Cervical Catheterization Research Articles

Use of Xylocaine to facilitate embryo transfer to Welsh pony recipient

Embryo transfer is a commonly used procedure in equine breeding worldwide. Embryos are trans-cervically transferred into the recipient uterus on Day 5 or 6 after ovulation and expected pregnancy rates range from 65 to 85% and 50 to 75% at days 14 and 45, respectively. Poorer results in pony mares may be attributed to the difficult passage of the cervix and the subsequent contamination of the cervix and/or release of inflammatory products. Paracervical block, i.e. local anesthesia of the cervical area is routinely used for gynecological procedures, such as intrauterine device placement, in women (Mody et al. Obstet Gynecol. 2018; 132(3): 575–582) but has not been reported for similar procedures in the equine. The present study aimed to evaluate the benefits of the application of an anesthetic gel on the cervix before transfer to facilitate the introduction of the transfer gun. Twenty-one grade 1 embryos (one morula and 20 blastocysts), 166-1300µm in diameter (mean±SEM=422±52µm), were collected from Welsh B pony mares at day 7 after ovulation. After collection, embryos were evaluated and conventionally transferred transcervically to recipient pony mares, under 8 years ofage, at day 5, 6, or 7 after ovulation (1 embryo per recipient). In the xylocaine group (XYL), 11 embryos were transferred 10 min after the application of 3ml of xylocaine gel (Xylocaine® gel 2%, AstraZeneca) at the base of the recipient's cervix. Ten other transfers were routinely performed without xylocaine as a control group (CTRL). Pregnancies were monitored by ultrasonography at day 14 and until an embryonic heartbeat was detected at day 21 days. In XYL, 8 (73%) and 6 (55%) recipients were pregnant on day 14 and 21, respectively. In CTRL, 6 (60%) and 4 (40%) recipients were pregnant on day 14 and 21, respectively. While, slightly better in XYL, both at day 14 and day 21, pregnancy rates were not statistically different between groups (P=0.66 and P=0.67 respectively). No significant difference was also obtained between the day of transfer for both groups (P>0.05). Transfers in XYL were subjectively found to be smoother by the operators. It can be concluded that the application of xylocaine on the recipient's cervix does not interfere with early gestation development and may ease cervical catheterization in pony mares. Further work with larger numbers is required to evaluate its potential benefits on transfer outcomes.

Feasibility, tolerability, and safety of hysterosalpingo-foam sonography (hyfosy). multicenter, prospective Spanish study

OBJECTIVETo determine the feasibility,tolerability, and safety of the ultrasound assessment of tubal patency using foam as contrast. METHODSThis was a prospective multicenter study of 915 infertile nulliparous women scheduled for sonohysterosalpingography with foam instillation (HYFOSY) for tubal patency testing as a part of the fertility workup. Clinical and sonographic data were recorded into a web-shared database. Tubal patency, cervical catheterization, pain during the procedure and post-procedural complications were collected. Patients reported discomfort or pain experienced during the procedure with a visual analogue scale (VAS) score. RESULTSNine hundred fifteen women were included in the final analysis. Median age was 34 (range, 21−45) years and median body mass index was 23 (range, 16−41) kg/m2. Of 839 women, only 8(0.95 %) cases were abandoned due to impossibility of introducing the intracervical catheter. Most of the cervical os were easily cannulated with either paediatric nasogastric probes or special catheter for intrauterine insemination / sonohysterosalpingography 688/914(75.3 %). With a median instillation of 4 mL (range 1−16) of foam, both tubes were identified in 649/875 (70.9 %) patients, while unilateral patency was observed in 190/875 (20.8 %). Only 36/875 (3.9 %) of the women had bilateral tubal obstruction. The median VAS score for perception of pain during HyFoSy examination was 2 (range 0−10), and only 17 (1.9 %) of women reported severe pain (VAS ≥ 7). Pain was unrelated to tubal patency or tubal blockage. Unexpectedly, difficult cervical catheterizations that needed tenaculum, were more likely associated with mild pain during procedure [nasogastric probe group 176/289 (70.9 %) vs. insemination catheter group 166/399 (41.6 %) vs. tenaculum group 190/218(87.2 %) p < 0.001]. Finally, among 915 patients, we only noticed 3 (0.32 %) complications of the technique: two vasovagal episodes and a mild urinary infection. CONCLUSIONHYFOSY is a feasible, well-tolerated and safe technique for the evaluation of tubal patency in infertile women.

Hysterosalpingography using Magnetic Resonance Imaging for infertility patients.

Objective:Some studies have shown that it is possible to evaluate tubal permeability through MRI. Our aim is to perform a prospective study and to perform a comprehensive review in the literature regarding HSG-MRI.Methods:We carried out a PUBMED search using the following keywords: hysterosalpingogram, hysterosalpingography, magnetic resonance imaging and MRI. As inclusion criteria, we included only papers published in English, and exams ran on humans. We also conducted a prospective inclusion of patients who had visited a human reproduction clinic between May/2017 and April/2019 for laboratory image diagnoses using HSG-MRI.Results:Following the inclusion and exclusion criteria, we included seven original papers. Review papers and those written in a language other than English, were excluded. Between the period of May/2017 and April/2019, we selected ten patients for our study. The average exam duration was 30 minutes. Cervical catheterization was possible in all cases. There were no major complications. We highlight that in 8/9 of patients, we could directly visualize uterine tubes with contrast (excluding one patient with bilateral tubal ligation).Conclusions:Our initial experience with HSG-MRI shows promise. We demonstrated an optimized protocol for conducting an HSG-MRI (with excellent image quality). HSG-MRI had some advantages, such as not using ionized radiation, less pain and being able to analyze pelvic anatomy. Patients referred for a pelvic MRI as part of a more detailed investigation into infertility can also benefit from undergoing a simultaneous HSG using MRI.

Effect of reduced glutathione (GSH) in canine sperm cryopreservation: In vitro and in vivo evaluation

The aim of this study was to compare the in vitro and in vivo efficiency of different concentrations (0, 10 and 20 mM) of reduced glutathione supplemented to the extender for canine semen cryopreservation. Six normospermic dogs were used and each ejaculate was divided in 3 experimental groups, according to GSH concentration (GSH-0, GSH-10 and GSH-20 Groups). After thawing, samples were evaluated by sperm motility by computer-assisted sperm analysis (CASA), flow cytometric evaluation of plasma and acrosome membrane integrity, mitochondrial membrane potential and activity, chromatin susceptibility to acid-induced denaturation, and measurement of spontaneous and induced production of thiobarbituric acid reactive substances (TBARS). In vivo tests were carried out with GSH-0 and GSH-10 groups, for which six bitches were inseminated with semen cryopreserved in extender without GSH or containing 10 mM GSH. Intrauterine insemination was performed by cervical catheterization on the 5th and 6th days after the LH surge, detected by serum progesterone and LH assays. In the CASA evaluation, GSH-20 group had the lowest total and progressive motility and lower percentage of sperm with rapid and slow speed. Groups treated with glutathione showed lower percentage of acrosome damage, but higher percentage of plasma membrane injury. GSH-20 group had higher percentage of sperm with low mitochondrial activity and higher concentration of induced TBARS. Both groups (GSH-0 and GSH-10) had positive pregnancies. In conclusion, 20 mM GSH supplementation to canine cryopreservation extender promoted sperm damage, especially to mitochondrial activity. However, addition of 10 mM GSH resulted in acrosome protection, preserving fertility rate.

Endoscopic transcervical catheterization in the domestic cat.

Feline-assisted reproduction is still not routinely performed in veterinary practice, although there is an increasing interest on the subject by cat breeders. In recent years, many techniques for artificial insemination in the domestic cat have been developed with regard to the intrauterine deposition of sperm through the catheterization of the cervix. Transcervical catheterization has been described also for diagnostic and therapeutic purposes. This article provides the first description of a new method for cervical catheterization, under the direct visualization of the cervix, using a rigid endoscope and a new specially designed transcervical catheter. The procedure was performed on 14 queens with a success rate of 85.71%.

Transcervical artificial insemination in dogs and cats: review of the technique and practical aspects.

The technique of transcervical catheterization for artificial insemination has gained practical importance over the last 3 and 1 decades in bitches and queens, respectively. The vagina of both species has a thickening of the dorsal aspect called dorsal medial fold, which restricts the lumen of the paracervix, making catheterization of the cervix difficult both with manual and endoscopic techniques. Manual catheters have been used initially in the bitch and are now gradually being replaced by rigid endoscopy through the adaptation of human cystoscopes and ureteroscopes. Cystoscopes provide excellent imaging of the vagina, but cervical catheterization is more difficult due to the oblique 30° viewing angle of its telescope and may not be long enough to catheterize large size bitches. Ureteroscopes allow an acceptable view of the vaginal mucosa and offer advantages such as the possibility to catheterize the cervix of bitches of all body sizes, manipulate the cervical tubercle when the external cervical os is not visible, offer a better visualization of the cervix using the shunt (a large Foley catheter which allows insufflation and distention of the vagina). Feline cervical catheterization has been achieved with three different types of catheters; the last one, developed following careful anatomical studies of how the feline vaginal lumen changes during estrus, allows cervical catheterization thanks to digital manipulation of the cervix through the rectum.

Endometritis subclínica diagnosticada mediante cytobrush y comportamiento reproductivo en vacas del municipio de Pupiales, Colombia

Objetivo: determinar la distribución de endometritis subclínica y el comportamiento reproductivo de vacas lecheras diagnosticadas mediante citología endometrial, del municipio de Pupiales, Nariño. Materiales y métodos: se realizó evaluación reproductiva (palpación rectal, ultrasonografía y evaluación del mucus vaginal) para determinar la ausencia de gestación temprana y de signos clínicos de infección uterina, y mediante cateterismo cervical y la técnica cytobrush se muestrearon 174 vacas a partir de los 30 días posparto. Posteriormente, se organizó la población objeto de estudio con base en su función ovárica (vacía ciclando normal o en anestro) y el estatus del útero (con presencia de endometritis o sin esta). Resultados: 43 vacas (24,7 %) presentaron cambios celulares indicativos de un proceso inflamatorio activo originado en endometrio. El 79,06 % de los animales diagnosticados con endometritis subclínica estaban cíclicas y tenían un bajo desempeño reproductivo. Conclusión: se determinó el alto impacto que tiene la endometritis subclínica en la fertilidad y en la eficiencia reproductiva. Se debe realizar una evaluación reproductiva temprana en conjunto con pruebas que permitan determinar la presencia de afecciones subclínicas concomitantes.

Embryo quality and transcervical technique are not the limiting factors in donkey embryo transfer outcome

Embryo transfer (ET) in the donkey resulted in a very low recipient pregnancy rates. The aim of these studies was to investigate if nonsurgical transfer techniques or donkey embryo quality affect donkey recipient pregnancy failure. In Study 1, the impact of transfer technique was investigated by evaluating if cervical catheterization is associated with prostaglandin release and suppression of luteal function and if donkey recipients would become pregnant after nonsurgical transfer of horse embryos. Four jennies, from 5 to 8 d after ovulation, were submitted to a sham transcervical ET and to evaluation of PGFM and progesterone plasma concentrations. Five 8 d horse embryos were nonsurgically transferred into synchronized donkey recipients (HD). Cervical stimulation caused a transient PGF 2α release in two of four jennies in the absence of a significant decrease in progesterone plasma concentration. All transferred horse embryos resulted in pregnancies in the jenny recipients. In Study 2, donkey embryo viability was investigated by 1.2 meters, 6-diamidino-2-phenylindole (DAPI) staining of 10 embryos and by the transfer of 6 and 12 donkey embryos in synchronized mare (DH) and donkey (DD) recipients, respectively, of known fertility. The estimated proportion of dead cells in DAPI stained embryos was 0.9% (range 0–3.9%) and below what is considered normal (20%) for horse embryos. Three of six and six of 12 of the DH and DD ETs, respectively resulted in pregnancies at 14 and 25 d (50%), a higher pregnancy rate than previously reported after DD ET. The overall results of this study suggest that the transcervical technique for ET and donkey embryo viability are not the reasons for the low pregnancy rates that have previously been described in donkey recipients, and that nonsurgical ET in donkeys can result in acceptable results.

Cervical catheterization is not responsible for the low pregnancy rate following transcervical embryo transfer in donkeys

Cervical catheterization is not responsible for the low pregnancy rate following transcervical embryo transfer in donkeys

Probing leukocyte traffic in lymph from oro-nasal mucosae by cervical catheterization in a sheep model

Lymph nodes are instructed via the lymph about ongoing events in tissues both during the steady state and under provoked inflammation. In order to probe for tissue-to-node transduction mechanisms, we have developed a novel in vivo technique of pseudo-afferent lymph collection from the oro-nasal mucosae which represent the main portals of entry of micro-organisms and efficient routes for vaccination. After lateral lymph node resection of the head, a network of lymph ducts was reconstructed as checked by lymphography. Subsequent catheterization of the cervical lymph duct allowed the collection of cells that were shown to originate from the oro-nasal mucosae. These cells included dendritic cells, monocytes, granulocytes, memory CD45RA neg CD2 pos integrin β7 lo CD4 T cells, CD25 pos CD4, CD8, γ/δ T cells, and B lymphocytes. This approach, which permits lymph collection over several weeks, opens a valuable and unique way to study leukocyte and particulate (micro-organisms, vaccines) trafficking from head tissue to nodes under homeostastic and immuno-stimulatory conditions in a highly physiological setting.

Intestinal barrier damage caused by trauma and lipopolysaccharide.

To investigate the intestinal barrier function damage induced by trauma and infection in rats. Experimental models of surgical trauma and infection were established in rats. Adult Sprague-Dawley rats were divided into 4 groups: control group (n = 8), EN group (n = 10), PN group (n = 9) and Sep group (n = 8). The rats in PN and Sep groups were made into PN models that received isonitrogenous, isocaloric and isovolumic TPN solution during the 7-d period. Rats in EN and Sep groups received laparotomy and cervical catheterization on day 1 and received lipopolysaccharide injection intraperitoneally on d 7. On the 7(th) day all the animals were gavaged with lactulose and mannitol to test the intestinal permeability. Twenty-four hours later samples were collected and examined. The inflammatory responses became gradually aggravated from EN group to Sep group. The mucosal structure of small intestine was markedly impaired in PN and Sep groups. There was a low response in IgA level in Sep group when compared with that of EN group. Lipopolysaccharide injection also increased the nitric oxide levels in the plasma of the rats. The intestinal permeability and bacterial translocation increased significantly in Sep group compared with that of control group. One wk of parenteral nutrition causes an atrophy of the intestinal mucosa and results in a moderate inflammatory reaction in the rats. Endotoxemia aggravates the inflammatory responses that caused by laparotomy plus TPN, increases the production of nitric oxide in the body, and damages the intestinal barrier function.

Transcervical artificial insemination in the domestic ferret (Mustela putorius furo)

The research was undertaken to develop a successful nonsurgical procedure for artificially inseminating ferrets. A fiberoptic endoscope used in conjunction with a specially designed speculum and catheter permitted cervical catheterization and intrauterine insemination. Sperm were collected from the cauda epididymides of 10 discarded breeder males; the number of sperm in diluted samples used for insemination ranged from 4.4–13.6 × 106/100 μl with progressive motility of sperm ranging from 40 to 60%. Sperm collected from each male were diluted with an egg-yolk extender (TEST) and used to inseminate 8–12 females, with deposition of sperm intravaginally or transcervically into the uterine body 0 or 24 hr after an ovulatory injection of human chorionic gonadotropin (hCG). The vaginal inseminations were used as a control, and no pregnancies resulted after insemination of 26 females. Intrauterine inseminations resulted in 4/24 (17%) of the ferrets pregnant when hCG administration was coincident with insemination, and 19/24 (79%) of the ferrets were pregnant when inseminations were done 24 hr after hCG administration. All inseminated females were euthanized on day 20 after insemination to count fetuses. The mean number of fetuses was 3.1 (range, 1–8). The number (millions) of motile sperm inseminated (X) had a significant effect on the percentage of fetuses (Y). Regression analysis indicated a linear relationship between the two variables, with an R2 value of 0.99 and a line of best fit described by the equation Y = 0.029 + 0.034 X. This paper is the first report of transcervical artificial insemination in the domestic ferret (Mustela putorius furo). The method can serve as a model for application to ferrets and other mammals, particularly endangered species. Zoo Biol 17:393–404, 1998. © 1998 Wiley-Liss, Inc.

Transcervical artificial insemination in the domestic ferret (Mustela putorius furo)

The research was undertaken to develop a successful nonsurgical procedure for artificially inseminating ferrets. A fiberoptic endoscope used in conjunction with a specially designed speculum and catheter permitted cervical catheterization and intrauterine insemination. Sperm were collected from the cauda epididymides of 10 discarded breeder males; the number of sperm in diluted samples used for insemination ranged from 4.4–13.6 × 106/100 μl with progressive motility of sperm ranging from 40 to 60%. Sperm collected from each male were diluted with an egg-yolk extender (TEST) and used to inseminate 8–12 females, with deposition of sperm intravaginally or transcervically into the uterine body 0 or 24 hr after an ovulatory injection of human chorionic gonadotropin (hCG). The vaginal inseminations were used as a control, and no pregnancies resulted after insemination of 26 females. Intrauterine inseminations resulted in 4/24 (17%) of the ferrets pregnant when hCG administration was coincident with insemination, and 19/24 (79%) of the ferrets were pregnant when inseminations were done 24 hr after hCG administration. All inseminated females were euthanized on day 20 after insemination to count fetuses. The mean number of fetuses was 3.1 (range, 1–8). The number (millions) of motile sperm inseminated (X) had a significant effect on the percentage of fetuses (Y). Regression analysis indicated a linear relationship between the two variables, with an R2 value of 0.99 and a line of best fit described by the equation Y = 0.029 + 0.034 X. This paper is the first report of transcervical artificial insemination in the domestic ferret (Mustela putorius furo). The method can serve as a model for application to ferrets and other mammals, particularly endangered species. Zoo Biol 17:393–404, 1998. © 1998 Wiley-Liss, Inc.

Pasteurella multocida infections in baboons (Papio cynocephalus)

The respiratory pathogenPasteurella multocida was isolated from infections of the laryngeal air sacs of two baboons and from abscesses in the neck or femoral area of two other baboons. The infections were associated with surgical procedures involving the cervical area, chronic catheterization, and chair restraint. The organism was also detected among the commensal pharyngeal flora in 2 of 15 clinically healthy, wildborn adult baboons. These findings suggest that the organism is harbored naturally in baboons and that exudative infections can occur secondary to specific procedures.

Giraffe restraint, habituation, and desensitization at the Cheyenne Mountain Zoo

AbstractThe giraffe restraint device manufactured at the Cheyenne Mountain Zoo has the capability to fully support the weight of an immobilized adult giraffe in an upright posture and allow physical restraint of giraffe. The unit has been used for either chemical or physical restraint 74 times, in 22 months, on seven different adult giraffe, without animal or personnel injuries. Habituation and desensitization of the giraffe are critical prerequisites for the successful use of the giraffe restraint device.Yohimbine effectively reversed the effects of xylazine sedation of giraffe. A drug combination of detomidine and azaperone offers promise as an alternative to either physical restraint or immobilization of giraffe for selected clinical and investigative procedures.Using the restraint device it has been possible to perform tuberculin testing, venipuncture, vaginal examination, rectal palpation, rectal ultrasound, cervical catheterization, hoof‐trimming, and placement of a hoof block on awake, habituated, and desensitized giraffe.