Mares and horses are integral components of equine studies, focusing on the reproductive and behavioral aspects of equine biology. Mares, or adult female horses, play a significant role in breeding programs and are often studied for their reproductive physiology, gestation, and maternal behaviors. Horses, as a broader category, encompass both sexes and all age groups, providing a comprehensive view of equine anatomy, physiology, and behavior. Research in this area often investigates the differences and similarities between mares and other horses in terms of hormonal cycles, reproductive health, and social interactions. This page compiles peer-reviewed studies and scholarly articles that explore the biological and behavioral characteristics of mares and horses, offering insights into their roles in equine science and management.
Bailey CS, Heitzman JM, Buchanan CN, Bare CA, Sper RB, Borst LB, Macpherson M, Archibald K, Whitacre M.Early, accurate diagnosis of ascending placentitis in mares remains a key challenge for successful treatment of the disease. Doppler ultrasonography has shown promise as a tool to diagnose pregnancy abnormalities and is becoming more available to equine clinicians. However, to date, no studies have prospectively compared this technique to standard B-mode measurement of the combined thickness of the uterus and placenta (CTUP). Objective: The objective of the current study was to compare Doppler and B-mode ultrasonography for the detection of experimentally-induced ascending placentitis in mares...
Vilés K, Rabanal R, Rodríguez-Prado M, Miró J.Artificial insemination (AI) involving the placing of frozen-thawed semen directly into the jenny uterine body is associated with very low pregnancy rates. This might be because of an exacerbation of the acute response of the endometrium to sperm, as seen in mares with persistent induced mating endometritis. Pregnancy rates can be increased in such mares, however, by including anti-inflammatory treatments in the insemination protocol (Bucca S, Carli A, Buckley T, Dolci G, Fogarty U. The use of dexamethasone administered to mares at breeding time in the modulation of persistent mating induced e...
Coutinho da Silva MA, Canisso IF, MacPherson ML, Johnson AE, Divers TJ.Placentitis is a prevalent cause of abortion, premature delivery and neonatal death in mares. Early diagnosis is paramount for the survival of the fetus and delivery of a live foal. Objective: To determine: 1) Serum amyloid A (SAA) profile in healthy mares during late gestation; 2) if placentitis affects SAA concentrations and 3) the effects of therapy on SAA concentrations and pregnancy outcome in mares with placentitis. Methods: In Experiment I, 15 healthy pregnant mares were evaluated from 280 days of gestation to 60 h post partum. In Experiment II, pregnant mares were inoculated intra-cerv...
Arnold CE, Love CC.Intraluminal masses in the oviduct might cause infertility and/or subfertility in mares by preventing transport of ova, sperm, or both, to the site of fertilization or the embryo into the uterus. Currently, there is no clinical test for oviductal patency in mares. The objective was to determine if the passage of microspheres from the oviduct to the uterus was associated with the presence or absence of intraluminal masses. In this trial, a standing laparoscopic technique was used to cannulate the oviducts and instill 15-μm fluorescent beads in 16 light-breed mares. At 48 hours after surgery, u...
Suthers JM, Pinchbeck GL, Proudman CJ, Archer DC.Risk factors for large colon volvulus (LCV) in the horse have not been previously reported. Knowledge of these risk factors may allow the introduction of measures that could be taken to minimise the incidence of LCV. Objective: To investigate risk factors for LCV in the horse. Methods: A prospective, multicentre, unmatched case-control study was conducted over a 24 month period in the UK. Data on 69 cases and 204 control horses, from 4 veterinary hospitals, were obtained via telephone questionnaires. Multivariable logistic regression was used to identify associations between horse and manageme...
Renzi S, Riccò S, Dotti S, Sesso L, Grolli S, Cornali M, Carlin S, Patruno M, Cinotti S, Ferrari M.The use of Mesenchymal Stromal Cells (MSCs) in orthopedic practice has recently and rapidly acquired an important role. Therapies based on the use of MSCs for the treatment of acute injuries as well as chronic inflammatory disorders are gradually becoming clinical routine. These cells have demonstrated intriguing therapeutic potentialities (i.e.: inflammation control, tissue regeneration and pathological scar prevention), that have been taken into consideration for use in both human and veterinary medicine. In particular, horses represent high performance athletes considered models for human p...
Greiner C, Cavalier E, Remy B, Gabriel A, Farnir F, Gajewski Z, Carstanjen B.The effect of pregnancy on bone metabolism was investigated in healthy mares. Venous blood samples were collected 7 times from 19 multiparous mares starting at 20-weeks pre-parturition, continuing 6 times in 4-week intervals, including the week of parturition and one week after parturition. Serum concentrations of osteocalcin (OC) and carboxy-terminal cross-linking telopeptide of type I collagen (CTX-I) were determined. Measurement cycles and age had a significant (p < 0.01) influence on OC and CTX-I values. Pregnancy influenced bone metabolism with peak bone formation and resorption values...
Faubladier C, Julliand V, Danel J, Philippeau C.The present study aimed at (1) describing age-related changes in faecal bacterial functional groups involved in carbohydrate degradation and in their activities in foals (n 10) from birth (day (d) 0) to 6 months (d180) and (2) investigating the effect of maternal supplementation (five mares per treatment) from d - 45 to d60 with fermented feed products on response trends over time of the foal bacterial carbohydratedegrading capacity. Maternal supplementation with fermented feed products stimulated foal growth from d0 to d60 and had an impact on the establishment of some digestive bacterial gro...
Canisso IF, Gallacher K, Gilbert MA, Korn A, Schweizer CM, Bedford-Guaus SJ, Gilbert RO.The major objective of this study was to determine whether short-term preovulatory progestagen treatment of mares could effectively delay ovulation. Secondary objectives were to determine the effect such supplementation had on signs of estrus, follicular growth, postovulatory luteal function and pregnancy rate. Thirteen cyclic mares of different breeds were used in this study during the natural breeding season. Once mares were confirmed in estrus with a follicle of 35 mm in diameter, they were assigned in random order to receive no treatment (control), placement of a progesterone-impregnated c...
Vernunft A, Löhrke B, Tuchscherer A, Weitzel JM, Viergutz T.Anti-Muellerian hormone (AMH) is synthesized only by granulosa cells in female mammals as an inhibiting factor for early follicular recruitment. Especially in preantral and small antral follicles, expression of AMH is very intensive. However, we hypothesize that AMH affects also the development of large follicles by an estrogenesis modification. This current investigation provides for the first time information about concentrations of AMH in equine follicular fluid and demonstrates their relationship to functional characteristics of follicle development. Therefore, fluids of follicles in diffe...
Klewitz J, Krekeler N, Ortgies F, Heberling A, Linke C, Sieme H.To assess pregnancy and live foaling rates after reduction of twin pregnancy via transvaginal ultrasound-guided aspiration (TUA) in mares and evaluate effects of gestational period, localization of conceptuses, fluid aspiration volume, and combination of TUA with embryonic or fetal puncture on these outcomes. Methods: Clinical trial. Methods: 44 mares pregnant with twins (25 to 62 days of gestation). Methods: TUA was performed in all mares and combined with embryonic or fetal puncture in 13. Follow-up ultrasonographic examinations were performed by referring veterinarians. Effects of gestation...
Różański P, Slaska B, Różańska D.The aim of the study was a quantitative and qualitative analysis of microflora, presentation of current data about prevalence of the microflora on the skin and mucous membranes, and determination of its possible effect on reproduction of English full blood horses bred in Poland. The material for analyses was sampled from the skin and mucous membranes (385 samples) of 55 English full blood mares. Taking into account reproduction traits, the mares were classified into three groups. Six yeast-like species, including five species from the genus Candida (C. albicans, C. guiliermondii, C. lusitaniae...
Minervini F, Giannoccaro A, Nicassio M, Panzarini G, Lacalandra GM.Ochratoxin A (OTA) is a renal mycotoxin and transplacental genotoxic carcinogen. The aim of this study was to evaluate the natural occurrence of OTA in equine blood samples and its placental transfer. For the assessment of OTA levels, serum samples were collected from 12 stallions, 7 cycling mares and 17 pregnant mares. OTA was found in 83% of serum samples (median value = 121.4 pg/mL). For the assessment of placental transfer, serum samples were collected from the 17 mares after delivery and from the umbilical cords of their foals, after foaling. Fourteen serum samples from pregnant mares con...
Choi YH, Norris JD, Velez IC, Jacobson CC, Hartman DL, Hinrichs K.The presence of heterogenous mitochondria from the host ooplast affects the acceptance of offspring obtained by somatic cell nuclear transfer. This might be avoided by obtaining oocytes from selected females, but is then complicated by low numbers of available oocytes. We examined the efficiency of equine somatic cell nuclear transfer using oocytes recovered by transvaginal aspiration of immature follicles from 11 mares. Use of metaphase I oocytes as cytoplasts and of scriptaid (a histone deacetylase inhibitor) treatment during oocyte activation were evaluated to determine if these approaches ...
Smith SE, Devine DV.To determine the feasibility of hand-assisted laparoscopic ovariectomy via colpotomy for bilateral ovariectomy in standing mares. Methods: Case series. Methods: Mares (n = 21) aged 2-21 years, weighing 312-582 kg. Methods: After a pilot study in 6 mares, the technique was used in 15 mares. Ovaries were identified and manipulated using 2 laparoscopic portals in the left paralumbar fossa. Transection and hemostasis of the ovarian pedicle was achieved using a LigaSure Atlas™ or chain écraseur. Ovaries were removed through a colpotomy by an assistant. Results: In 19 mares, both ovaries were suc...
Carter AM, Enders AC.Epitheliochorial placentation is a derived condition and has evolved separately in strepsirrhine primates and laurasiatherians (pangolins, whales, and hoofed mammals). Usually it is associated with a long gestation period, small litters, and precocial young. Oxygen transfer is facilitated by indenting of the uterine and trophoblast epithelia by maternal and fetal capillaries, respectively. Histotrophic nutrition is important, and adaptations include areolas and hemophagous regions. In pigs and horses, for example, iron is transported as uteroferrin secreted from the uterine glands and taken up...
Korosue K, Murase H, Sato F, Ishimaru M, Kotoyori Y, Tsujimura K, Nambo Y.To test the usefulness of measuring pH and refractometry index, compared with measuring calcium carbonate concentration, of preparturient mammary gland secretions for predicting parturition in mares. Methods: Evaluation study. Methods: 27 pregnant Thoroughbred mares. Methods: Preparturient mammary gland secretion samples were obtained once or twice daily 10 days prior to foaling until parturition. The samples were analyzed for calcium carbonate concentration with a water hardness kit (151 samples), pH with pH test paper (222 samples), and refractometry index with a Brix refractometer (214 samp...
Ferris RA, Dern K, Veir JK, Hawley JR, Lappin MR, McCue PM.To develop a broad-range 28S ribosomal DNA quantitative PCR (qPCR) assay for detection of fungal DNA in equine endometrial samples. Methods: 12 fungal samples from a clinical diagnostic laboratory and 29 samples obtained from 17 mares. Methods: The qPCR assay was optimized with commercially acquired fungal organisms and validated with samples obtained from the clinical diagnostic laboratory. Subsequently, 29 samples from 17 mares suspected of having fungal endometritis were evaluated via the qPCR assay and via traditional fungal culture and endometrial cytology. Amplicons from the qPCR assay w...
Mambelli LI, Winter GH, Kerkis A, Malschitzky E, Mattos RC, Kerkis I.Mesenchymal stem cells (MSCs), because of their immunomodulation and trophic activities, in addition to their capacity to regenerate damaged tissues, have potential for treatment of many diseases. The success of stem cell therapies depends, in part, on the method of cell delivery, which should provide wide cell distribution and homing in to injured sites. The objective of the present study was to developing a novel strategy for delivery of MSCs into the uterus of mares with endometrosis (degenerative alteration of uterine glands and surrounding stroma). Endometrosis was confirmed in all mares ...
Bidwell LA.Equine anesthesia is complicated regardless of the procedure being performed. Anesthesia for the mare experiencing dystocia is complicated by the size of the fetus, positioning of the mare for the procedure, and concern over drug effect on the fetus through the neonatal period. Anesthesia of the neonate is complicated by multiple factors, specifically, sensitivity to the drugs administered. Ventilatory support, minimizing drugs administered, and minimizing anesthesia time are essential for a positive outcome.
Ignácio FS, Bergfelt DR, Mendes D, Orlandi C, Araújo GH, Oliveira JV, Montechiesi DF, Carvalho LR, Meira C.The primary objective of this study was to examine the follicular and ovulatory responses following treatment with pFSH in association with ablation-induced or spontaneous follicular wave emergence or follicle deviation during diestrus in crossbred (Mangalarga×Arabian) and Brazilian Warmblood mares with a propensity for spontaneous multiple ovulations; secondary considerations were given to the collection of embryos. In Experiment 1, crossbred mares were administered (im) saline (control, n=7) or pFSH (25mg) when the largest follicle of the ablation-induced follicular wave reached ≥13mm (n=...
Keith L, Ball BA, Scoggin K, Esteller-Vico A, Woodward EM, Troedsson MH, Squires EL.The objectives were to: (1) evaluate the efficacy of varying intervals of oxytocin administration in preventing luteolysis in mares; (2) examine PGF(2α) release in mares experiencing prolonged diestrus secondary to oxytocin treatment; and (3) evaluate the endometrial expression of oxytocin receptor, estrogen receptor α, and prostaglandin synthesis enzymes after oxytocin administration. In experiment I, mares received oxytocin (60 IU, im) daily on Days 8 to 10, 8 to 12, or 8 to 14 postovulation, and control mares received sterile saline. Prolongation of diestrus was defined by elevation of se...
Haag KT, Magalhães-Padilha DM, Fonseca GR, Wischral A, Gastal MO, King SS, Jones KL, Figueiredo JR, Gastal EL.A Biopsy Pick-Up (BPU) method was tested to determine the feasibility of retrieving preantral follicles from mare ovaries in vivo. A total of 33 ovarian biopsy procedures were performed on 18 mares during the breeding season. Mares were 5 to 21 years old and biopsies were performed during the estrous and/or diestrous phase, as confirmed by transrectal ultrasonography. Follicles were mechanically isolated using a tissue chopper, counted, and classified as normal or abnormal and primordial or primary. Viability of isolated follicles was determined by Trypan Blue dye. A total of 256 biopsy attemp...
Antczak DF, de Mestre AM, Wilsher S, Allen WR.A remarkable feature of equine pregnancy is the development of the invasive trophoblast of the chorionic girdle and its formation of the gonadotrophin-secreting endometrial cup cells in early gestation. The details of this process have been revealed only slowly over the past century, since the first description of the endometrial cups in 1912. This centennial presents an opportunity to review the characteristics of the cells and molecules involved in this early, critical phase of placentation in the mare. The invasiveness of the chorionic girdle trophoblast appears to represent an atavistic at...
Woodward EM, Christoffersen M, Campos J, Horohov DW, Scoggin KE, Squires E, Troedsson MH.The first objective of this study was to evaluate intrauterine nitric oxide (NO) and endometrial inducible NO synthase (iNOS) in mares susceptible or resistant to persistent breeding-induced endometritis (PBIE) within 24 h after breeding. Mares susceptible (n = 6) or resistant (n = 6) to PBIE were inseminated over five cycles, and uterine secretions and endometrial biopsies were collected before and 2, 6, 12 and 24 h after insemination. Uterine secretions were analysed for NO and biopsies were analyzed for iNOS expression. A second experiment evaluated the effect of treatment with dexame...
Artiushin S, Timoney JF, Fettinger M, Fallon L, Rathgeber R.Enterocolitis caused by Clostridium difficile (C. difficile) is a serious, sometimes fatal, disease of neonatal foals and older horses. Toxins A and B (TcdA and B) produced by C. difficile are important virulence factors. Immunisation of mares with receptor binding domains of toxins may prevent or reduce the severity of C. difficile colitis in foals. Objective: To determine whether antibodies generated in the pregnant mare to the binding regions of TcdA and B will neutralise TcdA and B toxicity. Methods: Sequences encoding the binding domains of each toxin were isolated by PCR amplification fr...
Schauer SN, Guillaume D, Decourt C, Watson ED, Briant C, Donadeu FX.There is evidence in several species that high circulating LH concentrations can interfere with normal follicle development and ovulation. In the mare, high LH levels after induction of luteolysis with PGF(2α) have been temporally associated with an increased incidence of anovulatory follicles. We hypothesized that a premature increase in LH levels during a follicular wave in mares would disrupt normal follicle maturation leading to ovulatory dysfunction. In experiment 1, all follicles >10 mm were ablated at midestrous cycle in pony mares followed by twice daily administration of equine LH...
Inácio SV, de Brito RL, Zucatto AS, Coelho WM, de Aquino MC, Aguirre Ade A, Perri SH, Meireles MV, Bresciani KD.The present study aimed to analyze the occurrence of infection by Cryptosporidium spp. in mares and their respective foals. This study was carried out in 11 farms located in the municipalities of Araçatuba, Birigui, Guararapes and Santo Antônio do Aracangua, in the northwest region of the State of Sao Paulo, from November 2010 to March 2011. A total of 98 mares and 98 foals of several breeds were analyzed; among foals, 59 were males and 39 females, aged from three to 330 days. Feces were collected directly from the rectal ampulla, purified and processed according to modified Kinyoun stain. O...
Melkus E, Witte T, Walter I, Heuwieser W, Aurich C.In mares, mating-induced persistent endometritis contributes to low fertility. The condition is in part related to delayed clearance of mucus accumulated within the uterine lumen. The objective of this study was to investigate the endometrial response of healthy mares to intrauterine (i.u.) treatment with N-acetylcysteine (NAC). Oestrous mares (n = 12) were randomly assigned to a treatment (TM) or control (C) group and received an i.u. infusion of 5% NAC and saline (total volume 140 ml), respectively. Endometrial biopsies were collected in five of the mares 24 h after treatment, in the rem...
Murase H, Niwa H, Katayama Y, Sato F, Hada T, Nambo Y.Fungal placentitis is an infectious disease inducing abortion in pregnant mares. In the present report, we describe a field case of abortion caused by fungal placentitis with consecutive examinations. The progesterone level and combined thickness of the uterus and placenta (CTUP) were abnormal before the onset of clinical signs. Additionally, the estradiol level started to change before the appearance of clinical signs. Abnormal serum amyloid A values and an abnormal fetal heart rate were observed after the onset of clinical signs. The present report demonstrates that the progesterone level an...
Panzani D, Rota A, Pacini M, Vannozzi I, Camillo F.One year old fillies are able to conceive but, usually, not to give birth to a living foal. Although embryo transfer allows the production of foals from mature mares with repeated pregnancy losses, no reports are available on the use of one year old fillies as embryo donors. To evaluate this possibility, eleven 12-16 months old Haflinger mares were inseminated with fresh semen and subjected to embryo recovery. Some of the recovered embryos were non-surgically transferred into synchronized mature recipients. Pregnancies were terminated using PGF2alpha at day 25. Fillies' embryo recovery rate an...
Gronwall R, Brown MP, Merritt AM, Stone HW.Serum concentrations and the pharmacokinetics of chloramphenicol were determined in 6 healthy mares after a single IV administration (50 mg/kg of body weight) or after the 1st and 5th sequential intragastric (IG) administration (50 mg/kg/6 hours) of chloramphenicol. Synovial fluid, peritoneal fluid, CSF, and urinary concentrations of chloramphenicol after the IG administrations also were determined. Mean (+/- SEM) overall elimination rate constant (K) values for the IV, 1st IG, and 5th IG dosages were 0.42 +/- 0.064/hr, 0.42 +/- 0.049/hr, and 0.29 +/- 0.074/hr, respectively, and were not signi...
Ginther OJ.Recent findings on the development and natural outcome of twins from Day 17 (immediately after fixation) to Day 40 are reviewed. Incidence of embryo reduction was increased significantly when the vesicles became fixed unilaterally, rather than bilaterally, and when the vesicles were unequal in diameter. Of 68 mares with twins on the day of fixation, post fixation embryo reduction occurred in 41 (60 per cent). The incidence of reduction was 41 of 48 (85 per cent) following unilateral fixation; reduction occurred in all of 22 mares with vesicles of dissimilar size (4 mm or more difference in dia...
Stickle RL, Erb RE, Fessler JF, Runnels LJ.Unilateral ovariectomy was performed on 3 mares affected with granulosa cell tumors. Tumor fluid in each mare was found to contain estrogen, testosterone, and progesterone. In 2 mares, preoperative blood plasma concentrations of these hormones were comparable to those of a series of clinically normal mares. The other mare, which had a history of aggressive, masculine behavior, had higher testosterone content in the tumor fluid and in the preoperative blood sample. After surgical removal of the tumors, each mare developed follicles and ovulated with the remaining ovary. Each was eventually bred...
Dini P, Ducheyne K, Lemahieu I, Wambacq W, Vandaele H, Daels P.Several methods have been proposed to advance the onset of the breeding season in horses. Most of them are based on the exposure to an artificial lighting period combined with hormonal treatments. Mares exposed to an artificial photoperiod are most often housed indoors where the ambient temperature is often higher than the outside temperature. Mares held in barns are also exposed to different daylight intensities than horses kept outside, depending on the architecture. In the current study, we evaluated the impact of ambient temperature, daylight intensity and changes in body condition score (...
Palmer E, Duchamp G, Cribiu EP, Mahla R, Boyazoglu S, Bézard J.The aim of this study was to test the possibility that ovulation can occur from a preovulatory follicle emptied of its follicular fluid. Transport of the oocyte into the oviduct and fertilisation in 29% of cases demonstrated that ovulation can occur in the absence of follicular fluid but the higher fertility achieved in control mares (62.5%) suggested that follicular fluid does serve a role during ovulation, fertilisation and oviductal transport. Injection of horse oocytes into preovulatory follicles in mules after removal of the follicular fluid, followed by insemination of the mules with hor...
Behrendt D, Burger D, Gremmes S, Szunyog K, Röthemeier S, Sieme H.Stallion-like or aggressive behaviour in mares affected by unilateral granulosa theca cell tumour (GTCT) is well-known, but use of a GnRH-vaccine as an alternative to surgical removal of the neoplastic ovary has not been investigated. Objective: To determine the effect of immunisation against GnRH on ovarian size, testosterone concentration, Anti-Müllerian hormone (AMH) concentration, and owner-reported behaviour in four mares affected by unilateral GTCT. Methods: Retrospective case report. Methods: A presumptive diagnosis of GTCT was made in four mares based on clinical signs, behavioural ch...
De Bont MP, Wilderjans H, Simon O.To describe a standing laparoscopic ovariectomy technique with intraabdominal ovarian dissection inside a specimen retrieval bag for removal of large pathologic ovaries through small incisions. Methods: Case series. Methods: Mares (n=43) aged 2-21 years and weighing 380-680 kg. Methods: Unilateral laparoscopic ovariectomy was performed on 43 standing sedated mares. Ovaries were approached via 3 portal sites, 2 in the paralumbar fossa and a 3rd between the 17th and 18th ribs on the ipsilateral side. Ovaries were dissected free using either a LiNA Tripol-bipolar laparoscopic forceps or a Ligasur...
Burns PJ, Kumaresan P, Douglas RH.An experiment was conducted to measure plasma oxytocin concentrations at 4 different stages of the estrous cycle in 11 pony mares. Plasma oxytocin concentrations (muU/ml +/- SE) were found to be higher (P<.01) on day 2 of estrous (39.8 +/- 12.5) and day 5 post-ovulation (33.1 +/- 12.0) than on day 10 (2.3 +/- 1.6) and day 15 post-ovulation (6.8 +/- 4.1). A second experiment was conducted to measure jugular plasma oxytocin concentrations before and after sexual arousal in six pony stallions. Oxytocin concentrations (muU/ml +/- SE) were higher (P<0.06) after sexual arousal (50.5 +/- 8.9) than be...
Stammers JP, Hull D, Leadon DP, Jeffcott LB, Rossdale PD.The concentrations and fatty acid composition of the plasma free fatty acid, triacylglycerol and phospholipid fractions were determined in maternal and umbilical cord vein blood samples taken at delivery from 17 mares. Maternal and umbilical vein plasma free fatty acid concentrations were of a similar order and a positive correlation was found between the two levels suggesting that the equine placenta is permeable to fatty acid. Substantial amounts of the essential fatty acids and their longer chain derivatives were seen in both umbilical vein plasma free fatty acid and phospholipid fractions ...
Wynn MAA, Esteller-Vico A, Legacki EL, Conley AJ, Loux SC, Stanley SD, Curry TE, Squires EL, Troedsson MH, Ball BA.During the latter half of gestation in mares, there is a complex milieu of pregnanes in peripheral blood. Progesterone concentrations are often assessed by immunoassay during late gestation as a measure of pregnancy well-being; however, interpretation of results is complicated by the numerous cross-reacting pregnanes present in high concentrations during late gestation. Further, many mares are supplemented with an exogenous progestin, altrenogest, which may also cross-react with existing assays and further confound interpretation. The objectives of this study were: 1) to compare differences in...