Clinical application of hysteroscopic hydrotubation for unexplained infertility in the mare

Abstract

This study revealed that hysteroscopic hydrotubation using saline improved pregnancy rates in mares in which oviductal blockage was suspected as a cause of unexplained subfertility.

The Use of Hysteroscopy to Identify and Treat Reproductive Tract Abnormalities in the Mare

“…This allows for evaluation of the internal os of the oviduct as well as patency. Subsequent studies showed that hydrotubation with flushing of the oviduct results in improved conception in mares with unexplained infertility (Inoue and Sekiguchi 2018;. After hysteroscopic guided catheterization and flushing 26 of 28 mares became pregnant.…”

Clinical insights: Assisted reproductive techniques: More than a solution to subfertility?

“…A further impediment to sperm–oocyte interaction and, in particular, the subsequent descent of the fertilised embryo into the uterus, is occlusion of the ampulla by accumulations of inspissated follicular fluid, unfertilised oocytes or degenerate embryos which do not secrete the prostaglandin E2 required to initiate their descent into the uterus. Administering PGE2 onto the surface of the oviduct laparoscopically is one way to salvage fertility in mares presumed to be suffering from oviductal occlusion 6 ; recently, endoscope‐guided flushing of the oviducts via the uterus (“hysteroscopic hydrotubation”) was shown to be a valid alternative treatment for re‐establishing oviductal patency in mares, while avoiding the risks of laparoscopy 7 . Of course, oocyte recovery for oocyte transfer or fertilisation by intracytoplasmic sperm injection (ICSI) is also a way to salvage fertility in the case of oviductal occlusion.…”

“…Administering PGE2 onto the surface of the oviduct laparoscopically is one way to salvage fertility in mares presumed to be suffering from oviductal occlusion 6 ; recently, endoscope-guided flushing of the oviducts via the uterus ("hysteroscopic hydrotubation") was shown to be a valid alternative treatment for re-establishing oviductal patency in mares, while avoiding the risks of laparoscopy. 7 Of course, oocyte recovery for oocyte transfer or fertilisation by intracytoplasmic sperm injection (ICSI) is also a way to salvage fertility in the case of oviductal occlusion.…”

Clinical insights: Assisted reproductive technologies

“…Since there are risks associated with entering the peritoneal cavity, the recently described success of hysteroscopic hydrotubation (i.e. retrograde flushing of the oviducts via the uterotubal junction) for resolving unexplained infertility may make it an attractive alternative. In sport horses, by contrast, OPU‐ICSI is rapidly becoming a first‐line approach to tackle sub‐fertility, irrespective of the cause.…”