Evaluation of equine endometrium using Confocal Laser endomicroscopy


This project seeks to develop a novel stateoftheart diagnostic technique to evaluate the health of uterine tissue in broodmares. Confocal laser endomicroscopy (CLE) is an advanced imaging tool that is revolutionising the diagnosis of cancers and inflammatory diseases in human medicine (e.g. colon cancer). CLE is a miniaturised microscope embedded inside a videoendoscope that can be passed through a mare’s cervix to view and image uterine tissue at high magnification. In essence, we can capture “virtual biopsies” of multiple sections of the inside of the uterus (endometrium) instead of surgical biopsies. Endometrosis and endometritis are fibrotic and inflammatory conditions of the uterus in broodmares and have been proven to cause poor reproductive performance and as such are commonly found in barren mares. The current gold standard diagnostic practices have not changed much since the late 1970’s. This project seeks to improve diagnostic capabilities and enhance breeding efficiency in the Thoroughbred horse industry by working towards developing this novel method for the detection and understanding of uterine disease. The main outcomes from this project will be to determine the optimum time in the mares breeding cycle for imaging the uterus with CLE to generate best quality images and to also create a grading system and instructions that can be used by veterinary practitioners for CLE endometrial tissue imaging in broodmares.


Thoroughbred Horses

Research Organisation

The University of Adelaide

Objective Summary

The main objective of this study of this study will be to develop CLE as a novel diagnostic tool for assessment of uterine health in the mare. The first objective of this study is to determine the optimum phase of the mare’s oestrous cycle to use CLE for assessing endometrial tissue. By determining the optimum phase of the oestrous cycle for the application of this imaging modality, we hope to achieve maximal image quality and diagnostic yield. Improving the quality and efficiency of imaging the uterus will improve our understanding and diagnostic capabilities and in turn lead to improved health recommendations and treatment of reproductive disorders of the mare. We hypothesise that physiological endometrial oedema that is present during oestrus will negatively impact image quality during CLE examination and that images collected at dioestrus or early/late oestrus, when minimal oedema is present, will have improved quality and diagnostic yield. Our second objective is to create a universal grading system for this imaging modality by indexing a wide variety of equine endometrial tissue. An expected outcome will be to create an atlas describing the use of CLE for grading equine endometrium that can be interpreted and used by other clinicians in the assessment of equine uterine health. These objectives are in close alignment with Objective one and two, as outlined in the five year plan for the new Thoroughbred Horses RD&E program. Specifically, we aim to address objective 1: Continue to improve breeding outcomes and foal health and development. For the breeding industry to be successful, bred mares are expected to be productive and deliver live and healthy foals. A healthy uterine environment is a crucial factor in this process and as such accurate diagnosis, management and treatment strategies can all help to reduce reproductive inefficiency.

Project Code


Project Stage


Project Start Date

Thursday, July 30, 2020

Project Completion Date

Saturday, December 31, 2022

Journal Articles From Project

Not Available

National Priority

Frontier technologies for building and transforming Australian industries

National Priority

Adoption of R&D

National Priority

HOR-Improve breeding outcomes and foal health and development