INFERTILITY IN MARES

Wendy Conlon, BSC Equine Science

The main objective when breeding should be to produce the maximum number of live
healthy foals from the mares being bred.

The biggest obstacle in achieving this aim is the problem mare. The biggest category of
problem mare is the dirty mare or mare with persistent infection that keeps her from
either getting pregnant or maintaining a pregnancy.
FAILURE TO CONCEIVE
Many mares that cycle but fail to conceive have infections in their reproductive tracts
sometimes called dirty mares. There are of course several causes of a mare being
persistently infected.
All dirty mares either have, or are at risk of, inflammatory changes involving the lining of
the uterus (endometritis). The uterus is the place where the pregnancy will develop, so
mares with endometritis might either fail to conceive or undergo early pregnancy loss.

Dirty mares fall into the following categories:

Mares with acute infectious endometritis

Mares with chronic (long-term) uterine infection, often with scar tissue

Mares susceptible to persistent mating-induced endometritis

Acute Infectious Endometritis

An important cause of infection can be poor vulval shape. In the normal mare, the vulva
provides the first effective barrier to protect the uterus from infection. In the normal mare
the vulval lips are full and firm and meet evenly in the midline and there is 80% or more
of the vulval opening below the brim of the pelvis. If the vulval seal does not work
properly, sucking of air and contamination into the vagina can occur. The initial vaginitis
can lead to acute uterine infection, resulting in a dirty mare.
Diagnosis of endometritis can be made by collecting an endometrial swab during early
heat (oestrus) for bacteriological culture. This allows time for resolution of the problem
prior to breeding and maximises the chances of pregnancy.
Acute infectious endometritis is found most frequently in older mares that have had
several foals. Such mares have a breakdown in uterine defense mechanisms that allow the
normal genital flora to contaminate the uterus and develop into persistent endometritis.
The most favoured approach to treatment has been the infusion of various antibiotics
dissolved or suspended in water or saline into the uterus. The number of treatments
required depends on individual circumstances, but daily infusions for three to five days
during oestrus works well in most cases.
In addition, predisposing causes such as defective vulval conformation, should be
addressed. For example, a Caslicks procedure (stitching shut of the upper vulval lips) can
help prevent air contamination in a mare with poor vulval conformation.

Chronic Uterine Infection

These mares can have a wide range of degenerative changes (fibrosis, scar tissue and
glandular degenerative changes), and the infection has often been present for a long time.
Successful treatment of this category of dirty mare is difficult. There is no known
treatment for fibrosis or scar tissue. The degree of fibrosis or scar tissue relates to fertility
the more scar tissue or fibrosis, the poorer the fertility.

Persistent Mating-Induced Endometritis

Persistent mating-induced endometritis (delay of clearance) has come to be recognised as
the major reason for failure of mares to conceive. This means it is the most important
category of dirty mare.
The mare has a normal inflammatory response to semen whether from live cover or
artificial insemination. Semen is deposited directly into the uterus when mares are bred.
This means that bacterial and seminal components as well as debris contaminate the
uterus. This then results in uterine inflammation.
It was previously thought that the inflammatory response to breeding was due to bacterial
contamination of the uterus during insemination. It is now accepted that sperm
themselves as well as bacteria are responsible for the acute inflammatory response in
the uterus after insemination.
A transient uterine inflammation following insemination is useful and serves to clear the
uterus of excess sperm and debris associated with breeding. In most mares this transient
endometritis resolves spontaneously within 24 to 72 hours so that the environment of the

uterine lumen is ready to support the embryo when it descends into the uterus five to six
days after ovulation.
However, if the endometritis persists more than four or five days after ovulation this is
incompatible with embryonic survival. These mares which fail to clear these
inflammatory responses are referred to as susceptible, and they often develop a persistent
endometritis.
The physical ability of the uterus to eliminate bacteria, inflammatory debris, and fluid is
known to be the critical factor in uterine defense. It is a logical conclusion that any
impairment of this function renders a mare susceptible to persistent endometritis.
Detection of Susceptible Mares
This can be difficult, as there might only be subtle changes in the uterine environment
that arent readily detected by current diagnostic procedures. Many mares show no signs
of inflammation before mating, but this will fail to resolve the inevitable endometritis
following mating. Use of ultrasound to detect uterine fluid has proved useful to identify
mares with a clearance problem.
Excellent management is necessary prior to breeding these types of mares:
Hygiene good hygiene at foaling is essential, and all mares should be thoroughly
examined postpartum for the presence of trauma that might compromise the physical
barriers to uterine contamination. Gynecological examinations, particularly of the vagina,
should be performed as sterile as possible. Pay attention to hygiene at mating by using a
tail bandage and washing the mares vulva and perineal area with clean water (ideally
from a spray nozzle to avoid the need for buckets).
Timing of Breeding: breeding should occur at the optimal time, and the number of
coverings per cycle should be restricted to one to reduce the chance of infection. These

mares need very close monitoring of oestrus by rectal palpation and ultrasonography. The
use of ovulation induction agents (LH) is strongly recommended to ensure they are only
bred once. Prediction of ovulation can also be made easier by not breeding mares too
early in the year: before they have begun to cycle regularly. If feasible the use of artificial
insemination can help reduce (but not eliminate) the inevitable post-breeding
endometritis.
Ultrasound Evaluation of the Uterus: ultrasound can detect intraluminal uterine fluid, in
addition to endometrial cytology and bacteriology before breeding. Even if cytology and
bacteriology have been negative before breeding, mares susceptible to post-breeding
endometritis usually accumulate fluid in the uterine lumen for more than 12 hours after
breeding.

Prior To Breeding
A single breeding must be arranged one to three days before the anticipated time of
ovulation. Most stallion spermatozoa are viable in the mares reproductive tract for at
least 48 to 72 hours after breeding. They can also maintain viability in a proper container
for this period of time. Early breeding allows more time for drainage of fluid via an open
cervix and also utilises the natural resistance of the tract to inflammation during oesturs.
It allows sufficient time to flush the mares more than once before ovulation if necessary.
Treatment for endometritis is ideally performed before ovulation. Progesterone
concentrations rise rapidly in the mare after ovulation, uterine contractility decreases, and
the cervix closes. Progesterone decreases the immune response to inflammation, making
the mare more susceptible to infection. Thus, any post-ovulation treatment has an
increased risk of uterine contamination. In addition, uterine fluid is less likely to drain if
the cervix is beginning to close.
After Breeding
Oxytocin can be given every four to six hours after breeding to cause uterine contractions
to rid the uterus of unwanted fluid. Ultrasound examination of the uterus the day after
breeding can be performed to assess the amount of intrauterine fluid. If more than 2cm of
fluid is present, lavage of the uterus with 1 to 2 litres of warm, sterile saline using a
uterine flushing catheter is performed. During lavage, oxytocin should be given to
stimulate uterine contractions. In cases where the cervix has failed to relax adequately,
digital dilation of the cervix with scrupulous attention to cleanliness is indicated. This
is followed by infusion of antibiotics. Further doses of oxytocin are given every six hours
until the mare is re-examined the next day.
In some mares, the slower release of prostaglandin might be useful in addition to
oxytocin. A single prostaglandin injection should be given some six to eight hours after
the first oxytocin injection.

The mare is re-examined the following day and oxytocin treatment repeated if fluid is
still present. Only rarely will a second infusion of antibiotics or lavage procedure be
performed due to the risk of uterine contamination.

Conclusion
A dirty mare, once inseminated or bred, should not only be checked for ovulation, but
also for fluid accumulation in the uterus. That is one of the most reliable clinical signs of
susceptibility to post-breeding endometritis. If a mare is recognised as being susceptible
to this problem, intensive post breeding monitoring and treatment is necessary to improve
the chances of conception.