Use of a Mycobacterial Cell Wall Extract (MCWE) in Susceptible Mares to Clear Experimentally Induced Endometritis With Streptococcus zooepidemicus

The ability of an immunomodulator, mycobacterial cell wall extract (MCWE), to clear uterine infection in susceptible mares after an experimental challenge withStreptococcus zooepidemicus was evaluated. Thirty mares susceptible to endometritis, based on the presence of uterine fluid during both diestrus and estrus, were selected from a herd of 896 and inoculated with a live culture of 5 × 10⁶ CFU of S. zooepidemicus on day 1 of estrus. Twenty-four hours later, mares were evaluated by ultrasonography, bacteriology, exfoliative cytology, and uterine biopsy to confirm infection. Forty-eight hours after inoculation, and on confirmation of uterine infection, mares were randomly assigned to one of four unbalanced experimental treatments to receive 1500 μg MCWE IU (n = 10) or IV (n = 10), or placebo IU (n = 5) or IV (n = 5). Mares were examined at ovulation and 7 days post-ovulation for uterine fluid via transrectal ultrasonography and for bacteriology, exfoliative cytology, and uterine biopsy. Efficacy was based on the ability of the mare to clear endometritis as determined by negative bacteriology and reduced numbers of polymorphonuclear cells (PMNs) on uterine biopsy. Because no statistical difference was detected between routes of administration on day 7 post-ovulation, the data sets were combined and re-analyzed to evaluate overall efficacy. Endometritis was observed in all placebo-treated mares 7 days post-ovulation, whereas treatment with MCWE resulted in the elimination of endometritis in 35% of the mares by the time of ovulation, and 70% of the mares by 7 days post-ovulation. Treatment with MCWE, compared with the placebo group, resulted in a significant decrease in the number of mares positive for endometritis at ovulation based on exfoliative cytology and bacteriology (P < .01) and at 7 days post-ovulation based on biopsy, exfoliative cytology, and bacteriology (P < .001). Results indicate that MCWE was an effective treatment for the elimination of endometritis caused by S. zooepidemicus in mares.     

Development and Comparison of Sampling Techniques for a Broad Range,Semiquantitative Polymerase Chain Reaction Assay for Detection of Bacterial DNA in the Equine Uterus

Microbial culture from a double-guarded culture swab is commonly used to diagnose infectious endometritis. The objective of this study was to develop a quantitative polymerase chain reaction (qPCR) assay to detect a broad range of bacteria from equine uterine samples. Twenty-seven mares with a clinical history of endometritis had a double-guarded culture swab collected for analysis by qPCR and microbial cultures. An additional 12 mares had a uterine biopsy sample collected for qPCR analysis, microbial culture, and histopathology. Subsequently, a double-guarded culture swab for microbial culture and a cytology brush sample were also collected. The qPCR assay detected bacterial DNA in nine of 27 mares from a double-guarded swab and six of 12 mares from an endometrial biopsy. Positive microbial growth was detected in nine of 27 mares and four of 12 mares from a double-guarded culture swab. Bacterial DNA was detected in two of 27 mares and two of 12 mares without subsequent microbial growth. The simple presence of an organism's DNA allows for detection by nonculture-based systems, both live and dead organisms can be identified. In conclusion, the qPCR assay was determined to be a sensitive diagnostic technique for identifying pathogens associated with infectious endometritis. The primary application of the qPCR assay is detection of potential pathogenic bacteria in the uterus of a mare suspected of having infectious endometritis when a traditional microbial culture is negative. Further work is warranted to determine if mares positive for bacterial DNA and negative for microbial culture are affected clinically.     

The Use of Endometrial Biopsy in the Infertile Mare

The results of a study on endometrial biopsies obtained from 700 infertile mares are reported. Infiltrative endometritis was present in 51% consisting of a combination of an acute and chronic cellular response in 6%, mild chronic infiltrations in 35% and moderate to severe chronic infiltrations in 10%.

Demonstrable endometrial fibrosis was found in 88% of the mares with the majority having mild (51%) or moderate (35%) changes. The age of the mares and the average number of years barren gradually increased with the severity of endometrial fibrosis, as did the combined incidence of fetal loss (early embryonic death and abortion) during the three year period preceding the biopsy.

A significant decrease in foaling percentage for the year following the biopsy was observed with increasing severity of endometrial fibrosis. Chisquare analysis projected a decrease in foaling rate of 22.8% for each category increase in severity.

The number of years barren and the farm management system used also had a significant effect on foaling probability. The foaling rates for mares that were bred artificially (82%) under strict veterinary supervision using an extender incorporating gentamicin were significantly (P < 0.05) higher than for mares bred in a conventional manner under average management conditions (48%).

It was concluded that endometrial biopsy is a valuable diagnostic and prognostic technique. When the degree of fibrosis is used to predict foaling probability, the number of years barren and the breeding method to be used should also be considered to arrive at a more accurate prediction.

     

Endometritis in the mare caused by a Coryneform organism--a case report and experimental studies

Persistent purulent endometritis in a mare was attributed to an unclassified species of Corynebacterium. Following intrauterine infusions of 20% betadine for 5 days the purulent vulval discharge ceased and the mare appeared clinically normal. Based on histological examination of endometrial biopsy samples, the severe acute inflammatory reaction had largely resolved 2 days after therapy. Three maiden mares considered resistant to bacterial endometritis received single intrauterine inoculations of 1.8 X 10(9) colony-forming units of the Corynebacterium species. The uterine response was followed by vaginal speculum examinations, uterine cultures and cytology, and endometrial histology. After an acute inflammatory reaction, each mare had recovered completely within 2 weeks. Most rapid recovery occurred in the mare in estrus at the time of inoculation. Subsequent secondary infections were detected in two mares. The uncertainty of correlations between results obtained by various diagnostic techniques emphasized the problems associated with each. This report illustrates the concept that endometritis in individual mares may relate more to as yet unidentified "mare factors" controlling uterine defense than to primary invasion by bacteria.     

The Effects of Treatment with N-Acetyl Cysteine on Clinical Signs in Persistent Breeding-Induced Endometritis Susceptible Mares

Persistent breeding-induced endometritis (PBIE) is a major cause of infertility in mares. Endometrial inflammation that persists until embryonic descent ultimately results in early embryonic death. A poor endometrial biopsy grade (IIb or III) has been identified as a risk factor for PBIE. Intrauterine fluid accumulation (>2 cm in depth), pathologic endometrial edema, and elevated intrauterine neutrophil levels are all clinical features of PBIE. Commonly applied treatment options include uterine lavage and oxytocin therapy. N-acetyl cysteine (NAC), a mucolytic used to treat bacterial endometritis in mares, has anti-inflammatory properties and was investigated as a potential treatment for PBIE. A randomized, blinded, cross-over design clinical trial used NAC before breeding in PBIE-susceptible mares (n = 9). Intrauterine infusion of 3.3% NAC was performed 12 hours before insemination, and endometrial cytology and endometrial biopsy samples were obtained at 12 and 60 hours after insemination. Endometrial biopsies were evaluated for the degree of inflammation present. Clinical signs of endometrial edema and intrauterine fluid volumes were assessed by transrectal ultrasound at 12 and then every 24 hours after breeding. Data were analyzed using repeated measures analysis of variance and a Mann Whitney Wilcoxon Test. Treatment with NAC did not improve clinical signs in PBIE-affected mares. However, endometrial biopsies from mares treated with NAC displayed more diffuse and severe neutrophil infiltration than control cycles. Further research using a larger population of mares is required to evaluate the effects of NAC treatment on the endometrium of PBIE-susceptible mares.     

Escherichia coli Lipopolysaccharide-Induced Immunomodulation Along With Oxytocin Administration After Mating as a Treatment Protocol for Persistent Endometritis in Mares

Endometritis is accepted as a major hindrance to achieve optimal reproductive efficiency in mares. The objective of the present study was to evaluate the therapeutic efficacy of combined therapy of immunomodulator and ecbolic as an alternative stand-alone therapy for mares with persistent endometritis. On the basis of history, culture, endometrial cytology, and per rectal and/or ultrasonographic genital examinations, 76 subfertile mares were selected and assigned to three age groups and four treatment (G-1, 2, 3) and control (G-4) groups. At estrus, all the mares were bred once naturally. Thereafter, the mares of G-1 (n = 28) were aseptically treated at 6-hours after natural service with intrauterine infusion (in 50 mL normal saline solution) of 100 μg of Escherichia coli lipopolysaccharide (LPS). Additionally, these mares received two injections of 20 IU of oxytocin (IV) at 12 and 24-hours after infusion. Mares in group G-2 (n = 11) were treated with LPS as mares of G-1, whereas mares in G-3 (n = 12) received oxytocin injections only. The mares of G-4 (n = 23) did not receive any treatment. Pregnancy rates at day 21 and foaling rates were higher (P < .001) in group G-1 than in G-4. In G-1, higher percentage of mares at ages 6–10 years conceived and foaled than mares aged ≥16 years. On re-swabbing of mares that remained nonpregnant, the majority of G-1 and G-2 mares demonstrated sterile cultures and negative cytology, whereas uterine inflammation persisted in mares of G-3 and G-4. In conclusion, the combined therapy was effective for the elimination of persistent endometritis and improved reproductive performance of subfertile mares.     

The technique and clinical application of endometrial cytology in mares

Experimental studies of endometrial smears from 26 normal mares showed that after a period of sexual rest exceeding 7 days smears were generally free from inflammatory cells. Smears from 9 mares showing signs of persistent endometritis contained inflammatory cells in 91 per cent while bacterial culture was positive in only 45 per cent. Smears were also taken from 242 Thoroughbred mares as a routine procedure in 1977. It was concluded that endometrial cytology provides a better guide to uterine inflammation than bacteriology. The routine clinical use of endometrial cytology is recommended to aid the interpretation of both positive and negative bacterial cultures from the cervix.     

Results of bacteriological and cytological examinations of the endometrium of subfertile mares in stud farms in Serbia

Uterine microbiology, antimicrobial susceptibility and endometrial cytology were investigated in a total of 51 mares with fertility problems from 16 different stud farms in Serbia. Uterine cultures were performed after collection with a double guarded uterine swab, and endometrial cytology was evaluated after collection of endometrial cells with a special device (cytology brush). In 21 of 51 mares, at least one bacterial species was isolated from the uterus; the most frequent were Streptococcus equi subsp. zooepidemicus (13 isolates) and E. coli (four isolates). All isolates of Streptococcus equi subsp. zooepidemicus were susceptible to penicillin. Results from endometrial cytology were inconsistent; in 17 animals with positive bacteriological culture, cytology was not altered. It can be concluded that in Serbia, as in many other contries, Streptococcus equi subsp. zooepidemicus is the main cause for equine endometritis. It can be easily diagnosed by uterine culture but endometrial cytology does not always prove the existence of an endometrial infection with this agent.     

Changes in malondialdehyde concentrations and glutathione peroxidase activity in purebred Arabian mares with endometritis

Endometritis is an important factor in infertility. Free radicals play an important role in endometritis and we have investigated their possible role and scavenging systems in endometritis in purebred Arabian mares. The plasma concentration of malondialdehyde (MDA) and erythrocyte glutathione peroxidase (GPx) activity were compared in healthy mares and in mares with endometritis. The level of MDA was significantly increased while GPx activity was decreased in the mares with endometritis. Our findings support the notion that GPx is consumed by increased lipid peroxidation in purebred Arabian mares affected with endometritis.     

Comparison of endometrium before and after repair of third-degree rectovestibular lacerations in mares.

The endometrial response of mares to repair of third-degree rectovestibular lacerations was evaluated. Endometrial biopsy specimens from 8 mares with third-degree rectovestibular laceration were obtained immediately before surgery and from 9 to 15 days after repair. Presurgical endometrial biopsy specimens were classified as category I for 2 mares; category II, attributable to slight endometritis, for 5 mares; and category III, attributable to moderate-to-severe endometritis, for 1 mare. Within 15 days after rectovestibular repair, all endometrial biopsy specimens were classified as category I. Results indicated that mares with third-degree rectovestibular injuries are candidates for breeding by artificial insemination by 2 weeks after repair of the injury.     

Degenerative Endometrial Changes do not Change the Functional Capacity of Immigrating Uterine Neutrophils in Mares

An endometritis model was used to investigate the influence of degenerative endometrial changes (endometrosis) on functional parameters of uterine neutrophils in the horse. Six hours after intrauterine application of recombinant human interleukin‐8 (rhIL‐8), the uteri of 15 mares were flushed with phosphate‐buffered saline. Quantitative and qualitative flow cytometric assays were then made to determine the absolute numbers, viability, phenotype, generation of reactive oxygen species (ROS), and phagocytic activity of immigrated polymorphonuclear neutrophilic granulocytes (PMN). Recombinant hIL‐8 attracted similarly high numbers of similarly viable PMN into the uteri of mares with or without degenerative endometrial changes. Compared with blood PMN, immigrated uterine neutrophils displayed significantly upregulated expression of CD11a/CD18 (LFA‐1) on uterine PMN whereas major histocompatibility complex class I molecules were expressed at lower densities. The ability to phagocytose opsonized streptococci did not differ between uterine and blood PMN. However, uterine PMN displayed a higher capacity to generate ROS. On average, uterine PMN of mares with degenerative endometrial changes showed phenotypical and functional characteristics similar to those of mares with a histologically healthy endometrium. Therefore, degenerative endometrial changes per se did not reduce the functional capacity of equine uterine neutrophils in mares.     

Consequences of Intrauterine Enrofloxacin Infusion on Mare Endometrium

Endometritis is an important cause of infertility in mares. Enrofloxacin is a broad-spectrum antibiotic to which most equine endometritis pathogens are not resistant. The objective of this study was to determine whether enrofloxacin is safe to use as a conventional intrauterine infusion treatment. Nine healthy mares received intrauterine infusions of enrofloxacin (Baytril 100, 100 mg/mL, Bayer Health Care LLC, Animal Health Division) at 2.5 mg/kg daily for 3 days. Ultrasonographic examination and vaginal examinations were performed during the study. Endometrial biopsies were performed before treatment (S0) and 24 hours after the last treatment (S1) to evaluate acute effects. For evaluating chronic effects, biopsies were performed at 14 days (S2) and 60 days posttreatment (S3). Biopsies were graded histologically by the Kenny and Doig category scale. Difference in histological biopsy grade before and after treatment was compared between biopsies by using a repeated-measures one-way analysis of variance. and significant changes in grades were used to assess treatment effects. The vaginal and ultrasonographic examination after intrauterine infusion of enrofloxacin showed that all mares had severe purulent vaginitis and uterine fluid accumulation of ≥2 cm, with ≥1.5-cm thickening of the endometrial wall which persisted in most mares until the end of the study. Histologically, there was acute endometrial ulceration, necrosis, and hemorrhage in biopsy S1 in all mares, categorized as grade III. In biopsy S2, most mares developed fibrosis and inflammation graded as IIb (four of nine mares) or III (four of nine mares). In biopsy S3, fibrosis was extensive and had variable inflammation, graded as IIb (two of nine mares) or III (five of nine mares), with some mares healing to grade IIa (two of nine mares). There was an overall worsening of endometrial biopsy grade from I to III at S3 compared with S0 (P < .001). These results confirm that enrofloxacin is not suitable for conventional intrauterine infusion treatment in mares.     

Technique and interpretation of cervical and endometrial cytology in the mare

This paper illustrates and describes the findings obtained from cervical and uterine cytology smears in the mare. Cervical/endometrial cytology is a simple technique that provides valuable information to the clinician regarding the existence of an acute or active endometritis. The most frequent observation is the presence of neutrophils. Chronically infected/inflamed mares with some degree of inflammatory cellular infiltration can also be identified on the cytology smear by the presence of neutrophils, macrophages and lymphocytes. Microorganisms are sometimes found with either acute or chronic endometritis.

This technique is not a substitute for uterine culture and biopsy. The correct identification of bacteria should be based on the cultural characteristics of the microorganisms.     

Feasibility and Safety of Endometrial Injection of Autologous Bone Marrow Mesenchymal Stem Cells in Mares

​Chronic degenerative endometritis (CDE) is an important cause of fertility problems in older mares. It is estimated that 30% of mares breeding are over 18 years old and the high value of their progeny encourages the use of these animals in assisted reproduction procedures. Currently, cell-based therapies are broadly used in human and veterinary regenerative medicine and have been showed a good effect on the treatment of liver fibrosis. Thus, the present study aimed to evaluate the feasibility and safety of endometrial injection of autologous bone marrow MSCs in mares. Mares were examined by transrectal ultrasound and the endometrial stem cells injections performed during diestrous, using injection needles coupled to a teflon catheter through the biopsy channel of a flexible endoscope. After treatment clinical evaluations (heart reat, respiratory rate, staining of the mucosa, capillary refill time, body temperature and lameness score) were performed daily during seven days. The intrauterine fluid and endometrial edema was evaluated before, 24 and 48 hours after the procedure by ultrasonographic exams and the inflammatory infiltrate (polymorphonuclear cells and mononuclear cells) and degree of fibrosis by histological evaluations before (D0) and 15 (D15), 30 (D30) and 60 (D60) days after endometrial injections. The results were evaluated by Kolmogorov-Smirnov and Kruskal-Wallis test followed by Dunn test and for fertility rates was used Chi-square, considering a 5% significance level. Neither clinical alteration was observed in mares after treatment, as well as, intrauterine fluid and endometrial edema were not detected in any mare before and after cell therapy. After cell therapy, significantly more PMNs were found in D15 biopsies, however, these cells were not observed in D30 and D60 biopsies. No worsening on the histological architecture after treatment was observed in any mare. In conclusion, the results of this study showed that endometrial hysteroscopic injections of stem cells in mares is a safe procedure.     

Equine endometrial cytology: Collection techniques and interpretation

Endometritis is an important cause of reproductive pathology in the horse. Endometrial cytology preparations from unguarded swabs, guarded swabs or brushes, cap of a guarded swab, low volume lavage or even an endometrial biopsy sample can be utilised to rapidly evaluate uterine health. These cells can easily be stained with a modified Wright's stain and evaluated for the presence or absence of inflammatory cells and pathogens. Commonly visualised cell types are easily identified with a traditional light microscope at 400× or 1000× magnification. This technique provides an easy and rapid way to diagnose endometritis in the horse.     

Estimating prevalence of endometritis in smallholder zero-grazed dairy cows in Rwanda

Endometritis is a postpartum uterine disease of cows that interrupts reproductive cycles resulting in suboptimal fertility, reduced performance and profitability of the dairy herd. The objective of the study was to estimate the perceived and observed prevalence of endometritis among zero-grazed dairy cows in smallholder farms in Rwanda. A snowball sampling method was applied in cross-sectional survey to obtain data from 370 farms on 466 cows within their 21–60 days postpartum (dpp). The survey, conducted from September 2018 to March 2019, simultaneously examined cows using the Metricheck Device (MED) to determine the presence and type of vaginal mucus (VMC) based on a score scale of 0 to 3. Cows scoring VMC ≥ 1 were recorded as clinical endometritis (CLE)–positive. Cytotape (CYT) was used to determine the percentages of polymorphonuclear cells (PMN) in endometrial cytology sample. Cows with ≥ 5% PMN were recorded subclinical endometritis (SCLE)–positive, whereas cows with VMC-0 and < 5% PMN were considered healthy cows. At cow-level, endometritis prevalence was 70.2% with 67.2% CLE and 31.8% SCLE while at the herd-level, prevalence was 71.1% with 68.1% CLE and 34.4% SCLE. The differences between the diagnostic performance of the MED and CYT were significant (p < 0.001). Perceived prevalence by farmers was much lower (3.2%) and without agreement with the observed prevalence (kappa = − 0.02, p > 0.05). The highly observed prevalence and farmer underestimation of endometritis prevalence indicate knowledge gaps about endometritis. The extension service therefore needs to increase awareness and education among smallholder farmers about detection and management of endometritis.

     

Efficiency of uterine fluid cytology in the diagnosis of subclinical endometritis in the water buffalo (Bubalus bubalis)

This study compared endometrial cytology vis‐a‐vis uterine fluid cytology for assessment of uterine health in clinically normal and subclinical endometritis (SE)‐affected buffaloes. Uterine fluid samples and endometrial samples were collected from the buffaloes (n = 38) at oestrus using blue sheath and cytobrush, respectively. The smears were stained with Field stain for 3 minutes, and a minimum of 400 cells were counted in each smear for determination of the percentage of polymorphonuclear (PMN) leucocyte. The incidence of subclinical endometritis, based on the cytobrush cytology, was 23.08%. The correlation between cytobrush cytology with uterine fluid cytology was positive and significant (r = .37; p = .02). The ratio of PMN leucocyte in cytobrush cytology to uterine fluid cytology was 1:2.4. ROC analysis revealed that the threshold value of 6.16% PMN leucocyte in uterine fluid cytology showed a diagnostic sensitivity and specificity of 100% in differentiating normal from SE‐affected buffaloes. In conclusion, collection of uterine fluid was easier compared to collection of endometrial samples using cytobrush and the percentage of PMN leucocyte in uterine fluid cytology can be used as a tool for diagnosis of subclinical endometritis in buffaloes.     

Experimental Bovine Genital Ureaplasmosis II. Granular Vulvitis, Endometritis and Salpingitis Following Uterine Inoculation

Twenty-three virgin Holstein heifers received uterine inoculations with ureaplasma and were necropsied one to thirteen days later. Three heifers inoculated intracervically were necropsied on days 3, 5 and 11.

Granular vulvitis was produced on average by 3.6 days in fourteen of sixteen uterine inoculated heifers monitored for four or more days. Two cervically inoculated heifers monitored for over four days also developed granular vulvitis by the fourth day.

At necropsy, ureaplasma was recovered from 94% of uterine horn cultures for the first four days postinoculation and 50% during days 5 to 7. Thereafter all uterine cultures were negative. The percentage of positive ureaplasma recoveries from uterine tube flushings was lower than for uterine horns but remained positive for a longer period. By day 7, three of four uterine tube flushings were still positive. No bacterial pathogens were isolated from the uterine horns or uterine tube flushings.

On histopathology 50% of uterine inoculated heifers had endometritis up to six days postinoculation and a slightly higher percentage (58%) had salpingitis. Endometritis was not found in any heifers after day 6. Residual salpingitis was present in one heifer on day 7. Endometritis was present in cervically inoculated heifers necropsied on days 3 and 5 but not on day 11. Salpingitis was not found in any of the three cervically inoculated animals.

The study concluded that some strains of ureaplasma are pathogenic for the upper reproductive tract of the cow and should be considered significant when isolated from cases of granular vulvitis, endometritis or salpingitis.

     

Endometrial nitric oxide synthase activity in mares susceptible or resistant to persistent breeding‐induced endometritis and the effect of a specific iNOS inhibitor in vitro

Emerging research suggests that the nitric oxide system may play a role in persistent breeding‐induced endometritis (PBIE) in the mare. Differences in uterine nitric oxide (NO) levels between mares susceptible or resistant to PBIE and a dose‐dependent inhibitory effect of NO on uterine contractility have been demonstrated. The objectives of this study were to investigate the difference in total nitric oxide synthase (NOS) activity of the endometrium between susceptible and resistant mares and the effect of a specific inducible nitric oxide synthase (iNOS) inhibitor on the endometrial NOS activity in vitro. Six susceptible and six resistant mares were selected based on preset criteria and the results of an intrauterine challenge with killed spermatozoa during oestrus. Endometrial biopsy samples were collected 24 hr post‐challenge and cultured at 37°C for 24 hr in L‐arginine supplemented minimum essential medium with or without a specific iNOS inhibitor (1,400 W dihydrochloride, 1 mM). The medium and the cultured endometrial tissue were collected after 24 hr of culture and assayed for NO and total protein, respectively. Total NO content of the medium, normalized to endometrial tissue wet weight or total protein, was used as a measure of endometrial NOS activity. Non‐parametric tests were applied for statistical analysis. Susceptible mares had significantly greater endometrial NOS activity than resistant mares. The iNOS inhibitor treatment significantly reduced NOS activity in endometrial samples derived from susceptible and resistant mares. These findings provide a basis for in vivo testing of specific iNOS inhibitors as preventative or therapeutic options for PBIE in mares.     

Endometrial biopsy in mares under nonuniform breeding management conditions: Prognostic value and relationship with age

Endometrial biopsy plays an important role in fertility examination of the mare. The purpose of this study was to examine the prognostic usefulness of endometrial biopsy under nonuniform breeding management conditions, and to clarify any relationship with age of the mare. Based on endometrial histological changes, 192 mares from different farms were classified using a four-category grading system. There were significant associations between categories and fertility. Mean pregnancy rates in the four categories were 79, 49, 33 and 0% and mean foaling rates were 70, 42, 18 and 0%, respectively. Mares older than the median age (=11 years) had, on average, higher category scores and significantly lower fertility than younger mares. Within categories, there was a tendency towards higher fertility in younger mares. Although the precise prediction of fertility of the individual mare remains difficult, it is evident from this investigation that endometrial biopsy has considerable prognostic potential even under nonuniform breeding management conditions. Furthermore, the age of a mare must be considered when estimating her fertility potential.