Female Infertility Flashcards
Principle causes of infertility in females
Anatomical
○ Congenital / development
○Acquired
Physiological
○ Ovarian pathology
○ Uterine infection
○ Failure to establish pregnancy
Management issues
○ Nutrition
○ Oestrus detection
○ Genetic
○ Timing/management of mating
○ Expectation
○ Stress
Congenital anatomical infertility causes
○ Ovarian hypoplasia
○ Reproductive dysplasia
○ Free-martinism / Inter-sex
Ambiguous genitalia with spectrum of gonadal types
○ Persistence of hymen (mare)
Acquired anatomical infertility causes
○ Adhesions
E.g. Ovario-bursal, hydrosalphinx
Incidence increases with age
○ Endometrial fibrosis
Trauma leads to fibrosis
Associated with parturient injuries
○ Cystic endometrial hyperplasia (bitch)
Repeated hyperplasia in luteal phase
○ Reproductive tract neoplasia (uncommon)
Pathological Ovary Presentation
○ Oestrus not observed at expect time
○ Pregnancy diagnosis
○ Persistent oestrus
○ Irregular oestrous cycle
○ Important to understand reproductive expectations
Pathological Ovary Causes
○ Lack of follicular growth / oestradiol
○ Lack of an LH surge
○ Lack of GnRH / gonadotrophin
○ Lack of endometrial PGF2A production
○ May have underlying pathophysiological causes
Pathological Ovary Diagnosis
○ Hormone analysis
E.g. progesterone
○ Ovarian (uterine) palpation
○ Ovarian (and uterine) ultrasonography
Range of presentation from small, inactive ovaries to gross enlarged follicular structure
Pathological Ovary Treatment
○ Promote ovarian function
E.g. gonadotrophin via GnRH / eCG
○ Mimic luteal phase (with progesterone)
○ Induce luteinisation (ovulation) via GnRH / LH
○ Induce luteolysis (if luteal tissue is present)
○ Likely to re-occur
Anovulatory anoestrus
- Lack of cyclicity
- Delayed return post-partum / season
- Associated with NEB
- Cows, bitches, sows and following pregnancy failure in mare
Cystic ovarian disease
- Follicular structure that fail to ovulate and persist
○ Cows, sows
Persistent CL
- Failure to return to oestrus
- CL persists in absence of pregnancy
- Common in mare and cows
Reproductive Tract Infection
Ovaritis is rare
Endometritis, cervicitis, vaginitis is common in cows, mares and dogs
Typical times of presentation:
○ Post-partum - Associated with retained fetal membranes
○ Post-mating
Reproductive Tract Infection Treatment
- Antibiotics
- Stimulation of uterine contractions
Infectious Infertility
○ Many commensal organisms which are opportunistic
○ Venereal pathogens - AI reduces transmission
Bovine venereal campylobacterosis
Infectious pustular vulvovaginitis (IPV/IBR)
Contagious equine metritis
○ Systemic infections
E.g. BVD, IBR, BHV1
Raised temperature has adverse effect on ovarian function
Conception failure
○ Inappropriate timing of AI/mating
○ Delayed (or lack of) ovulation
○ Chromosomal abnormalities
Early embryonic death
○ Poor embryonic development
○ Failure to secrete maternal recognition signal
