Grade IIb: Mares classified as grade IIb have multifocal areas of moderate inflammation and/or multifocal fibrosis with 4 or more layers of fibroblasts surrounding glands or an average of 2-4 fibrotic glandular nests per 5 mm linear field. Grade IIa: Mares classified as grade IIa have mild to moderate inflammation of the endometrium and/or multifocal areas of periglandular fibrosis with 1-3 layers of fibroblasts surrounding glands or an average of 50 to 80% chance of conceiving and carrying a foal to term. Mares in this category have a > 80% chance of conceiving and carrying a foal to term. Grade I: Mares classified as grade I have a normal endometrium or mild, focal inflammation or fibrosis. Preferably, endometrial biopsies should be taken at the base of one of the uterine horns and be no less than 1 cm in length.
Endometrial biopsies are assessed and graded (grades I, IIa, IIb or III) based on the frequency, type and degree of inflammation, glandular nesting and periglandular fibrosis. The endometrial biopsy is the most frequent laboratory method used to evaluate fertility in mares and to assess the mare’s prognosis for successfully carrying a foal to term. The Texas A&M Veterinary Medical Diagnostic Laboratory (TVMDL) has a group of professionals with ample expertise in laboratory assessment of mare infertility. In addition to rectal palpation and ultrasound and endoscopic examination, a complete BSE should include ancillary laboratory work including uterine cultures, uterine cytology, endometrial biopsies and in some cases, hormonal profiles. This may be either as part of a pre-purchase assessment, for infertility work-ups, or as a routine on all open or maiden mares prior to the next breeding season. Mares are often presented to the veterinarian for a breeding soundness examination (BSE) to determine the likelihood a particular mare or a group of mares to carry a foal to term. Endometrial biopsy in a mare showing frequent areas of glandular nesting and periglandular fibrosis.
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