Most major infertility problems are complex and several factors can cause failure to produce offspring. In the last few years, much of the efforts of practitioners and researchers working in equine breeding industry have been directed to individuate the pathophysiological mechanisms underlying poor reproductive performances in mares. Endometritis is on the talk in much of the recent research as the most frequent cause of subfertility in mares that cycle normally but do not conceive and in mares that cycle normally and conceive but then suffer early embryonic death. Post-breeding persistent endometritis, bacterial and other infective endometritis and poor uterine clearance have all been discussed in an attempt to define risk factors and a diagnostic algorithm. The aim of this chapter is to perform a thorough review of recent literature about endometritis. The diagnostic algorithms are carefully examined, highlighting pros as well as pitfalls of each diagnostic aid. Suggested therapeutic protocols are examined in the effort to detect what is actually recommended and what would better benefit from further corroboration. The idea that a better etiopathogenetical understanding of the endometritis remains the key to access to a correct diagnostic protocol and to a successful therapeutic plan will inspire this chapter.
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