July 2008… This auditorium looks really huge. I can feel the stress growing in me. Huge pressure. I’ve never talked in public before. Especially in English. Especially in front of an audience of veterinary specialists. Younger me is definitely scared to death while he is about to deliver a short communication on the use of endoscopy to diagnose uterine disorders in the bitch. While I wait for the chairman to finish her introduction and give me the go, I can’t help but wonder : how did I end up here ?
I had always been fascinated by canine fertility. How can indeed a term that sounds so « simple » (when you think about it « just » needs one oocyte and a spermatozoon) could turn into something that complex ? For sure, we already knew well how to deal with the « most common causes. » But there were still lots of question marks on the remaining cases.
That’s how I got in this auditorium on summer of 2008. We were looking for those « other causes ». We were looking for modifications inside the uterus that could eventually explain why « it did not work ». And we found something. Some of the bitches we saw had signs of inflammation inside this organ. While we could not detect anything under ultrasounds (which remains the best tool IMO to diagnose most common uterine disorders in dogs and cats). For us, it was a beginning of a new era of exploration. In 2008, I presented preliminary results (see the abstract here). In 2009, we started doing endoscopy-guided uterine biopsies. In 2011, my former teammate published our results (see the abstract here). Similar results came from other teams, especially from this very large study (see abstract here) in which more than 40% of the bitches included were suffering from something we now call endometritis (see my previous blog here as well).
I left academics since then. But I’m still fascinated about this topic. I still follow what others are doing in this field. When I consult with other veterinarians on canine infertility, I always encourage them to look into those inflammatory uterine diseases.
I received an email recently from a veterinary colleague. After spaying a bitch that was suffering from chronic infertility (=bred several times but did not conceive despite all the usual recommended precautions), he asked for an histopathology exam on her uterus. He emailed me the result :
Two words. And they can definitely explain why he could not help this bitch to conceive. I found only one mention of this problem in dogs (in this large study I previously mentioned) : « Eosinophilic endometritis was significantly associated with a history of fetal loss during the same breeding cycle. » I also found mentions of this problem in other species, including humans. Not much to tell you the truth (maybe I should have looked further) but I did not find yet any discussion on how this could be treated.
My point here is : there is still much to learn. We are now able to identify more and more causes of infertility in canines. And some of them, not so long ago, we didn’t even suspect they were existing. This is a first important step.
It gives me lots of hopes for the future. Let’s now wait for more on potential therapeutic approaches. For sure, those will, again, change the game.
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