Infertility Flashcards
what is infertility
Infertility is the inability to
conceive and produce viable offspring
what can infertility and subfertility be the result of (2)
◦ Non-infectious causes
◦ Infectious causes
non infectious causes of infertility (10)
◦ Poor bitch breeding management
◦ Irregularities of the estrous cycle
◦ Structural anomalies of reproductive tract
◦ Disorders of sexual development (DSDs)
◦ Ovarian disease
◦ Uterine disease
◦ Hypothyroidism
◦ Systemic disease
◦ Nutrition
◦ Stress
most common cause of infertility/subfertility
Poor bitch breeding management (poor/no ovulation timing)
what are some irregularities of the estrous cycle (6)
◦ Anestrus
◦ Anovulation
◦ “Slow rise” in pre-ovulatory
progesterone levels
◦ Split heat
◦ Persistent estrus
◦ Insufficient luteal phase
persistent estrus; what do you have to distinguish it from, what happens
◦ Important to distinguish from vaginitis
◦ If have cornified vaginal cytology for >30 days without rise in progesterone
◦ Likely have repro tract pathology à secreting hormones
what do you need to distinguish split heat from
◦ Need to distinguish between true split heat & shortened diestral /anestrus phase (4 months inter-estrus interval)
what are three common vaginal structural abnormalities and how do they occur
◦ Vaginal septum
◦ Vaginal circumferential stricture
◦ Hymenal remnants
what can vaginal structural anomalies cause
◦ Vaginitis
◦ Infertility/subfertility (Male cannot penetrate (painful or completely unable), Bitch reactive to natural breeding, Can block sperm transport)
◦ UTIs, urinary incontinence
diagnosis of vaginal structural anomalies
◦ History
◦ Digital palpation
◦ Vaginoscopy
treatment of vaginal septum
◦ If small and can place finger around – can use spay hook with sedation + lidocaine gel
◦ Sometimes too large – has to be done under GA
◦ Want to incise the tissue as cranially as possible
◦ If left inside = issues at whelping = dystocia
what does vaginal hyperplasia occur in response to
estrogen (during proestrus & estrus)
what breeds are predisposed to vaginal hyperplasia
brachycephalic bitches
sequelae of vaginal hyperplasia
◦ 2 nd infections
◦ Self mutilation
◦ Interference with urination
◦ Inability to be bred naturally
reccurrence of vaginal hyperplasia
Can reoccur just prior to whelping as estrogen levels rise again =
obstructive dystocia?
Reoccur at each subsequent heat, usually gets worse at each cycle
how can vaginal hyperplasia subside on its own
Subsides on its own post-ovulation as estrogen levels decrease
treatment of vaginal hyperplasia
◦ Keep mucosa moist – lubricant with panties
◦ Can AI around it (genetics; parturition?)
◦ Surgical removal = reoccurrence
◦ Can induce ovulation if really bad to remove estrogen earlier – can’t breed if this is done
vaginal tumors; names and what are they dependent on
◦ Occasionally hormone dependent
◦ Leiomyomas, leiomyosarcomas
are DSDs common in dogs
yes
examples of DSDs in dogs
os clitoris, Persistent Mullerian Duct Syndrome (PMDS), segmental aplasia of uterus, hypoplastic ovaries, etc.
what breeds have hereditary DSDs
mini schnauzers, cocker spaniels
ovarian vs paraovarian cysts, examples
◦ If within the ovary = ovarian cyst
◦ If adjacent to the ovary = parovarian cyst
◦ Examples: follicular cysts, luteal cysts, etc.
what happens with follicular cysts, dx, treatment
Can secrete estrogen
◦ Persistent estrus
◦ Vulvar swelling, discharge
◦ Other signs of hyperestrogenism
◦ Cornification on estrus smear
Diagnosis: ultrasound
Treatment: OHE, or induce ovulation in valuable breeding bitch – may reoccur
how common is ovarian neoplasia in dogs
overall uncommon
what type of neoplasia can occur on the ovaries and what is the sign
Granulosa cell tumor
◦ Often secretes estrogen
◦ Signs of persistent estrus = as in
follicular cysts
◦ Can also secrete progesterone
◦ Can metastasize
treatment of ovarian disease (neoplasia)
◦ OHE
◦ Chemotherapy if metastatic
◦ Histopathology
diagnosis of ovarian disease (neoplasia)
◦ History & clinical signs
◦ Cornified vaginal epithelium
◦ Ultrasound
clinical signs of ORS
◦ Estrous signs
◦ Pseudopregnancy signs
causes for ORS
Ovarian tissue “left behind” re-vascularizes
◦ Anomalous reproductive anatomy
◦ Surgeon error
◦ Abnormal accessory ovarian tissue
what do you have to differentiate ORS from
Important to distinguish from exogenous hormone exposure
diagnostics for ORS
◦ Estrogen detection = vaginal cytology
◦ Progesterone
◦ LH test
◦ AMH
◦ Abdominal ultrasound
treatment of ORS
◦ Surgery; Risk factors
3 types of uterine disease
-endometritis
-cystic endometerial hyperplasia
-pyometra
diagnosis of endometritis
◦ Vaginal cytology
◦ Endometrial culture, biopsy & cytology
◦ Ultrasound?
