and using tissue culture. Cattle are of sufficient size to permit monitoring of reproductive and immune function throughout uterine infections, and primary cell cultures are readily established. In the whole animal, uterine infections suppress GnRH and LH secretion, and inhibit the growth of ovarian follicles and their estradiol secretion. The immune response is characterized by an influx of neutrophils into the uterus and increased concentrations of acute phase proteins in peripheral plasma. In vitro, the endometrial and ovarian cell function is modified by challenge with bacteria, their products such as lipopolysaccharide or pro-inflammatory cytokines. However, it is interesting to note that the susceptibility to uterine infection and the immune response are partially regulated by the ovarian steroid hormone mileu. In conclusion, the ease of working with cattle, the availability of tissues and the similarity of uterine infection between mammals, make Bos taurus a good model for studying uterine infection and immunity.

Effect of presence of clinical and subclinical endometritis at the initiation of Presynch-Ovsynch program on the first service pregnancy in dairy cows

The present study examined the effect of presence of clinical or subclinical endometritis at the initiation of Presynch-Ovsynch estrous synchronization program on the first service pregnancy rate in dairy cows. Lactating Holstein cows (N=275) were given a thorough reproductive examination at 32-38 days in milk, 3 days prior to the scheduled start of Presynch-Ovsynch program. Based on the reproductive exam findings the cows were diagnosed and classified into three groups as clinical endometritis, subclinical endometritis and normal. All cows received two set-up injections of 25mg PGF(2alpha) (Lutalyse((R)), Pfizer Animal Health, New York, NY, USA) i.m., 14 days apart starting at 35-42 days in milk (DIM). All cows received 75microg of GnRH (Cystorelin, Merial, Iselin, NJ, USA) i.m. 14 days after the second pre-synchronization injection of PGF(2alpha), followed by a third injection of 25mg PGF(2alpha) i.m. 7 days later. Cows received a second injection of 75microg of GnRH i.m. 54h after the third PGF(2alpha), and received timed artificial insemination at the time of the second GnRH injection or 24h later. Multivariate logistic regression was used to analyze the odds of pregnancy at the first service. Variables included in the model were endometritis status (clinical endometritis, subclinical endometritis and normal), farm (two), presence of corpus luteum (CL, yes or no), timing of second GnRH in relation to AI (0 or 24h), sire fertility (bulls with greater compared with lesser estimated relative conception rates), parity (primiparous and multiparous) and their interactions. Of all variable included in the model, cows with corpus letuem (OR=1.83 versus OR=1.00; P=0.05) 3 days prior to the scheduled start of Presynch-Ovsynch program and primiparous cows (OR=1.00 versus OR=0.55; P=0.04) had increased odds of becoming pregnant at the first service. No differences were found in the odds of first service pregnancy among clinical, subclinical endometritis and normal cows (P>0.1). In summary, presence of clinical or subclinical endometritis at the initiation of Presynch-Ovsynch estrous synchronization program does not harm the first service pregnancy rate in dairy cows.

Effect of repeated administration of PGF2alpha in the early post partum period on the prevalence of clinical endometritis and probability of pregnancy at first insemination in lactating dairy cows

Two experiments were performed to determine the effects of repeated administration of PGF2alpha in the immediate post partum period on the prevalence of clinical endometritis at 22 and 58 days post partum, and the probability of pregnancy at first insemination, in post partum dairy cows. In Experiment 1, 228 cows on day 7 post partum were used. Cows in Group 1 (n = 114) were treated twice with PGF2alpha (25 mg, im) 8 h apart on days 7 and 14 post partum, and only once on days 22 and 35 post partum. Cows in Group 2 (n = 114) served as untreated controls. Vaginoscopy and transrectal palpation of the genital tract were done on days 22 and 58 post partum. Cows in both groups were inseminated at estrus after a voluntary waiting period of 100 days. Pregnancy was determined by transrectal palpation between 45 and 50 days after insemination. Repeated administration of PGF2alpha in the immediate post partum period did not reduce the prevalence of clinical endometritis on days 22 or 58 post partum (65 versus 62% on day 22 and 28.3 versus 35.2% on day 58 in Groups 1 and 2, respectively). There was no significant difference in the probability of pregnancy at first insemination between cows in both groups. In Experiment 2, 418 cows on day 7 post partum were used. Cows in Group 1 (n = 209) were treated twice with PGF2alpha (25 mg, im) 8h apart on days 7 and 14 post partum, and only once on days 22 and 35 post partum. Cows in Group 2 (n = 209) served as untreated controls. Cows in both groups were subjected to the Presynch and Ovsynch protocols on days 49 and 75 post partum, respectively. Pregnancy was determined by transrectal ultrasonography between days 29 and 32 after timed insemination. There was no significant difference in the probability of pregnancy at first insemination between cows in both groups. In conclusion, repeated administration of PGF2alpha to cows in this herd had no effect on the prevalence of clinical endometritis at 22 and 58 days post partum, and that there was no effect on the probability of pregnancy after insemination at estrus among cows with a voluntary waiting period of > 100 days, or at timed AI at 85 days in milk when Presynch was employed.

Treatment of chronic endometritis in dairy cows with an intrauterine application of enzymes. A field trial

The use of proteolytic enzymes has been established in the non-antibiotic treatment of mastitis in dairy cattle. The objective of this study was to evaluate, if enzymes are efficacious in the treatment of chronic endometritis. In a controlled field trial, cows with vaginal discharge 21-27 days in milk (DIM) were randomly assigned to two treatment groups. Endometritis was classified into three categories, depending on the type of vaginal discharge: clear mucus with flakes of pus (E1), mucopurulent discharge or fluctuating contents in the uterus (E2), and purulent discharge (E3). In group ENZYMES (n=191), cows received an intrauterine treatment with a salve containing the enzymes trypsin (16 mg), chymotrypsin (16 mg), and papain (8 mg). Cows in group PGF (n=225) were treated with 0.5mg of cloprostenol. Cows that did not show any clinical signs of chronic endometritis were regarded as healthy control group (HC, n=699). In groups ENZYMES and PGF, all cows were re-examined 35-41 DIM. In group ENZYMES, cows were re-treated with enzymes if signs of endometritis were found, while in group PGF all cows received a second dose of cloprostenol, regardless of their clinical findings. Cure rate after the first treatment, defined as the absence of vaginal discharge at the re-examinations, was 59.7 and 68.0% in groups ENZYMES and PGF, respectively (P>0.05). Reproductive performance measures showed no significant differences between the two treatment groups. Service rate was significantly lower for ENZYMES and PGF, respectively, compared to HC. Conception rates to all services and percentages of cows pregnant by 250 DIM were significantly lower in group ENZYMES compared to HC, while no further differences were found between PGF and HC. In both treatment groups, cure rate and reproductive performance measures were better for cows categorized E1 or E2, than for cows categorized E3, respectively. Conception rate to all services for cows with endometritis category E1 was higher in group PGF than in group ENZYMES (P<0.05). The results of this field trial suggest that prostaglandin F(2alpha) is still the treatment of choice for chronic endometritis in dairy cattle.

Prevalence of endometritis and its effects on reproductive performance of dairy cows

Hostein cows (n=141) in five commercial dairy herds in central New York were examined for endometritis by examination of endometrial aspirates for presence of inflammatory cells, principally neutrophils, by endometrial cytology at 40-60 days postpartum. The prevalence of cytologically-diagnosed endometritis was 53%; within herds the prevalence varied from 37 to 74% (P=0.02). There was excellent agreement between two examiners (Kappa=0.864; P<0.0001). Parity did not influence prevalence of endometritis (P=0.53). Cytologically diagnosed endometritis was associated with profoundly impaired reproductive performance; Kaplan-Meier survival analysis revealed lower overall pregnancy rate (P<0.0001). Median days open was 206 for cows with endometritis and 118 for cows free of the condition. Overall, 76% of cows in this study became pregnant by 300 days postpartum; 63% of cows with endometritis and 89% of cows without endometritis were confirmed pregnant by 300 days postpartum (P<0.003). (For these two groups, 69, and 90% respectively, became pregnant during the duration of the study). Pregnancy to first service percentage was lower (11 versus 36%; P=0.001) for cows with than without endometritis, and these cows required more services before 50% became pregnant (3 versus 2; P=0.006). In a second study using 22 cows in a university-owned herd, the prevalence of cytological evidence of inflammation was 100% at 2 weeks postpartum, and dropped to 89, 58, and 41% at 4, 6, and 8 weeks, respectively. Endometritis diagnosed by endometrial cytology late in the voluntary waiting period was highly prevalent and exerted a profoundly detrimental effect on subsequent reproductive performance, making this condition potentially extremely costly to the North American dairy industry.

The effect of a single administration of cephapirin or cloprostenol on the reproductive performance of dairy cows with subclinical endometritis

This study examined the effect of a single administration of cephapirin iu or cloprostenol im on the reproductive performance of dairy cows with subclinical endometritis. Cows (n = 228) at 20-33 days in milk (DIM) from two commercial dairy farms, determined to be normal for clinical endometritis (based on absence of abnormal uterine discharge on vaginoscopic examination) were enrolled. At enrollment, a thorough reproductive examination was performed, including rectal palpation, ultrasonography (US) and endometrial cytology (EC). The case definition for subclinical endometritis was the presence of >18% neutrophils on EC examination or fluid in uterus (FIU) on US examination. All cows were randomly assigned to receive one of three treatments: 500 mg benzathine cephapirin iu, 500 microg cloprostenol im, or control (no treatment). Reproductive performance was monitored for a minimum of 8 months after treatment. Cows with subclinical endometritis treated with cephapirin or cloprostenol had a significantly increased relative pregnancy rate compared to control [hazard ratios 1.89 (P = 0.01) and 1.70 (P = 0.05), respectively]. In conclusion, a single treatment with cephapirin or cloprostenol at 20-33 DIM significantly improved the reproductive performance of cows with subclinical endometritis.

Clinical evaluation of postpartum vaginal mucus reflects uterine bacterial infection and the immune response in cattle

Bacteria contaminate the uterus of most dairy cattle after parturition and endometritis causes infertility. An endometritis score can be ascribed based on the vaginal mucus character and odour but it is not clear if the clinical score reflects the number of uterine bacteria or the inflammatory response. The present study tested the hypothesis that clinical evaluation of endometritis reflects the number of bacteria present in the uterus, and the acute phase protein response. Swabs (n = 328) were collected from the uterine lumen of dairy cattle, 21 and 28 days postpartum, vaginal mucus was scored for character and odour, and blood samples collected for acute phase protein measurement. Bacteria were identified following aerobic and anaerobic culture, and the bacterial growth density was scored semi-quantitatively. When bacteria were categorised by their expected pathogenic potential in the uterus, purulent or fetid odour vaginal mucus was associated with the growth density of pathogenic bacteria but not opportunist contaminants. When bacteria were analysed independently, Arcanobacterium pyogenes, Proteus and Fusobacterium necrophorum growth densities were associated with mucopurulent or purulent vaginal mucus. The bacterial growth densities for A. pyogenes, Escherichia coli, non-hemolytic Streptococci, and Mannheimia haemolytica were associated with a fetid mucus odour. Peripheral plasma concentrations of alpha(1)-acid glycoprotein were higher if there was a fetid compared with a normal vaginal mucus odour (1.50 +/- 0.09 mg/mL versus 1.05 +/- 0.02 mg/mL, P < 0.001), but did not differ significantly between vaginal mucus character scores. The evaluation of the character and odour of vaginal mucus reflects the number of bacteria in the uterus, and the acute phase protein response.

Prediction of the reproductive status of cattle on the basis of milk progesterone measures: model description

Reproductive management, in particular timely oestrus detection, is important for profitable dairy production. The aim of this study was to develop a biological model to predict reproductive state on the basis of milk progesterone measures. A number of additional inputs were incorporated to make use of other known effectors of reproductive performance that are not reflected in progesterone levels. These are: days from calving, breed, parity, signs of behavioural oestrus, insemination dates, pregnancy determinations, energy status, body fat status, milk urea content and reproductive disorders associated with calving. A dynamic, deterministic model was developed. It is designed to run each time a new trigger input (progesterone, behavioural oestrus, inseminations, pregnancy determinations) occurs using the current and previous values and can run in the absence of the additional inputs. The milk progesterone values are smoothed using an extended Kalman filter before being processed in the biological component of the model. The model predicts the reproductive status of the cow, which can be one of three mutually exclusive states: postpartum anoestrus, oestrus cycling, and potentially pregnant. The other model outputs are all reproductive status specific with the exception of days to next sample (DNS), which is calculated in each model run regardless of reproductive status. DNS is designed to feedback to the sampling system so that the frequency of milk sampling (i.e. progesterone measurement) can be varied according to the predicted likelihood of a future reproductive event, such as onset of oestrus cycling. The other model outputs are: risk of prolonged postpartum anoestrus, risk and type of ovarian cyst, onset of oestrus, likelihood of a potential insemination succeeding, and likelihood of being pregnant (following oestrus). The model was evaluated using three simulated datasets consisting of a timeseries of progesterone values centred on each of the three reproductive statuses and including relevant additional information. Test runs were carried out on the full datasets and then on reduced data. The data reductions were made by using only those values that would have been available if the model days to next sample function was used to control sampling frequency. The sensitivity of the model to noise in the raw progesterone data was examined by adding 1, 2, or 3 residual standard deviations (1.85 ng/ml) random variation to the original data and evaluating model performance. The model was found to be able to readily identify and distinguish reproductive states. A reduction in sampling frequency to 36% of original sample resulted in an average increase in days to detection of oestrus of 0.36. The addition of 1 S.D. noise did not cause additional oestruses to be detected and all oestruses were correctly identified. However, when 2 or 3 S.D. noise were added, the model found on average 1.4 and 3 extra oestruses. It was concluded that reproductive status can be predicted from milk progesterone values using a biological model and that such a model is robust to reductions in sampling frequency number and to a doubling in the random variation in the raw progesterone values. It therefore has the potential to provide the basis for a useful reproductive management tool.

The postpartum uterus

The cow is notable among the domestic species for the almost ubiquitous bacterial contamination of the uterine lumen after parturition and the high incidence of clinical uterine disease. Such uterine disease not only disrupts uterine tissues, but also ovarian follicle growth and function by perturbation of the hypothalamus, pituitary, and ovary. Other events such as the postpartum negative energy balance also have similar multilevel effects on postpartum endocrinology. Return of ovarian cyclical activity is dependent on the innate immune system resolving uterine bacterial contamination,prompt uterine involution, and a short interval to the negative energy balance nadir. Although the risk factors for uterine disease have been described, preventive strategies are not widely adopted. Thus, veterinarians must identify and treat uterine disease efficiently to limit their negative effect on fertility.

Uterine Involution and Fertility of Holstein Cows Subsequent to Early Postpartum PGF2α Treatment for Acute Puerperal Metritis

The objective was to evaluate the effect of 2 doses of PGF(2alpha) injected early postpartum on uterine involution, serum concentration of acute phase proteins at 12 d postpartum, and fertility in Holstein cows with acute puerperal metritis. Only cows diagnosed with retained fetal membranes and metritis and treated with ceftiofur hydrochloride for 5 d were used in the study. Two hundred cows were assigned randomly to be treated (n = 100) or to serve as controls (n = 100). Treatment consisted of 2 i.m. injections of PGF(2alpha) 8 h apart on d 8 postpartum. A subsample of 90 cows was selected randomly (45 treated cows; 45 controls) to evaluate uterine diameter using ultrasonography, uterine score, and serum concentrations of acute phase proteins at 12 d postpartum. The outcome variable for all cows was conception rate at first service. Postpartum, primiparous, treated cows had smaller uterine diameters and lower uterine scores than controls. Cows with a uterine diameter <5.1 cm at 12 d postpartum were 5.5 times more likely to conceive at first service than cows with larger uterine horn diameter. Treatment significantly reduced the concentrations of serum alpha1-acid glycoprotein. Within primiparous cows, treatment also increased conception at first service by 17%. It was concluded that 2 doses of PGF(2alpha) 8 h apart at 8 d postpartum in primiparous cows with acute puerperal metritis decreased the diameter of uterine horns and serum concentration of alpha1-acid glycoprotein at 12 d postpartum and increased the conception rate at first service.

Risk factors for postpartum endometritis and the effect of endometritis on reproductive performance in dairy cows in Korea

The objectives of this study were to determine the risk factors for postpartum endometritis by evaluating several reproductive factors in individual cows, and to determine the effect of endometritis on the subsequent reproductive performance in dairy herds in Korea. The data, including health status, parity and body condition score (BCS) of cows, and calving date, were collected from 320 cows in eight dairy herds calving from January 2001 to October 2002. We used logistic regression to evaluate the effects of these factors on endometritis. A stepwise procedure, used to obtain the appropriate model with alpha=0.05, revealed that retained placenta, metabolic disorders and parity are the important risk factors for endometritis. The mean intervals from calving to first service and conception were prolonged (P<0.01) by 23 and 36 days, respectively, in the endometritis group compared to the non-endometritis group. The first service conception rate was lower (P<0.05) in the endometritis group (47.6%) than in the non-endometritis group (62.6%). The number of services per conception was higher (P<0.05) in the endometritis group (1.9) than in the non-endometritis group (1.6). We conclude that retained placenta, metabolic disorders and cow parity are strongly correlated with the development of postpartum endometritis, which decreases reproductive performance in dairy herds in Korea.

Pregnancy rate following post-insemination intrauterine treatment of endometritis in dairy cattle

Summary Of 1500 examined Holstein cows in milk, there were 315 cows with mucopurulent discharges at the time of insemination (21%). Twenty-four hours after insemination, the infected animals randomly received no treatment (group I, control, n = 93), intrauterine infusion of 1 g oxytetracycline (group II, n = 63) and intrauterine infusion of 5 million IU procain penicillin G sodium (group III, n = 159). First service conception rate following treatment was 48.3, 49.2 and 47.7% in groups I, II and III, respectively. In conclusion, treatment with either antibiotic had no advantage relative to the control on first service conception rate.

Endometrial cytology and ultrasonography for the detection of subclinical endometritis in postpartum dairy cows

The objectives of the study were to validate the use of endometrial cytology (EC) and ultrasonography (US) to diagnose subclinical endometritis in clinically normal postpartum dairy cows, and to measure the impact of subclinical endometritis on reproductive performance. Holstein cows from two dairy farms were examined at Visit 1 (V1) at 20-33 days in milk (DIM), and clinically normal cows (n = 228), based on the absence of abnormal discharge on external inspection and vaginoscopy, were selected. The reproductive tract of selected cows was evaluated by transrectal palpation, US and EC. All cows in the study were re-examined at Visit 2 (V2) at 34-47 DIM (2 weeks after V1) and were subsequently followed for a minimum of 8 months (until pregnant or culled). Survival analysis was used to derive a case definition of subclinical endometritis, based on factors associated with decreased relative pregnancy rate. Positive EC at V1 (>18% polymorphonuclear leukocytes; PMN) or fluid in uterus at V1 (FIU1) were associated with a significant reduction in the relative pregnancy rate and identified cows with subclinical endometritis. Similarly, a positive EC (>10% PMN) at V2 or fluid in the uterus at V2 (FIU2), identified cows with subclinical endometritis. Cows with subclinical endometritis at V1 and at V2 had a relative pregnancy rate of 41 and 51% (hazard ratio for pregnancy of 0.59 and 0.49), respectively, compared to cows without subclinical endometritis. Given EC or US findings, no diagnostic criteria based on transrectal palpation of the uterus had predictive value for risk of pregnancy. In conclusion, subclinical endometritis, diagnosed by EC or US, was associated with reduced relative pregnancy rate.

Postpartum uterine health in cattle

Uterine health is often compromised in cattle because postpartum contamination of the uterine lumen by bacteria is ubiquitous, and pathogenic bacteria frequently persist causing clinical disease. The subfertility associated with uterine infection involves perturbation of the hypothalamus, pituitary and ovary, in addition to the direct effects on the uterus, and appears to persist even after clinical resolution of the disease. Absorption of bacterial components from the uterus can prevent the follicular phase LH surge and ovulation. In addition, the first postpartum dominant follicle has a slower growth rate and secretes less estradiol at the end of the growth phase. There are also localised ovarian effects of high uterine bacterial growth density, because fewer first dominant follicles are selected in the ovary ipsilateral than contralateral to the previously gravid uterine horn. Thus, it is important to diagnose and treat uterine disease promptly and effectively. Examination of the contents of the vagina for the presence of pus is the most useful method for diagnosis of endometritis. The character and odor of the vaginal mucus can be scored and this endometritis score is correlated with the growth density of pathogenic bacteria in the uterus, and is prognostic for the likely success of treatment. The challenge for the future is to design prevention and control programs to reduce the incidence of disease, and understand how the immune and endocrine systems are integrated.

Influence of stage of lactation and milk production on conception rates after timed artificial insemination following Ovsynch

Conception rates after timed artificial insemination (TAI) are of paramount importance for the success of protocols based on synchronization of ovulation. Stage of lactation and milk production level are known factors that influence dairy cow fertility. It was the objective of this study to analyse the effect of stage of lactation and milk production level on conception rates and pregnancy rates by 200 days in milk (DIM) in dairy cows synchronized with the Ovsynch protocol (Day -10, Day -1: 0.1 mg of D-Phe6-gonadorelin, Day -3: 0.5 mg of cloprostenol, Day 0: AI). A total of 1,288 dairy cows were assigned to two groups and classified in three production levels (high, average, low). Cows of all milk production levels in Group 1 (Simultaneous Ovsynch, SO) were synchronized with the Ovsynch protocol simultaneously for TAI between 73 and 81 DIM. In Group 2 cows with average milk production were synchronized at the same time as Group 1, while low producing cows were synchronized 3 weeks earlier and high producing cows were synchronized 3 weeks later than Group 1, respectively. First service conception rates (FSCRs) were lower (P<0.05) in cows synchronized earlier than in cows of the same production level synchronized later (low production: 14.4% (22/153) versus 34.5% (51/148); high production: 28.2% (40/142) versus 41.4% (53/128)). Milk production level had no significant impact on conception rates after TAI in cows synchronized at the same stage of lactation. At 200 DIM fewer cows with high production level were pregnant than cows with average or low production (P<0.05). This effect was independent of the stage of lactation at the initiation of Ovsynch. Endometritis at a postpartum examination did not influence conception rates after TAI. In conclusion, stage of lactation, but not milk production level, has a major influence on conception rates after TAI. Early AI after Ovsynch is less efficient and therefore its return on investment should be evaluated carefully.