Changes in intrauterine pressure after oxytocin administration in reproductively normal mares and in those with a delay in uterine clearance

The effect of uterine massage and number of embryo flushing attempts on embryo recovery in mares

The aims of this study were to determine the effect of the embryo flushing technique and the number of flushing attempts performed by operators of different experience on embryo recovery (ER). Ten non-lactating mares were inseminated with the same stallion in six cycles each (n = 60). Embryo flushing (EF) was performed 7-9 days after ovulation by three operators (OP; 20 EF cycles each): OP1 had performed >500 EF before the study, while OP2 and 3 had performed 0 EF. Each EF was performed with 2 flushing attempts (FA) using 1L of ringer's lactate "in-and-out" using two EF techniques: 1) uterine massage (UM): continuous ballottement and massage of the uterus per rectum during ringer lactate recovery, 2) gravity flow (GF): the ringer lactate was allowed to flow back without massaging the uterus. In both groups, 20 IU of oxytocin were administered at the second FA and the ringer lactate was allowed to remain in the uterus for 3 min before recovery. An extra FA was performed in each group using 0.5 L of ringer lactate and uterine massage. More embryos (P < 0.05) per ovulation were recovered in the UM (17/33, 0.51) than in the GF group (8/36, 0.22). For the UM group, 16/17 embryos (94.1 %) were recovered in the first FA, while only one embryo in the second FA (1/17, 5.9 %). In the GF group, 4 embryos were recovered in each FA. No embryo was found in the extra FA in the UM group, while seven additional embryos were found in the GF group (5/7 flushed by OP1; P < 0.05). The overall ER per cycle was 70, 40, and 45 % for OP1, 2 and 3, respectively. In conclusion, highest embryo recovery is achieved in EF performed with UM, with the majority of embryos being flushed in the first FA.

Relationship between Clinical Uterine Findings, Therapy, and Fertility in the Mare

Persistent breeding-induced endometritis (PBIE) is a major cause of subfertility in horses and the susceptibility is increased by several factors. The aim of this study was to determine the effects of clinical uterine findings and PBIE therapies, respectively, on pregnancy rate in mares. The analysis included records from 220 mares (390 cycles) inseminated at an artificial insemination (AI) center in Switzerland. Gynecological examinations were performed repeatedly before and after AI to determine cervical tone, uterine edema, and intrauterine fluid accumulation. Pregnancy rate was lower (p < 0.001) in barren mares compared to mares of other reproductive status. A more flaccid cervix (p = 0.009) was observed at the time of ovulation in pregnant cycles, but there was no difference (p > 0.05) regarding uterine edema. Intrauterine fluid accumulation reduced pregnancy rate (p = 0.002). Oxytocin administration had beneficial effects on pregnancy rate (p = 0.015), especially for barren mares, while uterine lavage did not have any effect (p > 0.05). The results show that cervical tone and intrauterine fluid accumulation, but not its degree, are useful parameters for assessment of fertility in mares. Oxytocin treatment improved pregnancy rates in mares with PBIE while uterine lavage had a limited effect.

Expression of Oxytocin/Neurophysin I and Oxytocinase in the Equine Conceptus from Day 8 to Day 21 Post-Ovulation

Leucyl and cystinyl aminopeptidase (LNPEP/oxytocinase) is an enzyme that metabolizes oxytocin in serum and tissues. The presence of oxytocin/neurophysin I (OXT), oxytocin and LNPEP and their relationship to other genes is unknown in the equine conceptus. Our objective was to characterize gene expression of LNPEP and OXT on D8, 10, 12, 14, 15, 16 and 21 conceptuses in relationship to other genes. Immunohistochemistry, western blot and liquid chromatography with tandem mass spectrometry (LC-MS/MS) were used for identification of oxytocin and LNPEP in D15, 16 and 18 conceptuses. LNPEP was increased at D15 compared to D10, was immunolocalized in the equine trophectoderm and endoderm, and protein was confirmed by LC-MS/MS. Maximal abundance of OXT was at D21, and lowest on D12 and D14, but no protein was identified. OXTR abundance was highest on D14 and D21. LNPEP was correlated with PTGFR and PTGES on D12 and D14-D15, and high expression of PTGES, PTGS2 was found on D14, D15 and D21; PTGFR was found on D8 and D12-21. LNPEP may have a role in prostaglandin regulation and conceptus fixation by decreasing the availability of oxytocin. Further investigation on the role embryonic LNPEP during pregnancy is warranted.

Comparative study utilizing different post-breeding treatment regimens in cyclic Arabian mares

BACKGROUND AND AIM

Post-breeding treatment is the most common practice in the reproductive management of mares. Oxytocin, uterine lavage, and intrauterine (I/U) antibiotic are usually used as prophylactic therapy. This study aimed to determine the most efficient prophylactic treatment regimen among six treatment protocols applied during natural breeding of cyclic Arabian mares.

MATERIALS AND METHODS

The current study was conducted on cyclic Arabian mares that were subdivided into three age categories (n=968): Category I (5-10 years, n=380), Category II (11-15 years, n=361), and Category III (≥16 years, n=227). Six prophylactic treatments were applied after 4 h of breeding. According to the treatment regimen, treated mares (n=483) were divided into six treatment groups: A (n=80), treated with I/U antibiotic (1 g gentamicin); B (n=81), I/U lavage (normal saline 500 mL); C (n=83), intramuscular (I/M) oxytocin (10 IU); D (n=82), I/U antibiotic and I/M oxytocin; E (n=78), I/U lavage and I/M oxytocin; and F (n=79), I/U lavage with I/U antibiotic and I/M oxytocin. Non-treated mares were classified as controls (n=485). Ultrasonography was performed to monitor pregnant mares 30 and 60 days after mating, and mares were followed until foaling.

RESULTS

Pregnancy and foaling results reveals that in age Category I, treatment with oxytocin alone or oxytocin with I/U lavage showed the highest pregnancy and foaling rates (p<0.01). In age Category II, the highest pregnancy and foaling rates were observed in lavage treatment (p<0.01), whereas, in age Category III, the good pregnancy and foaling rates were monitored in treatment with oxytocin and I/U lavage (p<0.01).

CONCLUSION

Treatment with systemic I/M oxytocin is ideal in early age group mares (5-10 years of age). However, irrespective of the age categories, all mares exhibited high pregnancy and foaling rates after treatment with systemic I/M oxytocin and I/U lavage with normal saline (0.9%) 4 h post-breeding.

Treatments for Endometritis in Mares Caused by Streptococcus equi Subspecies zooepidemicus: A Structured Literature Review

Bacterial infections are the main causes of endometritis in mares. It is well known that the most common bacterial pathogen is Streptococcus equi subspecies zooepidemicus (SEZ). This structured review was completed according to the PRISMA procedure to search endometritis treatment protocols published between 1990 and 2020 it was our intent to evaluate the actual effects of different treatment protocols for endometritis caused by SEZ. The trials included were collected from Pubmed, CAB and Agricola. Ten articles with 116 horses and 17 different interventions were identified. The results of this structured review indicated that the reported antibiotics, immunomodulatory agents and fresh white blood cell treatments were superior for treating SEZ caused endometritis in mares, whereas oxytocin and uterine lavage alone may not be as effective as presumed. The inclusion and evaluation of more randomized controlled trials may be helpful for further elucidation of the differences.

Case Report: Use of Amniotic Microvesicles for Regenerative Medicine Treatment of a Mare With Chronic Endometritis

Chronic endometritis is an inflammation in the inner layer of uterine mucosa, with or without an infectious process, which affects the animal's fertility but not its general health. A variety of treatments has been adopted over the years but to date, no effective cures have been able to renew the injured tissue. Since the defects in the fetal-maternal communication are caused by degenerative changes due to chronic endometrial inflammation, our working hypothesis was a new approach to this disease by the regenerative medicine using amniotic derived microvesicles (MVs) for their anti-inflammatory and regenerative effects. The MVs are responsible for horizontal transfer of genetic materials, including microRNA (miRNAs) that are involved in paracrine communication between origin cells and target cells. Thus, intrauterine MV infusion may be beneficial in degenerative chronic endometritis and in the fetal–maternal talk. The selected mare was an 11-year-old Friesian, with a history of failed pregnancies despite numerous insemination attempts. Punctual and evident heats characterized the reproductive history, but no insemination attempts had been made for many years. The first (failed) insemination was when the mare was 9-years-old. In the next two reproductive seasons, other attempts were made at regular intervals but none was successful. After a final insemination attempt using a stallion of proven fertility, the collection of an 8-day old embryo suggested that the mare was affected by implantation failure related to endometritis. The mare was treated with two cycles of intrauterine administration of amniotic-derived MVs. The success of the intrauterine administration of MVs was demonstrated by an improvement in the classification of endometritis and in a successful artificial insemination (AI) with implantation of an embryo, as detected at day 14 and with a pregnancy that is still ongoing. Probably, MVs were able to restore the injured endometrium and re-establish the proper communication for a successful embryo implantation.

Oxytocin stimulated release of PGF2α and its inhibition by a cyclooxygenase inhibitor and an oxytocin receptor antagonist from equine endometrial cultures

Uterine inflammation results in a poor uterine environment and early embryonic loss in the mare due to an inhibition of maternal recognition of pregnancy caused from increased prostaglandin F2α (PGF2α). Oxytocin binds to endometrial cell receptors to activate prostaglandin synthesis. An oxytocin receptor antagonist (Atosiban) and a cyclooxygenase inhibitor (indomethacin) both decrease PGF2α production. The aim of this study was to evaluate the in vitro effects of Atosiban and indomethacin on equine uterine prostaglandin secretion. Equine endometrial explants were harvested on day two of behavioral estrus. Endometrial explant cultures were challenged with oxytocin (250nM) and PGF2α concentrations were measured over time. Explants were also cultured with Atosiban and indomethacin for 6h to determine the influence on PGF2α secretion. When endometrial explants were challenged with oxytocin, PGF2α concentrations were greater (P<0.0001) at each time point over the 24h of culture as compared to controls. Oxytocin failed (P<0.001) to elicit PGF2α release in explants cultured with either Atosiban or indomethacin. These findings show equine endometrial explants can be stimulated with oxytocin to increase secretion of PGF2α and this secretion can be inhibited through an oxytocin receptor antagonist and a Cox inhibitor, suggesting that this response to oxytocin involves an oxytocin receptor mediated event that activates the prostaglandin synthesis cascade through cyclooxygenase. Furthermore, this data suggests a role for the use of these inhibitors in vivo to decrease uterine PGF2α secretion and prevent early luteal regression and embryonic loss.

Pharmacokinetics of carbetocin, a long-acting oxytocin analogue, following intravenous administration in horses

REASON FOR PERFORMING STUDY

Current therapy protocols to treat persistent post mating endometritis and retained fetal membranes in mares typically include the administration of ecbolic drugs. Evaluation of the pharmacokinetics and tolerability of carbetocin, a long-acting oxytocin analogue, after i.v. administration is required.

OBJECTIVES

To determine the pharmacokinetic parameters (principally half-life) of carbetocin in horses.

METHODS

Five mature mares and one gelding received 0.175 mg carbetocin i.v. All animals were monitored periodically throughout the study for elevation in rectal temperature, heart rate, respiratory rate and signs of pain or discomfort. Plasma samples were collected for determination of carbetocin concentrations by radioimmunoassay.

RESULTS

Administration of carbetocin was well tolerated by all horses and its half-life was 17.2 min.

CONCLUSIONS

The half-life of carbetocin is greater than that previously reported for oxytocin (6.8 min).

POTENTIAL RELEVANCE

Carbetocin is an attractive alternative to oxytocin therapy in broodmare management.

Equine post-breeding endometritis: A review

The deposition of semen, bacteria and debris in the uterus of the mare after breeding normally induces a self-limiting endometritis. The resultant fluid and inflammatory products are cleared by 48 hours post cover. Mares that are susceptible to persistent post-breeding endometritis (PPBEM) have impaired uterine defence and clearance mechanisms, making them unable to resolve this inflammation within the normal time. This persists beyond 48 hours post-breeding and causes persistent fluid accumulation within the uterus. Mares with PPBEM have an increased rate of embryonic loss and a lower overall pregnancy rate than those without the condition. To enhance conception rates, mares at high risk need optimal breeding management as well as early diagnosis, followed by the most appropriate treatment. This article reviews the pathogenesis, diagnosis and treatment of PPBEM and the management of affected mares.

Oxytocin-induced PGF2alpha Release in Mares With and Without Post-breeding Delayed Uterine Clearance

The aim of the present study was to evaluate within 24 h post-ovulation oxytocin-induced PGF(2alpha) release in mares with and without post-breeding delayed uterine clearance (DUC). Twenty-one of 34 mares with a variable amount of intrauterine fluids accumulation were considered to be affected by delayed uterine clearance (DUC group), while the other 13 mares did not show any uterine fluid accumulation, and were considered as controls (WDUC group). Both DUC and WDUC mares were administered with 20 IU oxytocin i.m. 90 min after the ultrasound examination performed 24 h after breeding. Immediately before, 5 and 10 min after oxytocin administration, blood samples were collected for 15-ketodihydro-PGF(2alpha) (PG-metabolite), 17beta-estradiol, and progesterone analysis. Ultrasonography performed 24 h after oxytocin treatment showed a complete uterine clearance in all DUC mares. The oxytocin-induced PG-metabolite increase was detected in 71.4% DUC mares compared with 38.5% in WDUC group, with a positive trend of release, as evidenced from 5 min after oxytocin administration. In WDUC mares, no significant differences in oxytocin-induced PG-metabolite trend of release were observed. In conclusion, the results of the present study showed the importance of PGF(2alpha) involvement in the pathogenesis of post-breeding DUC in the mare.

Making sense of equine uterine infections: the many faces of physical clearance

Equine uterine infections inflict major losses on the equine industry. Persistent inflammation of the oviduct and uterus leads to loss of the conceptus and mares susceptible to infection have weakened uterine defences partly due to retention of inflammatory exudate. Bacteria may trigger inflammation, resist phagocytosis, or adhere to the endometrium and types of infection range from genital commensals in susceptible mares to reproductive pathogens in normal mares. Uterine infections are diagnosed by history, detection of uterine inflammation, and isolation of typical organisms and susceptible mares may be identified by detection of intrauterine fluid during oestrus, or at 6-48 h post-breeding. Therapy includes oxytocin, uterine lavage, antibiotics, and prostaglandin analogues and clinical studies indicate additive benefits of oxytocin and antibiotics. Improved conception rates have been associated with autologous, intrauterine plasma, despite controversy about its bactericidal efficacy. Because of the potential for endometrial damage, intrauterine antiseptics require caution.

Uterine activity, sperm transport, and the role of boar stimuli around insemination in sows

This paper describes changes in spontaneous myometrial activity around estrus, factors that affect myometrial activity, and the possible role of uterine contractions in the process of (artificial) insemination, sperm transport and fertilization. Myometrial activity in the sow increases during estrus. The activity is myogenic in origin, but several factors have been shown to affect myometrial activity. Natural mating stimulates uterine contractions through several mechanisms. The presence of a boar, rather than the act of mating, induces central oxytocin release in the sow and thus increases uterine activity. Estrogens in the ejaculate of a boar can trigger prostaglandin release by the endometrium and thus increase uterine activity. Tactile stimulation of the genital tract (cervix) or tactile stimulation of the back and flanks of the sow during artificial insemination does not cause a release of oxytocin. There is hardly any evidence for the effects of these latter stimuli on uterine activity, and if they are present at all, the effects are very small. Evidence for the effects of synthetic boar odor on oxytocin release and/or uterine activity is inconsistent. The mere presence of a boar during insemination, in contrast, clearly stimulates uterine activity through the release of oxytocin. Hormonal stimulation (intrauterine) of uterine activity with estrogens, prostaglandins, or oxytocins before, during or after insemination generally improves fertilization rate, especially in situations with reduced fertility. Therefore, uterine contractions are believed to play an important role in the transport of sperm cells to the oviducts after insemination. Whether uterine contractions are absolutely necessary for sperm transport through the uterine horns, however, is not clear. Intensive stimulation of uterine contractions using hormones can also reduce the fertilization rate, probably by increasing the reflux of sperm cells during insemination. In this respect, the presence of a boar during AI seems more adequate, as only sows with a low level of uterine activity show an increase in uterine activity in response to this stimulus.

The effect of semen extender, seminal plasma and raw semen on uterine and ovarian blood flow in mares

Transrectal color Doppler sonography was used to evaluate the effect of intrauterine infusion of skim milk semen extender, seminal plasma and raw semen on the endometrium and blood flow in the uterine and ovarian arteries in mares. Six Trotter mares (mean age: 12 years) were examined during estrus in three cycles. Each mare received an intrauterine infusion of 20 ml of skim milk semen extender, seminal plasma or raw semen during estrus in one of three cycles. Blood flow measurements in both uterine and ovarian arteries and the determination of intrauterine fluid via sonography were performed before each infusion and 1, 3, 6, 12, and 24 h after infusion. Forty-eight hours later, the intrauterine infusion and measurements were repeated using the same time intervals. Changes in blood flow were detected using transrectal color Doppler sonography and were evaluated using the mean time-averaged maximum velocity (TAMV) of the blood flow. Cytological and bacteriological examination of uterine swabs performed 48 h after the second infusion revealed less inflammation and bacterial growth in mares infused with skim milk semen extender than in those infused with seminal plasma or raw semen. There was an increase in intrauterine fluid as early as 1 h after infusion of any of the substances. The infusion of skim milk semen extender had no effect on uterine blood flow. Within 1 h after infusion of seminal plasma or raw semen, there was an increase in the TAMV values of both uterine arteries (P<0.05). In contrast, ovarian blood flow increased only in the artery ipsilateral to the preovulatory follicle and only after the infusion of raw semen (P<0.05). In conclusion, the changes in uterine perfusion observed after intrauterine infusion may be associated with endometrial inflammation and vasodilatory components in the seminal plasma, whereas the changes seen in ovarian blood flow are possibly attributable to the interaction between sperm and oviduct.

Aberrations in uterine contractile patterns in mares with delayed uterine clearance after administration of detomidine and oxytocin

An experiment was conducted to determine whether the uterotonic effects of oxytocin, a drug used to treat mares that have a delay in uterine clearance were affected by the sedative detomidine (an alpha2-agonist), a drug used to treat fractious mares. An additional objective was to identify propagation patterns of uterine contractions and determine whether these patterns differed between normal mares and mares with delayed uterine clearance (DUC). Intrauterine pressure was measured in five reproductively normal mares and four mares with DUC during estrus using an 8-F Milar catheter with two discrete pressure sensors. Mares received one of three treatments in random order: detomidine (0.001 mg/kg; i.v.); detomidine followed in 10 min by oxytocin (10 IU; i.v.); and saline (0.9% NaCl 0.5 ml; i.v.) followed in 10 min by oxytocin. All treatments induced waves of contractions; however, only three mares with DUC exhibited contractions after administration of detomidine. Normal mares experienced more uterine contractions (P < 0.01) that tended to last longer (P < 0.06), and were of greater intensity (P < 0.04) than mares with delayed clearance. Administration of detomidine before oxytocin increased the number of contractions (P < 0.02) and increased the maximum intrauterine pressure in the uterine horn (P < 0.05) in normal mares as compared to response after administration of saline and oxytocin. Detomidine had no effect in mares with delayed clearance. All mares had more propagating than non-propagating uterine contractions (74 +/- 8 versus 25 +/- 8%, respectively). Normal mares exhibited a normal propagation pattern more frequently (P < 0.0001) than mares with DUC. Simultaneous (P < 0.05) and inverted (P < 0.03) contractions occurred more frequently in mares with DUC. Administration of detomidine increased the number (P < 0.01), and tended to increase the percentage (P < 0.07) of normal propagating uterine contractions in normal mares, but did not affect propagation patterns in mares with DUC. In conclusion, detomidine augmented the uterotonic effect of oxytocin in normal mares but not in mares with DUC. Data suggest that mares with DUC have a defect in myoelectrical signaling and a decrease in the contractile strength of the uterine muscle.

Myometrial activity around estrus in sows: spontaneous activity and effects of estrogens, cloprostenol, seminal plasma and clenbuterol

A new, nonsurgical, open-end catheter technique was used to study spontaneous uterine activity around estrus in sows, and the effects of estrogens, seminal plasma, cloprostenol, and clenbuterol on uterine activity. In the first experiment, uterine activity was studied in 14 multiparous, cyclic sows, during one or more estrous cycles, from day -4 to day 4 of the cycle (day 0: first day of standing estrus). From a few days before estrus until estrus, the percentage of sows showing any uterine contractions increased from 55 to 100%, and frequency and mean amplitude of uterine contractions for these sows increased from 15 to 22/h, and from 20 to 40 mmHg on average. After estrus, uterine activity decreased. There were large differences between sows in uterine activity, which were consistent over the days of the cycle. In the second experiment, 11.5 microg of estrogens in 100 ml saline (n = 17), 100 ml seminal plasma (n = 5), 1 mg cloprostenol in 100 ml saline (n = 10), 0.30 mg clenbuterol in 100 ml saline (n = 11), or 100 ml saline (n = 5) was infused IU, after recording spontaneous activity. Infusion with saline or seminal plasma did not affect uterine activity. Estrogens increased frequency of contractions. Cloprostenol increased both frequency and amplitude of contractions. Clenbuterol reduced both frequency and amplitude of contractions. In conclusion, this study shows that spontaneous uterine activity in sows is increased around estrus, and it supports the role of estrogens in boar seminal plasma in affecting uterine activity around mating. Further, this study has yielded possible tools to study the relation between uterine activity and sperm transport.

Effect of dose and day of treatment on uterine response to oxytocin in mares

To determine the effect of dose and day of oxytocin treatment on intrauterine pressure, 6 normal mares were treated with 10 or 25 IU oxytocin 2 days before ovulation, on the day of ovulation and 2 days after ovulation. Intrauterine pressure (IUP) was measured using micro-tip-catheters (one placed intrauterine, a second and third serving as reference sensors in the vagina and external to the mare) and transmitted by telemetry for 30 min to establish a baseline before saline was administered, iv, and for an additional 30 min after saline administration. Oxytocin was then given, iv, and IUP was recorded for 60 min. No change in IUP was observed after saline injection. The administration of both 10 (n=16) and 25 (n=10) IU oxytocin induced a response (P<0.01). The intensity of response depended on the day of administration (P<0.01) and the dose of oxytocin (P<0.001). The variation of response was significantly greater after 10 IU oxytocin (CV 15.78%) compared with 25 IU oxytocin (CV 6.42%). The uterine response was greatest on Day 2 prior to ovulation and lowest on Day 2 after ovulation. The response was negatively correlated to increasing plasma progesterone (10 IU oxytocin: r = -0.435, 25 IU oxytocin: r = -0.265). There was no correlation between the uterine response and plasma estradiol-17beta concentration (P<0.01). In conclusion the results of this study show that oxytocin administration to mares before ovulation provides a greater response than after ovulation. A decline in the intensity of response after ovulation can be compensated for with a higher dose of oxytocin. Furthermore, the use of the multiple catheter technique is an effective method for assessing changes in uterine pressure.

Post-breeding endometritis in the mare

Post-breeding endometritis is a major cause of subfertility in the mare. Endometritis is a normal event in the immediate period after mating, but the presence of ultransonographically visible uterine fluid more than 12 h later is thought to be evidence of uterine pathology. In mares that are free of venerally transmitted endometritis, treatment is aimed at removing the intraluminal fluid. If the endometritis persists past day 5, when the embryo enters the uterine lumen, the cytotoxic environment will not be compatible with pregnancy. Reproductive anatomy, defective myometrial contractility, lowered immune defences, overproduction of mucus, inadequate lymphatic drainage, or a combination of these factors will predispose the mare to post-breeding endometritis.