SummaryA transient mating-induced endometritis is most likely physiological in the mare, serving to remove excess spermatozoa, seminal plasma, and contaminants from the uterus. However, the inflammatory reaction has to be resolved and inflammatory products cleared from the uterus prior to embryonal descent into the uterine lumen. Mares that fail to clear a semen-induced inflammation from the uterus develop a persistent mating-induced endometritis which may result in infedility. lf susceptibility to persistent mating-induced endometritis is suspected, the mare should be monitored by transrectal ultrasonography for intrauterine fluid accumulation at 6-1 2 hours intervals after breeding. Treatment should be aimed at assisting the uterus to physically clear contaminants and inflammatory products. Post-mating uterine lavage and/or the use of uterotonic drugs are recommended aI 6 12 hours after breeding in mares susceptible to persistent endometritis. Endometritis is a major cause of subfertility in the mare and has a significant economic impact on the equine industry (Dimmock 1939; Collins, 1964;Bain, 1966;Hughes et al., 1966;Ricketts 1975; Gordon and Sarlin, 1978;Kenney, 1978; Doig et al., 1981; de la Conch-Bermejillo and Kennedy, 1982;Traub-Dargatz et al., 7997J. Based on the current understandjng of its etiology and pathophysiology, endometritis should be considered as a multifactorial disease with at least four different causes: (1) sexually transmitted diseases, (2) chronic infectious endometritis, (3) persisting mating-induced endometritis, and (4) endometrosis (chronic degenerative endometritis). Sexually transmitted diseases and chronic infectious endometritis are often diagnosed first after the invading microorganism already has adhered to the endometrial epithelium and started its replication in the uterus. Similar to infectious diseases in other organ systems, infections in the female reproductive tract (sexually transmitted endometritis and chronic infectious endometritis) are most effectively treated with an appropriate antic t o microbial. In contrast to infectious endometritis, matinginduced endometritis has a known starting point and treatment can therefore, be initiated before the infection or inflammation has established itself in the endometrium. This report will review the therapeutic aspects and pathophysiology (as it relates to therapy) of mating-induced endometriti s .
Pathophysiology of mating-induced endometritisRegardless of if mares are bred by natural service or by artificial insemination, semen is deposited directly into the uterus. This provides an excellent oppodunity for uterine contamination with bacteria. In addition, recent reporls have shown that soermatozoa without bacterial contamination induce an uterine inflammatory response (Kotilainen et al., 1994; Troedsson, 1995; Troedsson et al., 7995a). RaIher than considering a transient post-mating endometritis as a pathological condition, mating-induced endometritis isPferdeheilkunde 13