Uterine haemodynamics in young and aged pregnant mares measured using Doppler ultrasonography

Developmental programming of production and reproduction in dairy cows: I. Association of maternal parity with offspring's birth weight, milk yield, reproductive performance and AMH concentration during the first lactation period

Multiparous dams have been reported to produce offspring with greater fertility and higher AMH concentration, as a marker of ovarian reserves, as compared with nulliparous and primiparous dams. Yet it has remained to be addressed whether this phenomenon can still be true for old multiparous cows which might experience some geriatric changes in their reproductive system. Therefore, the present study was conducted to evaluate the productive and reproductive performance of offspring with different maternal parity. To this end, offspring were classified based on their maternal parities into four categories, including offspring of nulliparous (no previous parity), primiparous (one previous parity), young multiparous (two to six previous parities) and old multiparous (seven or more previous parities) dams. In study I, data of birth weight, milk yield and reproductive variables of 11,788 offspring and data of their maternal parity were retrieved. In study II, blood samples (n = 521) were collected from offspring with various maternal parity for measurement of serum AMH. Birth weight was the lowest in the offspring of nulliparous dams (P < 0.0001) and it was lower in offspring of primiparous and old multiparous dams than offspring of young multiparous dams (P < 0.05). Milk production was the lowest in offspring of old multiparous dams (P < 0.01), and it was lower in offspring of young multiparous dams than offspring of nulliparous and primiparous dams (P < 0.0001). Offspring of old multiparous dams had greater first service conception rate, less services per conception and shorter calving to conception interval than offspring of nulliparous, primiparous and young multiparous dams (P < 0.05). Furthermore, AMH concentration was higher in offspring of old multiparous dams than offspring of nulliparous and primiparous dams (P < 0.05). In conclusion, the present study revealed greater milk production in offspring resulting from dams with lower parity, probably due to the genetic selection for improvement of milk production in dairy cows which imparts the younger generations greater genetic merits for milk production. Reproductive performance, however, was greater in offspring born to dams with higher parity, particularly those born to old multiparous dams, and this phenomenon might be related to their lower milk production and higher AMH concentration.

The effects of aging and gestational month on uteroplacental vascular perfusion, and umbilical artery hemodynamics in pregnant jennies

This study aimed to correlate the pulsed wave spectral indices of the middle uterine artery at both sides with placental development in jenny within mid-late pregnancies, and establish umbilical Doppler values for different ages and different gestational months. Twenty Equus Asinus pregnant jennies 260-450 kg (average, 320 ± 10 kg) were examined from 5 to 9 months of pregnancy with different ages (4-14 years). Monthly B-mode ultrasound examination was performed on both the combined thickness of the uterus and placenta (CTUP; mm) and umbilical artery cross-sectional diameter, and Doppler mode examination was performed on both the middle uterine (MUA at right [R] and left [L] sides) and umbilical arteries to measure both Doppler indices that expressed by resistance (RI) and pulsatility indices (PI), and blood flow rate. CTUP was elevated within pregnancy time at different ages (P < 0.05). L. PI was significantly declined throughout different ages (P < 0.05), but this declining trend was not observed in L. RI. The L. blood flow rate (R; bpm) was elevated among different ages and different months (P < 0.05). Both RI and PI were significantly decreased from 5 to 9 month of gestation period in jennies (P < 0.05).. The umbilical arteries cross-sectional diameter (Umb A; mm), was elevated among different ages and different months, while both Doppler indices were declined. A positive correlation was found (between both Doppler indices of both umbilical and uterine arteries P < 0.001). There was elevated vascular perfusion in uterine and umbilical arteries associated with reduced both Doppler indices along the course of pregnancy at different ages.

Evidence of maternal and paternal age effects on speed in thoroughbred racehorses

Effects of parental age on offspring viability have been reported in a wide range of species. However, to what extent parental age influences offspring traits beyond viability remains unclear. Moreover, previous research has primarily focused on maternal age effects. The purpose of this study was to test for paternal and maternal age effects on offspring speed in thoroughbred racehorses. We analysed over 900 000 race performances by over 100 000 horses on British racecourses between 1996 and 2019. With knowledge of the age of all 41 107 dams and 2 887 sires at offspring conception, we jointly modelled maternal and paternal age effects using a 'within-individual centring' approach. Within-parents, we identified a significant effect of maternal age on offspring speed of -0.017 yards s^-1 yr^-1 and a corresponding paternal age effect of -0.011 yards s^-1 yr^-1. Although maternal age effects were stronger (more negative), the existence and magnitude of paternal effects is particularly noteworthy, given thoroughbred sires have no involvement in parental care. Our results also suggest that the selective disappearance of both sires and dams is ongoing. These findings could potentially be used to optimize thoroughbred racehorse breeding decisions, and more generally, add to the increasing body of evidence that both maternal and paternal age affect a range of offspring characteristics.

Evidence of maternal and paternal age effects on speed in thoroughbred racehorses

Effects of parental age on offspring viability have been reported in a wide range of species. However, to what extent parental age influences offspring traits beyond viability remains unclear. Moreover, previous research has primarily focused on maternal age effects. The purpose of this study was to test for paternal and maternal age effects on offspring speed in thoroughbred racehorses. We analysed over 900 000 race performances by over 100 000 horses on British racecourses between 1996 and 2019. With knowledge of the age of all 41 107 dams and 2 887 sires at offspring conception, we jointly modelled maternal and paternal age effects using a 'within-individual centring' approach. Within-parents, we identified a significant effect of maternal age on offspring speed of -0.017 yards s^-1 yr^-1 and a corresponding paternal age effect of -0.011 yards s^-1 yr^-1. Although maternal age effects were stronger (more negative), the existence and magnitude of paternal effects is particularly noteworthy, given thoroughbred sires have no involvement in parental care. Our results also suggest that the selective disappearance of both sires and dams is ongoing. These findings could potentially be used to optimize thoroughbred racehorse breeding decisions, and more generally, add to the increasing body of evidence that both maternal and paternal age affect a range of offspring characteristics.

Evidence of maternal and paternal age effects on speed in thoroughbred racehorses

Effects of parental age on offspring viability have been reported in a wide range of species. However, to what extent parental age influences offspring traits beyond viability remains unclear. Moreover, previous research has primarily focused on maternal age effects. The purpose of this study was to test for paternal and maternal age effects on offspring speed in thoroughbred racehorses. We analysed over 900 000 race performances by over 100 000 horses on British racecourses between 1996 and 2019. With knowledge of the age of all 41 107 dams and 2 887 sires at offspring conception, we jointly modelled maternal and paternal age effects using a 'within-individual centring' approach. Within-parents, we identified a significant effect of maternal age on offspring speed of -0.017 yards s^-1 yr^-1 and a corresponding paternal age effect of -0.011 yards s^-1 yr^-1. Although maternal age effects were stronger (more negative), the existence and magnitude of paternal effects is particularly noteworthy, given thoroughbred sires have no involvement in parental care. Our results also suggest that the selective disappearance of both sires and dams is ongoing. These findings could potentially be used to optimize thoroughbred racehorse breeding decisions, and more generally, add to the increasing body of evidence that both maternal and paternal age affect a range of offspring characteristics.

Effect of acetylsalicylic acid on uterine blood flow, gestation length, foal birth weight and placental weight in pregnant Thoroughbred mares - a clinical pilot study

The aim of this double-blinded placebo-controlled study was to investigate the effect of acetylsalicylic acid (ASA) on uterine blood flow, gestation length, placental and foal weights in pregnant mares. Sixteen Thoroughbred mares of different age (13.3 ± 4.1) and parity (7.4 ± 3.1) were randomly assigned to three treatment groups. Mares in group C (n = 4) served as controls and received 5000 mg lactose orally once daily from D 120 (D 0 = day of ovulation) until parturition. Mares in group ASA1 (n = 7) received 5000 mg ASA orally once daily from D 120 until parturition. Mares in group ASA2 (n = 5) received the same dose ASA as group ASA1 from D 120 to D 285, but twice daily from D 285 until parturition. Mares were examined by ultrasonography on D 14, 28 and 60, and in 21-days intervals from D 120 until parturition. The cross-sectional area, time average maximum velocity (TAMV), and pulsatility index were measured in both uterine arteries and the blood flow volume was calculated for each uterine artery and then summarized. All 16 mares carried a normal pregnancy and delivered live foals. In group ASA2 TAMV in the ipsilateral artery was significantly higher (P = 0.03) and these mares showed a tendency of increased total blood flow volume (P = 0.07) during late pregnancy (D 305 to 346). Results indicate that oral administration of 5000 mg of ASA twice daily in pregnant mares causes a rise in uterine blood flow during late pregnancy.

Doppler Ultrasound in the Reproduction of Mares

Doppler ultrasonographic (US) is a method that provides real-time information on vascular architecture and hemodynamic aspects of blood vessels. It can determine the presence, direction, and speed of blood flow, being subdivided into the categories of color Doppler (color flow and power flow) and pulsed Doppler. The objective of this chapter was to compile data from several studies addressing the use of US Doppler correlated with pathophysiological phenomena of equine reproduction. Initially we decided to describe the technique, advantages, and disadvantages of each Doppler mode. Then the applicability of US Doppler in mares related to equine reproduction. Thus, within this chapter, you will find the form of use and descriptions of studies carried out on vascular perfusion of the follicular dynamics, the corpus luteum, the uterine segments, which we have divided into post-insemination evaluation, endometritis diagnosis and pregnancy diagnosis. So, we hope that this chapter will expand the knowledge about US Doppler and increase the number of veterinarians who will introduce the technique into their practical routine.

Female age and parity in horses: how and why does it matter?

Although puberty can occur as early as 14-15months of age, depending on breed and use, the reproductive career of mares may continue to advanced ages. Once mares are used as broodmares, they will usually produce foals once a year until they become unfertile, and their productivity can be enhanced and/or prolonged through embryo technologies. There is a general consensus that old mares are less fertile, but maternal age and parity are confounding factors because nulliparous mares are usually younger and older mares are multiparous in most studies. This review shows that age critically affects cyclicity, folliculogenesis, oocyte and embryo quality as well as presence of oviductal masses and uterine tract function. Maternal parity has a non-linear effect. Primiparity has a major influence on placental and foal development, with smaller foals at the first gestation that remain smaller postnatally. After the first gestation, endometrial quality and uterine clearance capacities decline progressively with increasing parity and age, whilst placental and foal birthweight and milk production increase. These combined effects should be carefully balanced when breeding mares, in particular when choosing and caring for recipients and their foals.

Managing Reproduction Emergencies in the Field: Part 2: Parturient and Periparturient Conditions

Selected conditions affecting broodmares are discussed, including arterial rupture, dystocia, foal support with ex utero intrapartum treatment, uterine prolapse, postpartum colic, the metritis/sepsis/systemic inflammatory response syndrome complex, and retained fetal membranes. Postpartum colic beyond third-stage labor contractions should prompt comprehensive evaluation for direct injuries to the reproductive tract or indirect injury of the intestinal tract. Mares with perforation or rupture of the uterus are typically recognized 1 to 3 days after foaling, with depression, fever, and leukopenia; laminitis and progression to founder can be fulminant. The same concerns are relevant in mares with retention of fetal membranes.

Assessment of dopperfluxometric indices of maternal-fetal structures in pregnant ewes

The aim of this study was to evaluate the blood flow of the uterine artery, fetal aorta and umbilical artery in the physiological pregnancy of sheep by means of pulsed Doppler throughout the gestational period. Thirty Santa Inês ewes weighing between 45.4±4.3 kg and aged 2 to 5 years were selected. The evaluations were carried out weekly from the 3^rd to the 21^st gestational week. Peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) were obtained. Analysis of variance was performed, and the minimum significant comparison of means was obtained by the BH test with adjusted P<0.05. The results were expressed as mean ± standard error. For the fetal aorta, there was an increase in the EDV values and a decrease in the PSV and RI throughout pregnancy. For the uterine artery, PSV and EDV did not present significant variation, whereas the RI showed a reduction in the last week. Increased EDV values were found for the umbilical artery throughout pregnancy. For the PSV there was no significant difference, as the RI was reduced at the end of pregnancy. The results obtained are expected to contribute to a more complete understanding of the hemodynamic changes resulting from pregnancy.

Endometrial angiogenesis induced by uterine insufflation with an oxygen-ozone gas mixture in mares

Ozone (O₃ ) therapy has been used to improve peripheral tissue oxygenation in humans and domestic animals. The goal of the present study was to characterize histological changes in the endometria of healthy equines following tissue exposure to gas mixtures enriched with different concentrations of O₃ . Cycling mares without endometrial degeneration were divided into three groups according to treatment (n = 9 mares/group). The uteri from the O₃ , ½O₃ and control groups were insufflated for 3 min with gas containing 42, 21 and 0 μg O₃ ml^-1 , respectively. Treatments were performed every three days from D0 to D6. Endometrial samples were collected immediately before the first treatment and 24 hr after the last treatment. The following nine histological parameters were evaluated: (i) the number of endometrial blood vessels, (ii) endometrial vascular degree (EVD), (iii) increase rate of blood vessels, (iv) increase rate of EVD, (v) glandular total area, (vi) glandular lumen area, (vii) intraglandular secretion area, (viii) glandular epithelial height and (ix) luminal epithelial height. In the O₃ group, a positive effect from treatment (p < .01) was detected for all vascular parameters (i, ii, iii and iv), glandular total area, intraglandular secretion area and glandular epithelial height. Compared to the control group, the ½O₃ group had greater (p < .01) EVD (84.1 ± 12%) and a higher increase rate of blood vessels (151.9 ± 47.1%). Uterine insufflation with low or intermediate concentrations of the O₂ -O₃ gas mixture induced endometrial angiogenesis. Morphometry, but not morphology, of the endometrial glands was affected by local O₃ therapy. These findings would be of great significance for the development of new therapies for infertility in mares.

Postpartum Polyneuropathy in a Mare: A Case Report

Obstetric paralysis is a generic term used to describe postpartum locomotor alterations resulting from nerve damage, widely reported in cattle, but rare in equines. The aim of this study is to report a case of a peripheral polyneuropathy in a primiparous mare, 3 years old, of Mangalarga Marchador breed, after a dystocia lasting approximately 12 hours. At the time of delivery, the head of the fetus was exposed in the vulva and there was flexion of the thoracic limbs. These events culminated in a framework of extreme abduction of the pelvic limbs, thus generating functional impotence and leading the animal to adopt a frog anddecubitus position. After three days of treatment with no improvement in the clinical framework, the animal was euthanized. In the postmortem examination, perineural hemorrhagic lesions were observed in the obturator and sciatic nerves, characterizing the diagnosis of obstetric paralysis. It is possible the outcome of the case would have been satisfactory if there had been an early fetotomy or postpartum treatment had been more prolonged; however, these measures depend on the availability of equipment, conditions of care, and consideration of the owner.

Genetic and Environmental Factors Influencing Gestation Length in Lusitano Horses

Breeding and parturition records collected over a period of 35 years in the Alter Real stud of Lusitano horses were used to calculate gestation length (GL). The 1027 gestations by 209 mares mated to 60 stallions had a mean GL of 338.1 ± 9.26 days. The mixed model analysis of variance indicated that the sex of the foal and inbreeding of the dam and foal had no significant effect on GL (P > .05). On the other hand, GL increased linearly with mare age, with an estimated regression coefficient of 0.155 ± 0.069 days/year (P < .05). Year and conception month affected GL (P < .05), with longer gestations observed when breeding occurred between January and April, followed by a decline of about 5 and 10 days in GL of mares bred in May and in June-July, respectively. Important differences were observed between stallions (P < .05), with most stallions resulting in a distribution of GL in an interval of ±5 days. The inclusion of the mare as a random effect in the mixed model resulted in an estimated repeatability of GL of 0.427, indicating that mares tend to be regular in having long or short gestations across their lifetime. Variance components estimated in an Animal Model resulted in heritability estimates of 0.39 for maternal genetic effects and 0.19 for direct genetic effects, with no association between the two components. Overall, the mare seems to have the major genetic influence on GL in Lusitano horses, but environmental factors, such as month of conception and also the age of the mare, have a noticeable effect.

Treated and untreated anovulation associated with ovarian and uterine blood flow in Arabian mares (a case study)

To investigate the development of treated and untreated hormonal anovulatory follicles (AnOV) associated with uterine and ovarian vascularization, rectal Doppler ultrasound of seven Arabian mares was performed before and after the development of an AnOV. In addition to measuring the diameter, area and volume of the follicle, daily colour and power Doppler scans were analysed in order to measure red, blue and power blood flow areas in pixels. Serum levels of estradiol (E2), progesterone (P4), leptin, insulin-like growth factor-I (IGF-1) and nitric oxide (NO) were measured as well. The diameter (cm), area (cm2), volume (cm3), area in pixels, antral area in pixels, circumference, and percentage change in circulation of the AnOV progressively increased (P<0.0001) after the disappearance of uterine oedema compared to the values obtained during oedema. The blue, total colour and power areas of the AnOV increased after the disappearance of uterine oedema (P<0.0001). When the antral area was excluded, the percentage of the granulosa layer in the colour and power Doppler decreased after the disappearance of uterine oedema. The ipsilateral uterine horn and uterine body had significantly (P<0.0001) high blue and red blood flow vascularization areas in the presence of uterine oedema. The AnOV was associated with low P4, IGF-1 (P<0.001), and leptin (P<0.05). Treatment of the AnOV follicle with GnRH resulted in its luteinization and induced ovulation 9 and 30 days later. It can be concluded that an abrupt increase in blood flow due to decreased progesterone and E2 and increased IGF-1 causes anovulation. The absence of oestrous behaviour and high uterine-oedema-associated follicular and ipsilateral uterine horn vascularization are predictors of ovulation failure.

Half a century of equine reproduction research and application: A veterinary tour de force

Over the past 50 years, per season pregnancy rate in Thoroughbred mares have risen from 70 to >90% and foaling rates from 55 to >80%. Some of the significant pharmacological treatments and diagnostic methods which have driven this marked improvement in breeding efficiency are reviewed. They include the application of artificial lighting to hasten the onset of ovulatory oestrous cyclicity in early Spring, rapid steroid hormone assays to aid in determining the stage and normality of the mare's cycle, prostaglandin analogues, synthetic progestagens and Gonadotrophin-releasing Hormone (GnRH) analogues to better control and manipulate her cycle to good effect, transrectal ultrasound scanning to monitor follicle growth, endometrial architecture and ovulation and to allow accurate, early pregnancy diagnosis thereby enabling successful ablation of one of twin conceptuses. Also, flexible videoendoscopy to monitor physiological and pathological changes in the uterine endometrium and rigid laparoscopy to apply prostaglandin to the oviducts to dislodge and clear suspected blockages of them to restore fertility. The outbreak of Contagious Equine Metritis in Newmarket in the spring of 1977 and the swabbing-related changes to mare and stallion management, plus the improved veterinary hygiene methods, which followed are also recounted. The past half century has witnessed many technical and therapeutic advances that have enhanced tremendously the diagnostic and treatment capabilities of studfarm veterinary surgeons. They, in turn, have improved greatly the efficiency of breeding Thoroughbreds and other types of horses.

Transrectal Doppler sonography of uterine blood flow in ewes during pregnancy

In sheep, there is a lack of information on the behaviour of hemodynamic indices and parameters of blood flow velocity of the uterine artery during pregnancy, making it impossible to determine the real meaning of the values found and their probable relevance in normal physiological or pathological states. The objective of the present study was to evaluate the blood flow velocity parameters and hemodynamic indices of the uterine artery in ewes (18) during pregnancy (33). Based on non-invasive colour Doppler sonography, we evaluated the peak systolic velocity (PS), end diastolic velocity (ED), time-averaged maximum and minimum velocity in a cardiac cycle (TAMAX and TAMEAN), pulsatility index (PI), resistance index (RI), systolic/diastolic ratio (S/D), heart rate (HR), arterial diameter (AD) and the blood flow volume (BFV). Examinations started on day 28 and continued at two-week intervals until parturition. The Doppler parameters and the diameter of the uterine artery underwent significant changes during pregnancy. In the evaluated animals, indices related to resistance of the uterine artery, namely the impedance of blood flow, decreased throughout the initial, middle and late stages of gestation (PI: 1.15, 1.04, 0.97; RI: 0.61, 0.59, 0.57; S/D: 2.68, 2.52, 2.39, respectively) (p < 0.05). In contrast, the contents related to higher uterine irrigation increased during gestation (PS, ED, TAMAX, TAMEAN, HR, AD and BFV) (p < 0.05). No differences were found between the means of the variables in relation to the right and left uterine arteries and between single and multiple pregnancies in the hemodynamic indices. The present study is the first to demonstrate changes in uterine hemodynamics throughout pregnancy in sheep.

Identification of vessel degeneration and endometrosis in the equine endometrium, using narrow-band imaging hysteroscopy

In this study, endometrosis and angiosclerosis in mares were studied. Endometrosis is a severe, progressive, and irreversible fibrotic condition that affects the endometrium, whereas angiosclerosis refers to thickening of vessel walls due to degenerative changes leading to reduced elasticity of the walls and lower perfusion. Histologic evaluations were performed on biopsies and compared with vascular features of the endometrial surface obtained via narrow-band imaging (NBI) hysteroscopy. First, it was determined if hysteroscopic evaluation of the endometrium using NBI resulted in a better visualization of the vascular pattern (i.e., vessel-versus-background contrast was increased) compared with using white light. This was found to be the case for examinations in vivo (n = 10), but not when using abattoir uteri (n = 3). In the second part of this study, it was determined if vascular densities and sizes as derived from NBI images could be used as indicators for the degree of degenerative changes of the equine endometrium and its vessels. Narrow-band imaging hysteroscopic evaluations were performed (n = 10), and endometrial biopsies (n = 32) were collected. Histologic specimens were evaluated for degree of endometrosis and angiosclerosis, and they were classified in Kenney categories. Narrow-band imaging images were analyzed for vascular pattern. Samples classified to Kenney category I, or without signs of vessel degeneration, had significantly higher vascular densities than samples from Kenney category IIa or with angiosclerosis. In conclusion, narrow-band imaging facilitates enhanced visualization of the vasculature of the equine endometrium during hysteroscopies, which has applications in detection of endometrosis and angiosclerosis.

The effect of isosorbide dinitrate on uterine and ovarian blood flow in cycling and early pregnant mares: A pilot study

Poor uterine perfusion has been proposed as a cause of infertility in mares. The objective of this study was to investigate the effect of isosorbide dinitrate (ISDN), a nitric oxide donor, on uterine and ovarian blood flow resistance during diestrus and early pregnancy in mares. Six Trotter mares, aged 7 to 14 years, were examined daily during the first 11 days of three diestrous periods, and five of those mares were also examined during the first 11 days of two pregnancies. Six mares randomly received a placebo, a low dose (30 mg, ISDN30), or a high dose of ISDN (60 mg, ISDN60) through three nonconsecutive cycles. The treatments were administered orally, every 12 hours from Day 1 to 11 of the cycle (Day 0 = ovulation). Five of the 6 mares received a placebo or 60 mg of ISDN orally every 12 hours from Day 1 to 11 of pregnancy. The mares were short cycled on Day 12 of each trial. Transrectal color Doppler was used to determine blood flow resistance semiquantitatively and expressed as pulsatility index. Mean pulsatility index of both uterine arteries combined and of the dominant (ipsilateral to the CL) ovarian artery was lower (treatment effects: P ≤ 0.01; time effects: P ≤ 0.002) in mares receiving 30 mg or 60 mg of ISDN compared with placebo-treated mares. Blood flow resistance in the dominant ovarian artery was lower in ISDN-treated pregnant mares than in placebo-treated pregnant and cycling mares (treatment effect: P = 0.04; time effect: P = 0.003). Isosorbide dinitrate increases uterine and ovarian perfusion in cycling mares and ovarian perfusion in early pregnant mares. Further studies are needed to investigate these effects in relation to fertility of the mare.

Physiopathologic mechanisms involved in mare endometrosis

Endometrosis is a degenerative chronic process, characterized by paramount fibrosis development in mare endometrium. This condition is one of the major causes of subfertility/infertility in mares. As in other organs, fibrosis might be a pathologic sequel of many chronic inflammatory diseases. However, aetiology and physiopathologic mechanisms involved in endometrial fibrosis are still controversial. This review presents new hypotheses based on our newest data. As the first line of innate immune defence, systemic neutrophils arrive in the uterus at mating or in the presence of pathogens. A novel paradigm is that neutrophils cast out their DNA in response to infectious stimuli and form neutrophil extracellular traps (NETs). We have shown that bacterial strains of Streptococcus zooepidemicus, Escherichia coli or Staphylococcus capitis, known to cause endometritis in mares were able to induce NETs release in vitro by equine PMN to different extents. An intriguing dilemma is the dual action of NETs. While NETs play a desirable role fighting micro-organisms in mare uterus, they may also contribute to endometrial fibrosis. A long-term in vitro exposure of mare endometrium explants to NETs components (myeloperoxidase, elastase and cathepsin G) up-regulated fibrosis markers TGFβ and Tissue inhibitor of metalloproteinase (TIMP-1). Also, pro-fibrotic cytokines regulated collagen deposition and fibrosis. Changes in expression of connective tissue growth factor (CTGF), interleukins (IL)1-α, IL-1β, IL-6 and receptors in endometrium with different degrees of fibrosis and/or inflammation were observed. A putative role of CTGF, IL and NETs components in endometrosis development should be considered. Additionally, we speculate that in sustained endometritis in mares, prostaglandins may not only cause early luteolysis or early pregnancy loss, but may also be related to endometrial fibrosis pathogenesis by stimulating collagen deposition.