Principle Causes of Infertility in the FEMALE Flashcards
Name some of the main causes of infertility in the female?
- Ovaries with some form of pathology
- Poor or mismanagement
- NEB
- Inappropriate timing
- To get appropriate timing need to be able to detect oestrus – easier in some species than others!
- Horses ovulate before the end of oestrus – when trying to manage this, it becomes a lot harder, not so much of a problem in the wild
- Infections of the reproductive tract, mainly uterus – possibly vagina or cervix. Unlikely for the ovary to be infected!
- Whites in dairy cow
- Uterus should be aseptic environment! If its not, embryo is unlikely to be able to attach
BOB ROBS LIST:
- Aberrant development of the genitalia and/or ovaries
- Irregular or abnormal oestrous cycles
•Cystic ovaries comes under here
3.Vulvar or vaginal discharge
•Probably come from endometrium
- Failure to become pregnant
- Embryonic death
- Miscellaneous
Name some of the congenital and developmental anomalies?
Largely structural
Animal is largely born with these
- Ovarian hypoplasia
- Reproductive tract dysplasia
- Freemartinism
- Inter-sex
What is ovarian hypoplasia?
What is the treatment and how common is it?
- One or both ovaries absent (rare)
- Rare for both ovaries to be absent!
- Ovarian hypoplasia (uncommon in most species)
- Virtually no follicles, no cycle, no oestrus
- Often bilateral
- Flaccid uterus
- No treatment
What is segmental dysplasia?
Segmental dysplasia of paramesonephric ducts (1 in 1000)
- Developmental obstruction
- Ovaries function normally
e.g. Uterine didelphys, Uterine unicornis, Partial aplasia
- Can establish pregnancy normal etc. – depends on which degree the obstruction is occurring
- If one horn bigger than horn – can be confused with pregnancy
What is Uterine didelphys?
A reproductive tract dysplasia
Uterus didelphys (sometimes also uterus didelphis) represents a uterine malformation where the uterusis present as a paired organ when the embryogenetic fusion of the Müllerian ducts fails to occur. As a result, there is a double uterus with two separate cervices, and rarely a double vagina as well
What is Uterine unicornis?
A reproductive tract dysplasia
Uterus unicornis is defined as complete agenesis of one uterine horn. … Ipsilateral renal agenesis is present in approximately 29% of cats with uterineabnormalities
What is seen with a persistence of hymen?
•Bulge from vulva
Strain at service (pain to mate
What is this?
Uterine didelphys
What is free-martinism?
Vascular anastomosis of adjacent chorioallantoic sacs of heterozygous foetuses. Transfer hormones from one animal to other. Female will be masculinised.
What is seen with the repro tract with free martinism?(3)
- Prominent clitoris hairy vulva
- Paramesonephric ducts absent or grossly hypoplastic
- Ovaries vestigial and/or masculinarised
How can you diagnose free martinism? (2)
- Failure to detect cervix via a probe or by rectum
- Sex chromosome chimerism
How many animals who are heterosexual twins turn out to be free martins?
Which animals does it affect (2)?
95%
Cows and goats
How can an animal be inter-sex and default to develop female?
- SRY gene on the Y chromosome (it is not activated and therefore they become female)
- Often female at birth
What are the 3 causes of ambiguous genitalia?
- Spectrum of gonadal types
- XX: male pseudohermaphrodite
- XO: Turners syndrome
How can you dianose inter sex?
Karotyping
Where is inter sex quite common? (3)
pigs (0.1-0.6%), goats and some dog breeds (American Cocker Spaniel)
What is the normal ovary structure?
Follicle which houses the oocyte
Follicle grows. Takes many months from primordial to ovulatory
Antral follicles which are seen on U/S- follicular waves form these
Cohort of follicles grow (top U/S pic)- some grow and some undergo atresia. Then get a dominant follicle
You can get a CL and dominant follicle at the same time (see 2nd down U/S pick).
Dominant – dominant over other follicles
Follicular waves happen even with CL
CL produces progesterone
CL prevents D follicle being ovulated
If there is a D follicle and you give GnRH – D follicle will ovulate and form an accessory CL. No chance of being fertilised as in a high progesterone environment (CL)
What can be seen in this pic?
What are the 3 most common presentations on a dairy farm for ovarian infertility? (3)
- Persistent CL
- Not seen bulling – oestrus not observed
- Silent oestrus
- Might be in anoestrus – anovulatory and oestrus. Not cycling normal
- No dominant follicles
- No CL
- Very small – hard on rectal
- Cyst – a large follicle that has failed to ovulate.
- Often not due to infection – ovulitis is RARE
What can cause a lack/cessation of cyclicity? (2)
- Delayed post-partum or season
- Associated with NEB
What is the incidence of anovulatory anoestrus? (4)
- Common in dairy cows (especially high yielding)
- Prolonged anoestrus in bitches
- Whelped/pseudopregnancy – 200 days (5-7 months). So longer than this
- Sows (associated with MMA)
- Pregnancy failure in mare
- 35 days – form endometrial cups which produce ECG. In essence if they form these and loose pregnancy we cant do much- effectively anoestrus
What is the clinical presentation of anovulatory anoestrus?
- Small, inactive ovaries
- i.e. no dominant follicle or CL
- Irregular progesterone profile
What is this?
Cystic ovarian disease
What is the pathogenesis of Cystic ovarian disease?
Hormonal insufficiency of LH
Surge centre or anterior PG = not enough GnRH or LH
May not grow enough so not enough oestradiol for +ve feedback to stimulate LH surge
Either way – follicle wont ovulate and will continue to grow
How can we diagnose Cystic ovarian disease (3)
Ultrasound
- Differential based on thickness of wall
- Always check both ovaries
- Can have big follicle cysts and then the other ovary may have a CL. So can conclude the animal is cycling by the presence of a CL
- ‘Normal’ CL can have thin walls
Plasma / milk progesterone if you think it is a luteal cyst
•e.g. > 2 ng/ml: indicate luteal tissue
Accurate diagnosis is difficult (dynamic structures) – cannot do it on a one off visit!! IT is a persistent structure you don’t know is persistent until you check again
What is this and what is seen with it?
Prognosis?
Granulosa cell tumour
Very large, lobulated, some cyst formation (fluid filled).
- Production of oestrogens / androgen
- Generally benign with infrequent metastasis
- Contra-lateral ovary often small
- Enlarged ovary with multiocular ultrasonographic appearance
- Elevated plasma testosterone / inhibin due to granulosa cells
- Can monitor this way
Survival removal with good prognosis
