Reproductive Anatomy Research Articles

Documenting the availability and accessibility of reproductive health services for youth in Albania

Abstract Youth in Albania are initiating sexual activity at an earlier age. However, use of all forms of contraception has declined in the last decade and uptake now stands at 4%. The self-reported prevalence of sexually transmitted infections (STIs) and STI symptoms has risen dramatically, as has reliance on abortion as a predominant method of family planning. In 2020-2022, we conducted a multi-method qualitative study in Albania to document the availability and accessibility of sexual and reproductive health (SRH) services and examine challenges that youth face when seeking SRH care. This study comprised a document review, a curriculum review, a community-based survey with 273 youth, semi-structured interviews with 15 youth, semi-structured interviews with 15 key informants, and a service mapping exercise in Tirana. Lack of adequate infrastructure and bureaucratic hurdles make it difficult for youth to navigate and access SRH services in Albania. A third of survey participants (n = 90, 33%) expressed discomfort inquiring about SRH matters, while nearly two-thirds rarely or never sought SRH services from a doctor or clinic. Furthermore, Albania’s school-based sexuality education curriculum lacks in topics, content, and responsiveness, resulting in inconsistent learning experiences and limited knowledge of SRH. Sexuality education is primarily focused on the anatomy and physiology of reproduction, leading to significant knowledge gaps in other aspects of SRH. Only half of survey participants (n = 150, 55%) had received any education on birth control, contraception, or family planning; and only few had knowledge about gender identity (n = 103, 38%), or consent (n = 77; 28%). Widespread lack of awareness and fear of judgment contribute to the underutilization of SRH services among youth in Albania. Improving knowledge and awareness, alongside investing in infrastructure and capacities, are essential to enhancing accessibility and quality of SRH services for Albanian youth. Key messages • Lack of knowledge and awareness prevent youth from accessing SRH services. • Establishing youth-friendly services and training health providers and educators are crucial to delivering confidential and non-judgmental youth-friendly SRH care.

Community college student perceptions of digital anatomy models as a curricular resource.

Digital model platforms and applications are common in anatomy education and continue to grow in number, which suggests that educators and students find use for these tools despite the lack of widely accepted best practices. Consequently, it is a challenge for educators to mindfully integrate digital models into curriculum. This short-term, longitudinal study investigated the effects of integrating a monoscopic digital model as a teaching tool during lectures on reproductive and endocrine anatomy as an intervention in a community college human anatomy and physiology course. Student use and perceptions of digital models were analyzed for correlation with the nature of the course content and the intervention (n = 92). Academic content significantly affected self-reported student use (p < 0.001) as well as student perceived usefulness of the model (p = 0.02). These findings support the conjecture that digital anatomy models may be better for achieving certain specific learning goals opposed to all learning goals. Integration of digital models as an instructional method did not consistently influence student behavior but it made a difference in participant ability to recognize this technology outside of the lecture. Overall, participants had a positive perception of digital models, although they were not perceived as more important than all other curricular resources. Inclusion of monoscopic digital models for teaching anatomy should be considered by educators since teaching with digital models can demonstrate strengths and weaknesses for students within the context the of learning objectives, assisting students to make more informed decisions about effective learning tools.

Shell morphology and reproductive anatomy of Levantina mardinensis (Gastropoda, Helicidae) from a new locality of Mardin, Türkiye

ABSTRACT The genus Levantina Kobelt, 1871, comprises 25 taxa inhabiting rocky environments across the Middle East. This study focuses on documenting a new location of L. mardinensis Kobelt, 1900, and provides a detailed analysis of its shell morphology and reproductive anatomy, contributing to the knowledge and conservation of this land snail from Mardin, southeastern Türkiye. The distribution of L. mardinensis is widespread in Mardin Province and extends into northern Syria and Iraq. The study provides measurements for previously unreported shell characteristics of specimens from Eskikale (Mardin), including aperture height, aperture width, spire height, and body whorl height, with high-resolution images for visual reference.

Genomic Sequencing to Detect Cross-Breeding Quality in Dogs: An Example Studying Disorders in Sexual Development.

Disorders of sexual development (DSDs) in dogs, similar to humans, arise from genetic mutations, gonadal differentiation, or phenotypic sex development. The French Bulldog, a breed that has seen a surge in popularity and demand, has also shown a marked increase in DSD incidence. This study aims to characterize the genetic underpinnings of DSDs in a French Bulldog named Brutus, exhibiting ambiguous genitalia and internal sexual anatomy, and to explore the impact of breeding practices on genetic diversity within the breed. We utilized a comprehensive approach combining conventional cytogenetics, molecular techniques, and deep sequencing to investigate the genetic profile of Brutus. The sequence data were compared to three other male French Bulldogs' genome sequences with typical reproductive anatomy, including Brutus's father and the canine reference genome (CanFam6). We found a Robertsonian fusion involving chromosome 23 previously reported in dogs as a causative mutation responsible for sex reversal syndrome. Our findings revealed a 22% mosaicism (78,XX/77,XX), the absence of the sex-determining region (SRY) gene, and the presence of 43 unique Single Nucleotide Variants (SNVs) not inherited from the father. Notably, the run of homozygosity (ROH) analysis showed Brutus has a higher number of homozygous segments compared to other Bulldogs, with a total length of these fragments 50% greater than the average, strongly suggesting this dog is the product of the mating between siblings. Although no direct causative genes for the DSD phenotype were identified, four candidate loci warrant further investigation. Our study highlighted the need for a better annotated and curated reference dog genome to define genes causative of any specific phenotype, suggests a potential genetic basis for the DSD phenotype in dogs, and underscores the consequences of uncontrolled breeding practices in French Bulldogs. These findings highlight the importance of implementing strategic genetic management to preserve genetic health and diversity in canine populations.

Dr. Vasant Ramji Khanolkar: A Revolutionary Pathologist in India.

Dr. Vasant Ramji Khanolkar is known as the Father of Pathology in India. His outstanding contributions include research on the epidemiology of cancer in India, leprosy, reproduction anatomy, and family planning practices in India. He had the lion's share in medical education in India and started the subjects of Biophysics and Applied Biology at Bombay University. He recognized the importance of basic science, experimental biology, biochemistry, biophysics, and numerology in medical education. He suggested many changes in the medical education curriculum of India and strengthened the research facilities in medical education. Dr. Vasant Ramji Khanolkar was honored with Padma Bhushan, a prestigious award by the Government of India.

Menstrual health education: school health curriculum topics by grade level recommended by specialized medical professionals in menstrual health clinics

Study ObjectiveEvidence-based menstrual health education is not mandated in any U.S. state or territory. Aspects of normal and abnormal menstruation impact quality of life and educational engagement, but many youth are not prepared to know when to seek medical help. We sought to determine which topics should be included in a 3rd through 8th grade school-based menstrual health curriculum. MethodsWe conducted a cross-sectional online survey of medical professionals who care for patients with menstrual problems. We asked participants to indicate the top three menstrual health topics by grade and we compared the most common responses by year. We also solicited general comments about curriculum content. ResultsSurveys from 55 medical professionals met criteria for analysis. The most frequent topics to be selected were normal and abnormal menstruation, reproductive anatomy, puberty timeline, and menstrual products. A majority recommended the topics of puberty timeline (38, 69.1%) and reproductive anatomy (34, 61.8%) for 3rd grade, introducing normal menstruation (31, 56.4%) and menstrual products (24, 46.3%) in 4th grade, and abnormal menstruation (27, 49.1%) in 6th grade. More complex topics such as world cultures around menstruation (14, 25.5%) and period poverty (11, 20.0%) were preferred for 8th grade. Many providers emphasized the importance of teaching normal versus abnormal menstruation in a school health curriculum. ConclusionMedical professionals provide recommendations for a school-based menstrual health curriculum that introduces topics at developmentally appropriate ages from a medical perspective, teaches basic menstrual symptom management, and instructs on warning signs for abnormal menstruation.

Towards equity & inclusion: a critical examination of genetic Counselling Education on Intersex Healthcare

BackgroundIntersex describes a diversity of individuals with variations in sex characteristics (VSC), reflecting underlying differences in reproductive anatomy, hormones, and/or genes and chromosomes. With a shift towards socially-conscious clinical practices, genetic counsellors (GCs) are increasingly needing to provide comprehensive care to individuals with VSC and their families. However, the current quality of training provided to genetic counsellors on intersex health is unclear.MethodsQualitative interviews were conducted between Jan-Feb 2021 with 20 current and graduated students of Canadian GC training programs to assess the quality of GC education on intersex health topics. An agency-based model of VSC health as proposed by Crocetti et al. was used to guide the inductive thematic data analysis.ResultsResults revealed three key themes: limited discussions on psychosocial considerations when caring for intersex individuals, enthusiasm for integrating more intersex training into the curriculum, and personal initiative in ensuring equity and justice in the care of individuals with VSC.ConclusionsThese findings demonstrate existing knowledge gaps in the GC curriculum, with a need to increase the profession’s overall awareness on intersex issues. GC training programs have an opportunity to meet the desires of students while promoting person-centered and validating healthcare for the intersex community.

Sibling Species Amblyraja hyperborea and A. jenseni in Slope Waters of Eastern Canada: An Ecomorphological Description

Deepwater survey data and specimens collected from the Grand Banks to Baffin Bay in the Northwest Atlantic were used to examine the distribution, morphometrics, meristics and maturity of two siblings, Amblyraja hyperborea and A. jenseni. Our study confirmed that the two species occupy different locations, their distributions separated by Davis Strait, a biogeographic break separating Atlantic from Arctic waters. A. hyperborea with a smaller maximum size and size at maturity inhabited colder Arctic slope waters in Baffin Bay while larger A. jenseni were located in warmer Atlantic slope waters. Despite their distributional separation and thus reproductive isolation, spine counts and body morphology were almost indistinguishable between species. Only upper jaw teeth row count and difference in the size of spines on the mid-rear wings differentiated the two species. Also, for both species, the proportion of dorsal fins joined, disc shape and relative tail length changed with total length. Secondary reproductive anatomy, clasper length and vas deferens weight, shell gland and uterus weight underwent initial acceleration in growth when the gonads transitioned to stage 2 (adolescent, maturing). Also, YOY A. hyperborea were found to distribute at shallower depths than larger stages, constituting a nursery, which was not observed for A. jenseni.

O-116 Fertility in transmasculine people

Abstract Transgender and gender diverse (TGD) people apply for gender-affirming care at any age to manage gender identities or expressions that differ from the gender socially attributed to their sex assigned at birth. Gender-affirming hormonal treatment (GAHT) and gender-affirming surgery (GAS) may alter reproductive function and/or anatomy, limiting future reproductive options to varying degrees, if persons have the wish to either give birth and, or to become a biological parent. The desire to have children in TGD people does not differ from that of the cis population. In those persons assigned female at birth but who identify as male or genderdivers medical transition often comprises testosterone to induce masculinisation. The effect of testosterone on the uterus and ovaries and further reproductive outcome has not been fully clarified so far. There are several histological studies showing ovarian cortical and stromal changes following testosterone exposure, it is uncertain what the consequences for future fertility may be. It seems there is persistent activity in folliculogenesis by the descriptions of follicle count, distribution and oocyte retrieval. However, there are studies showing a negative effect on fertilization rate in presence of testosterone. Reports on successful ovarian stimulation, fertilizations, pregnancies and live births have been published, with and without testosterone discontinuation. In this lecture an overview will be given of the recent literature and guidelines on fertility outcome in TGD people assigned female at birth, specifically the effect of medical transition. Recommendations on counseling and ways of fertility preservation will be discussed.

The gross reproductive morphology of the male Temminck's pangolin Smutsia temminckii (Smuts, 1832)

AbstractThe Temminck's pangolin (Smutsia temminckii) is one of eight pangolin species worldwide and the only pangolin present in southern Africa. Historically, pangolins have not been able to reproduce successfully in captivity and this may be in part due to the lack of knowledge and understanding with regards to the pangolin reproductive system (anatomy, physiology, biology) in all eight species. This original study describes the gross anatomy of the male Temminck's pangolin from three adult individuals investigated. The male Temminck's pangolin presented a short, conical penis with ascrotal (internal) testes, similar to many other myrmecophagous mammals such as the aardvark (Orycteropus sp.) and anteaters (suborder: Vermilingua). However, the orientation of the penis of the Temminck's pangolin differed in that it was oriented cranioventrally, in contrast to the caudal orientation of the giant anteater. The testes were found to be bilaterally flattened with an elongate oval shape, similar to the aardvark. The specific characteristics of the reproductive tract of the male Temminck's pangolins are thought to be adaptations to their peculiar lifestyle as the male portrays characteristics that indicate adaptation to a lower basal metabolic rate and body temperature as well as to their defensive mechanism of rolling up into a ball. Our study suggests the male Temminck's pangolin reproductive anatomy is most similar and comparable to the Xenarthrans and the aardvark that display the same fossorial activities as pangolins, and the male morphology is not comparable to the phylogenetically closely‐related Carnivora.

(019) EXPERIENCE WITH VARIOUS GENITAL VIBRATORS: A QUALITATIVE STUDY

Abstract Introduction Mainstream society and health professionals typically do not regard genital vibrators as medical devices. Vibrators have been shown to improve sexual satisfaction (Alexander et al., 2017). There are currently no studies that compare participants' preference, satisfaction of orgasm, and frequency of orgasms with multiple different styles of devices. Objective The primary outcome was to compare three different styles of genital vibrator devices via the level of satisfaction and reasons for satisfaction or dissatisfaction for the various devices. The secondary outcomes were to determine if there was a quantitative change in the Female Sexual Function Index (FSFI) scores or the Patient Global Impression of Improvement (PGI-I). Methods The study was a prospective observational design with mixed methods of qualitative and quantitative outcomes. Participants with female reproductive anatomy aged ≥18 that were sexually active with a partner or through self-stimulation and have achieved orgasm in the past were eligible. Participants completed the FSFI prior to undergoing the intervention. They then had six weeks to use the three devices (wand, dual pronged or clitoral suction device) at their own discretion. At the conclusion of the six weeks, they completed the FSFI and PGI-I. Participants then underwent an open and semi-structured interview via telephone. The information from these interviews was transcribed and analyzed using Dedoose software by two independent reviewers. Results Individuals with no self-reported sexual dysfunction aged 18-55 years old were recruited in January 2023. All completed both the pre- and post-intervention questionnaires. Nineteen participants completed the semi-structured interviews, one participant was lost to follow-up. Self-reported overall sexual satisfaction was improved in 90% of participants after introduction of the genital vibrators based on PGI-I (Figure 1). 55% of participants reported the suction clitoral stimulator device was their preferred vibrator, 35% preferred the wand device, and 10% preferred the dual pronged device. When comparing pre and post intervention FSFI there were no statistically significant differences in total FSFI scores nor any of the individual domains (27.15 vs. 28.25, p=0.104). Ease of use, enjoyment, comfort, intensity, partner use, change in orgasm, novelty, and battery/charge were commonly recurring themes during the interview. Table 1 demonstrates examples of quotes and frequency of mentions. There was no difference in number of times each vibrator was used based on self-report (p=0.875) (Figure 2). Conclusions The introduction of genital vibrators may lead to improved sexual satisfaction in individuals with no baseline sexual dysfunction. The majority (90%) of participants reported improvement in overall sexual satisfaction with the use of genital vibrators, with the suction clitoral stimulator device being the preferred style. Novelty, comfort, size, and intensity of vibrators were frequently addressed as important factors in improving the likelihood and quality of orgasm. Additionally, positive comments surrounding partner use were frequently addressed by participants, suggesting the importance of exploring vibrator use outside of masturbation alone. Use with a partner can lead to improved communication with the partner and a more satisfying sexual experience overall. Disclosure No.

The Impact of Teaching Aids in Learning of Women's Reproductive Organs For Blind Teenage Students At SLBN A Kota Bandung

This research explores the impact of puppet media as teaching aids in teaching the anatomy of female reproductive organs to blind children in class 9 at SMPLB N Pajajaran, Bandung. In the context of sexual education for children with special needs, understanding reproductive anatomy is crucial for self-protection against sexual abuse and sexually transmitted diseases. Using a qualitative approach, this study examines strategies, techniques, and methods in inclusive education to help blind children understand female reproductive anatomy. It considers their developmental needs and abilities in selecting suitable learning media. The research aims to benefit students, teachers, and schools by enhancing knowledge and skills related to reproductive health and offering new methods for teaching sexual education. Theoretically, it seeks to advance the development of effective learning tools for blind children. This research is urgent because it promotes awareness and protection of reproductive health among blind students, ensuring inclusive and equitable sexual education. It supports national education goals by addressing the special needs of each child, contributing to a smarter and more inclusive society.

Observations on the anatomy of the funiculus spermaticus and the testis in Brachyteles sp. (SPIX, 1823) primates - Atelidae.

Analysing the literature about the reproductive anatomy on New World Primates, one can see the need of standardisation on the description methods and, more importantly, the lack of detailed information. The problem is aggravated by the difficult access to specimens of the endangered species such as Brachyteles sp. This paper's objective was to extend knowledge on the male reproductive anatomy of these primates. The testis and funiculus spermaticus of Brachyteles are described in detail. We utilised one individual of Brachyteles arachnoides, two hybrids (B. arachnoides × Brachyteles hypoxanthus) and photographs of the testis of a third fresh specimen of a hybrid individual. The septum formed by tunica dartos adheres to the testis and separates the scrotum in two testicular cavities. Passed the spermatic cord, the external spermatic fascia continues with the tunica dartos, covering the cranial half of the testis. The fascia cremasterica divides itself in bundles of fibres and forms loops around the testicles creating a sac like structure that seems to be unique among Neotropical Primates. The appendix testis is described for the first time in platyrrhini. It is presented as a sessile structure in the extremitas capitata of the testis. Previous literature on the reproductive anatomy of platyrrhini is limited. Despite that, it can be said that the large size and volume of the testis, and complex structure of the cremaster, could consist of a heat loss reduction strategy in cold and humid forest environments. Except for the larger size of the testicles in hybrid individuals, no other significant morphological differences were found between B. arachnoides and hybrids (B. arachnoides × B. hypoxanthus).

Likeness across Nature

Abstract Over the course of a long career, Hieronymus Fabricius of Aquapendente sought to train students and readers to think across nature. This article suggests that we read his program as inculcating an “anatomical eye”: a visual language of the body’s logic and nature’s intention that encoded knowledge, which expert anatomists derived from touch and sight combined. Fabricius both taught and learned haptically, observing organs’ divisions through variations in texture and measuring the differences in reproductive anatomy across animals with his fingers. Through dissections of sheep, cattle, horses, sharks, guinea pigs, dogs, and humans, he gathered details about how nature had produced both startling likenesses and particularities across the animal kingdom. While artists sometimes struggled to capture his experience, Fabricius’s longstanding commitment to working with them revealed that, whatever the challenges, the potential for expanding the “anatomical eye,” and the reputation that came with it, was worth the risk.

Tuberculosis in pregnancy and assisted reproductive technology.

Tuberculosis is a chronic infectious disease caused by mycobacterium tuberculosis infection. In the world, tuberculosis is an important factor affecting women's reproductive health, which can cause reproductive tract anatomy abnormalities, embryo implantation obstacles, ovarian reserve and ovulation dysfunction, leading to female infertility. This group of women usually need to seek assisted reproductive technology to conceive. Latent tuberculosis infection during pregnancy has no clinical manifestation, but may develop into active tuberculosis, leading to adverse pregnancy outcomes. Most pregnant women do not need to be treated for latent tuberculosis infection, unless they are combined with high-risk factors for tuberculosis progress, but they need close follow-up. Early diagnosis and treatment of active tuberculosis in pregnancy can reduce the incidence rate and mortality of pregnant women and newborns, and treatment needs multidisciplinary cooperation.

Multiple sources of evidence unravel a complex taxonomic history: the new genus Leonoria of the Spermacoce clade (Spermacoceae-Rubiaceae)

For a long time, the taxonomic status of Denscantia, a genus endemic to the Atlantic Forest along the Brazilian coast, has been a topic of discussion. Phylogenetic analyses using two nuclear and four chloroplast DNA markers from 82 accessions representing 19 genera of the Spermacoce clade (tribe Spermacoceae, Rubiaceae) confirm that the Brazilian genus Denscantia is biphyletic. Together with the recovered phylogenetic relationships, the analyses of reproductive morphological characters, leaf morphology and anatomy, histochemical, geographic distribution ranges, and ecological niche derived from climatic space further demonstrate that Denscantia calcicola is a distinct lineage from the other Denscantia species. Therefore, the above-mentioned species should be taxonomically designated as a new monospecific genus, Leonoria. Significant morphological differences between Leonoria and Denscantia were found in inflorescence organization, style shape, fruit dehiscence and pollen morphology. Morphological and anatomical variation among leaf traits was found in epidermal cells, trichome distribution, mesophyll histochemistry and vascular organization. The analysis of occurrence records of 207 specimens demonstrates a clear ecological distinction between of Denscantia s.s. and Leonoria, which is ecologically confined to limestone outcrops associated with seasonally dry forests. The current study highlights the importance of an integrative taxonomic approach combining multiple sources of evidence to unravel complex taxonomic history within Spermacoceae.

Structural analysis of the female reptile reproductive system by micro-computed tomography and optical coherence tomography†.

Volumetric data provide unprecedented structural insight to the reproductive tract and add vital anatomical context to the relationships between organs. The morphology of the female reproductive tract in non-avian reptiles varies between species, corresponding to a broad range of reproductive modes and providing valuable insight to comparative investigations of reproductive anatomy. However, reproductive studies in reptilian models, such as the brown anole studied here, have historically relied on histological methods to understand the anatomy. While these methods are highly effective for characterizing the cell types present in each organ, histological methods lose the 3D relationships between images and leave the architecture of the organ system poorly understood. We present the first comprehensive volumetric analyses of the female brown anole reproductive tract using two non-invasive, non-destructive imaging modalities: micro-computed tomography (microCT) and optical coherence tomography (OCT). Both are specialized imaging technologies that facilitate high-throughput imaging and preserve three-dimensional information. This study represents the first time that microCT has been used to study all reproductive organs in this species and the very first time that OCT has been applied to this species. We show how the non-destructive volumetric imaging provided by each modality reveals anatomical context including orientation and relationships between reproductive organs of the anole lizard. In addition to broad patterns of morphology, both imaging modalities provide the high resolution necessary to capture details and key anatomical features of each organ. We demonstrate that classic histological features can be appreciated within whole-organ architecture in volumetric imaging using microCT and OCT, providing the complementary information necessary to understand the relationships between tissues and organs in the reproductive system. This side-by-side imaging analysis using microCT and OCT allows us to evaluate the specific advantages and limitations of these two methods for the female reptile reproductive system.

Bulk and single-cell transcriptome datasets of the mouse fetal and adult rete ovarii and surrounding tissues

The rete ovarii (RO) is an epithelial structure that arises during development in close proximity to the ovary and persists throughout adulthood. However, the functional significance of the RO remains elusive, and it is absent from recent discussions of female reproductive anatomy. The RO comprises three regions: the intraovarian rete within the ovary, the extraovarian rete in the periovarian tissue, and the connecting rete linking the two. We hypothesize that the RO plays a pivotal role in ovarian homeostasis and responses to physiological changes. To begin to uncover the nature and function of RO cells, we conducted transcriptomic profiling of the RO. This study presents three datasets, and reports our analysis and quality control approaches for bulk, single-cell, and nucleus-level transcriptomics of the fetal and adult RO tissues using the Pax8-rtTA; Tre-H2B-GFP mouse line, where all RO regions express nuclear GFP. The integration and rigorous validation of these datasets will advance our understanding of the RO’s roles in ovarian development, female maturation, and adult female fertility.

Dairy village: the role of veterinary services in unlocking dairy industry potential through assisted reproductive technologies

The “Dairy Village” concept was designed to overcome the constraints of estrus synchronization and AI particularly associated with eletion of the breeding animals and subsequent management of estrous cows in Ethiopia. All necessary inputs, including sexed semen, were acquired before the fieldwork. The knowledge and skill gaps were identified and addressed with the active involvement of veterinarians and AI technicians who underwent specialized training to ensure proper physical and gynecological examinations during the selection of cows and heifers. Accordingly, a refresher training was delivered on topics of reproductive anatomy and physiology, assessment of ovarian status, semen handling, and insemination at the optimal time to establish pregnancy. Besides, awareness creation seminars were held every year on topics of benefits of reproductive technologies and management of breeding cows to 99 smallholder dairy farmers. Only 578 cows/heifers were found fit for breeding out of the 1262 cows/heifers that were brought for evaluation; including 81 animals that spontaneously showed estrus. A total of 497 cows/heifers were synchronized using a single IM injection of Lutalyse. Animals responding to the treatment (404 cow/heifers) and those spontaneously in estrus (81cows/ heifers) were inseminated using sex- sorted HF semen 18-24hrs into the standing estrus. Pregnancy rate was 80% (388/485) and 287 calves were born (96% female). Results of this project indicate that rigorous gynecological examination during the selection of cows prior to estrus synchronization and judicious application of hormonal treatments can yield improve the success of ES/AI projects under field conditions. Furthermore, the dairy village approach to enhanced milk production through efficient use of sex-sorted semen has generated replacement heifers from superior breed that will substantially improve the livelihoods of village farmers.

Discrepancies Between Imaging Reports and Operative Findings in Patients With Cloaca: A Call for Expansion of the Mullerian Anomalies Classification

BackgroundThere is wide variation in the language used to describe Mullerian structures. To standardize terminology, the American Society of Reproductive Medicine (ASRM) created the Mullerian Anomalies Classification (MAC) in 2021. The objective of this study was to evaluate the applicability of the MAC nomenclature to pediatric patients with cloaca. MethodsA retrospective review of all patients with cloaca was performed at a single institution. Descriptions of Mullerian structures were evaluated and compared to the ASRM MAC categories. Descriptive statistics were used to report findings. Results36 patients with cloaca were identified, 13 (36%) of whom had congenital Mullerian structures that could not be adequately described by the MAC terminology. All 13 patients had two hemiuteri that were not connected in the midline and were not accurately described as uterus didelphys. Additionally, 5 of these 13 patients had reproductive anatomy that was connected by a fistula or ectopic connection to other pelvic structures. ConclusionDespite the ASRM expansion of the Mullerian anomalies nomenclature, more than a third of our patients with cloaca could not have their Mullerian structures accurately described. Describing anatomy with accurate and consistent language can improve communication between healthcare providers and may allow patients and families to better anticipate fertility options. Study TypeRetrospective. Level of EvidenceIV.