Animal Reproduction Science 127 (2011) 135139

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Animal Reproduction Science

journal homepage: www.elsevier.com/locate/anireprosci

Reproductive performance of dairy cows with luteal or follicular

ovarian cysts after treatment with buserelin
Monica Probo a , Antonella Comin b , Antonio Mollo c, , Fausto Cairoli a , Giuseppe Stradaioli d ,
Maria C. Veronesi a
a
b
c
d

Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, University of Milan, Via G. Celoria, 10 20133 Milan, Italy
Department of Food Science, Faculty of Veterinary Medicine, University of Udine, Via Sondrio, 2/A 33100 Udine, Italy
Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, University of Padua, Viale dellUniversit, 16 35020 Legnaro (PD), Italy
Department of Animal Sciences, Faculty of Veterinary Medicine, University of Udine, Via Sondrio, 2 33100 Udine, Italy

a r t i c l e

i n f o

Article history:
Received 4 February 2011
Received in revised form 13 July 2011
Accepted 17 July 2011
Available online 16 August 2011
Keywords:
Dairy cow
Ovarian cysts
GnRH
Therapy

a b s t r a c t
In dairy farm management economic losses resulting from cystic ovarian degeneration are
well known. In spite of this, neither the denition nor the aetiopathology of ovarian cysts are
clear and agreed upon. Also the usual classication in luteal and follicular cysts, requiring
ultrasound examination together with assessment of P4 to be accurate, is not very helpful
in eld conditions. Consequently a single treatment is often provided for both types of cysts,
and since the 1970s treatments with GnRH and its analogues have been considered very
useful. Nevertheless differences in recovery rates after GnRH treatment in animals with
either luteal or follicular cysts are reported. Thus, the aim of this study was to evaluate
recovery rate, recovery time and conception rate after treatment with buserelin (GnRHanalogue) in cows with ovarian luteal or follicular cysts. In a 5 years period, 150 cows with
cysts out of a total of 990 animals, were detected and treated intravenously between 45
and 60 days PP with 20 g buserelin. No statistically signicant differences were found
in recovery rates and in conception rates between the two types of cysts. Comparison of
recovery times showed signicantly shorter recovery for cows with luteal cysts. The results
emphasise the usefulness of GnRH to treat ovarian cysts regardless of their type, in relation
to both recovery and conception rates. Intervals from treatment to resumption of ovarian
activity were affected by the characteristics of ovarian cysts, with a faster recovery for the
luteal type.
2011 Elsevier B.V. All rights reserved.

1. Introduction
The severe economic inuence of ovarian cysts on the
dairy industry is well-known, since losses caused by prolonged calving intervals and increased culling rates must
be added to the direct costs of medical treatment.

Corresponding author. Tel.: +39 0498272949; fax: +39 0498272954.

E-mail addresses: monica.probo@unimi.it (M. Probo),
antonella.comin@uniud.it (A. Comin), antonio.mollo@unipd.it (A. Mollo),
fausto.cairoli@unimi.it (F. Cairoli), giuseppe.stradaioli@uniud.it
(G. Stradaioli), maria.veronesi@unimi.it (M.C. Veronesi).
0378-4320/$ see front matter 2011 Elsevier B.V. All rights reserved.
doi:10.1016/j.anireprosci.2011.07.019

During the last few years, the denition of ovarian cysts

has been frequently revised. Silvia et al. (2002) dened
them as follicle-like structures, with a minimum diameter
of 17 mm, persisting for more than 6 days in the absence of a
corpus luteum and clearly interfering with normal ovarian
cyclicity. Wiltbank et al. (2002) dened them as follicular structures of 20 mm or more in diameter, persisting for
at least 7 days in the absence of a corpus luteum. More
recently, ovarian cysts have been dened as follicles with a
diameter of at least 20 mm, present on one or both ovaries
in the absence of any active luteal tissue and which clearly
interfere with normal ovarian cyclicity (Vanholder et al.,
2006).

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M. Probo et al. / Animal Reproduction Science 127 (2011) 135139

Despite many years of research on this subject, a commonly accepted denition is still lacking, probably due to
cyst heterogeneity (type, time of occurrence, clinical signs).
The statement that a single follicle persists, for example,
may not always be exact when we recall that, sometimes after a time of persistence, a specic cystic follicle
may spontaneously regress (Kesler and Garverick, 1982;
Day, 1991) and be replaced by other cysts (Cook et al.,
1990; Savio et al., 1990); it is probably more correct
to state that the anovulatory condition persists (Peter,
2004). Spontaneously regressing anovulatory follicles are
frequently found in the early postpartum, when critical
hormonal changes are responsible for resumed regular
ovarian cyclicity. Considering the high percentage of spontaneous regression (Day, 1991; Kesler and Garverick, 1982),
the detection of anovulatory follicles in the rst weeks after
calving should not be considered as an ovarian impairment.
From a practical point of view, an ovarian dysfunction may
be suspected when anovulatory follicles are detected not
earlier than 7 weeks after calving, when reproductive functions are thought to be restored (Gier and Marion, 1968;
Sheldon and Dobson, 2004).
The exact pathogenesis of cystic ovarian degeneration
(COD) in dairy cows is still not completely understood, and
it is generally accepted that the etiology is multifactorial, in
which genetic, phenotypic and environmental factors are
involved (Vanholder et al., 2006). The most widely accepted
hypothesis is based on neuro-endocrinological dysfunction of the hypothalamic-pituitary-gonadal axis (Kesler
and Garverick, 1982; Liptrap and McNally, 1976).
As regards the role of progesterone (P4) levels in cyst
formation, Hatler et al. (2003) found that 66% of cows with
follicular cysts had plasma P4 concentrations which were
intermediate (0.10.93 ng/ml) at the time of cyst detection. In another study, Vanholder et al. (2005) found that, at
the time of formation, only a minority of cysts (25%) were
associated with suprabasal P4 levels (0.32 ng/ml) and that
these concentrations are able to block the LH surge, inhibiting ovulation, but differences in the protocols make the two
experiments difcult to compare. Moreover, a recent study
(Probo et al., 2011) found no evident biological changes in
P4 during the cystic condition, with plasma P4 concentrations always ranging from 0.3 to 1.2 ng/ml.
Plasma P4 levels have been demonstrated to be positively correlated with cyst thickness (Douthwaite and
Dobson, 2000) so that measurement of P4 concentrations
can be used to determine cyst type. In any case, accurate
classication and diagnosis of cyst type requires ultrasound
examination together with assessment of P4, since each
examination alone frequently leads to ambiguous results
(Dobson et al., 1977; Hanzen et al., 2000). However, milk
or plasma P4 tests are not extensively available and, as
it is often difcult to differentiate luteal from follicular
cysts in farm conditions (Lopez-Gatius and Lopez-Bejar,
2002), a single treatment is often provided for both types.
The possibility to diagnose luteal cysts would allow to
treat them with PGF2 shortening the recovery time, while
using PGF2 on follicular cysts would result useless. Since
the 1970s, hCG and GnRH analogues have been used to
treat ovarian cysts, and both appear to be equally effective
as regards treatment response and fertility (Peter, 2004).

Between the two, the use of GnRH and its analogues has
been considered as very interesting, due to its satisfactory success rate, irrespective of type of cyst, absence of
antigenic effects, and low pharmaceutical cost (Carruthers,
1986; Ngategize et al., 1987). In a study employing various doses of GnRH, Bierschwal et al. (1975) found a
recovery rate of 6482%, a mean time from treatment
to oestrus of 22.222.8 days, and a conception rate of
7287%; similar results were also found by Ijaz et al. (1987),
with 6580% of cows re-establishing ovarian cyclicity after
GnRH treatment. Nevertheless, poor or no response by
luteal cysts to GnRH has also been previously reported
(Dobson et al., 1977; Sprecher et al., 1990), and opinions
vary among bovine practitioners regarding differing recovery rates after GnRH treatment in animals with luteal or
follicular cysts. Thus, the aim of this study was to evaluate recovery rate, recovery time and conception rate after
treatment with buserelin in cows with ovarian luteal or
follicular cysts.
2. Materials and methods
2.1. Farms, animals and treatments
The study took place over a 5-year-period in four herds
(200300 cows each) located in northern Italy (Lat 9 55
N; Long 45 52 E), signicant climatic variables of the area
are reported in Table 1. The herds were characterised by
mean annual milk production of 8700 kg per cow (3.8%
fat and 3.5% proteins). The diet was formulated to provide 23 kg/day, 16.0% crude protein, 1.90 Mcal/kg NEL (Net
Energy of Lactation), 31.4% NDF (Neutral Detergent Fibre),
40.5% NSC (Non-Structural Carbohydrates) and 6.1% crude
fat.
During postpartum (PP) monitoring, starting from the
4th week PP, a single practitioner examined by rectal palpation once a week the genital tracts of 990 Friesian cows,
together with an ultrasound examination (real-time linear
array, 7.5 MHz rectal probe, Esaote Pie Medical, Florence,
Italy) for better evaluation of the morphology and evolution
of ovarian structures.
Only cows bearing follicular structures with diameter
larger than 20 mm, in the absence of any corpus luteum and
persisting for at least 7 days, were considered as affected
by ovarian cysts.
The ultrasound examination was combined with assessment of P4 plasma values to identify cyst type. A plasma
progesterone cut-off of 1 ng/ml was used. Cysts with a
thicker wall (3 mm), a visible echogenic rim or echogenic
spots, and a P4 concentration 1 ng/ml, were considered
as luteal (group A); cysts with a thin wall (3 mm), a uniformly anechogenic uid and a P4 concentration <1 ng/ml
were considered as follicular (group B) (Vanholder et al.,
2006).
At conrmed diagnosis, all cows with ovarian cysts were
then treated, one time, intravenously between 45 and 60
days PP with 20 g buserelin (GnRH-analogue).
After treatment, animals were clinically checked twice
a day to detect oestrus. Recovery was identied as the presence of normal oestrus, without any relapse of cysts, within
30 days of treatment. Only cows in oestrus, within 30 days

M. Probo et al. / Animal Reproduction Science 127 (2011) 135139

137

Table 1
Mean maximum and minimum temperatures ( C) and mean maximum humidity (%) registered in the 5 years of the experiment.
January

February

March

April

May

June

July

August

September

October

November

December

T max
(SD)

5.9
(1.8)

9.3
(1.5)

14.5
(1.4)

19.0
(1.8)

24.0
(1.7)

28.2
(1.6)

30.2
(1.0)

29.1
(2.4)

24.0
(1.4)

18.2
(1.4)

11.6
(1.0)

6.5
(1.5)

T min
(SD)

1.2
(2.1)

0.2
(1.7)

3.7
(1.1)

7.8
(1.2)

12.6
(0.9)

16.8
(1.2)

18.3
(0.9)

17.6
(1.6)

13.5
(1.3)

9.8
(1.5)

4.6
(1.5)

0.7
(1.8)

hum %
max(SD)

95
(2)

92
(4)

90
(3)

91
(4)

98
(4)

87
(3)

87
(4)

89
(5)

90
(4)

95
(3)

95
(2)

95
(3)

of treatment with a pre-ovulatory follicle and normal condition of the genital tract (uterine tone, cervical mucus)
were submitted to AI 12 h after detection of oestrus with
semen of proven fertility. Pregnancy diagnosis was carried
out by palpation per rectum within 6 weeks of AI.
2.2. Hormonal analysis

than with follicular cysts (16.1 2.1 vs 24.5 4.0 days;

p < 0.05 respectively) (Table 3).
No signicant differences were observed in conception
rates between the two groups of cysts.

4. Discussion

Blood samples were taken into heparinized vacuum

tubes from the jugular vein before treatment. Samples were
centrifuged (20 min at 1000 g) within 30 min of collection, and plasma was stored at 20 C until analysis of P4
levels.
Plasma concentrations of P4 were measured by the validated radioimmunoassay method (Bono et al., 1996). The
intra- and inter-assay coefcients of variation were 6.9%
and 6.98%, respectively; assay sensitivity was 13 pg/mL.
2.3. Statistical analysis
Recovery
and
conception
rates
(pregnant
cows/inseminated cows) were evaluated with the Fisher
test, and recovery time by the t-test for independent
samples, with p < 0.05. Data were checked for normality
by the ShapiroWilk test.
3. Results
Irrespectively of type of cyst, 150 cows with cysts out of
a total of 990 animals were detected, with a prevalence of
15.15%.
Classication of type of cyst, based on plasma P4 concentrations, ultrasound, or both, is listed in Table 2.
Data on recovery rates and recovery time, and conception rates in cows with luteal or follicular cysts treated
with buserelin, are shown in Table 2. No statistically significant differences were found in recovery rates between the
two types of cysts. Since the ShapiroWilk test (W = 0.971;
p = 0.302) provided sufcient evidence of normal distribution, comparison of recovery times with the t-test showed
signicantly shorter recovery for cows with luteal cysts

In our study, the prevalence of ovarian cysts was 15.15%,

higher than the 6.3% reported by Hooijer et al. (2001) on
14,974 lactations, but comprised in the wide interval, from
5.6% to 18.8%, reported by Garverick (1997). The decision
to classify luteal and follicular cysts by both P4 levels and
ultrasound was based on the well-known limitations of
these identication methods alone (Dobson et al., 1977;
Hanzen et al., 2000). Douthwaite and Dobson (2000) stated
that ultrasound scanning was more accurate in diagnosing
follicular cysts than luteal ones, and that the combination
with plasma P4 concentrations gives the most accurate
assessment of cyst type (92% for follicular cysts, and 82%
for luteal ones). Seventeen of the 150 cows with cysts
were therefore excluded from the study, since P4 levels and
ultrasound results were contradictory.
The administration of 20 g of buserelin stimulated
resumption of ovarian cyclicity in about 71% of the
133 cows, in agreement with the 6482% reported
by Bierschwal et al. (1975) after varying GnRH doses
(50250 g).
Seventy percent of the treated cows were inseminated
within 4 weeks of treatment, and 40.3% became pregnant.
Considering the last 5 years, the mean conception rate
among the 4 herds was higher (51.6%), although it must be
borne in mind that the results of the present study are based
on cows recovering from pathologic conditions. In a eld
study in the Netherlands, 50% of cows treated for cysts with
GnRH were inseminated within 24 days of treatment, and
more than 50% of the cows which became pregnant after
treatment needed only one insemination (Hooijer et al.,
1999). Recovery time in the present study was comparable
with that of Hooijer et al. (1999), although the pregnancy
rate after rst insemination was lower. This discrepancy

Table 2
Classication of cysts in cows according to evaluation criteria such as plasma P4 concentrations and ultrasound measurement of ovarian structures.
Type of cysts

According to P4 measurements
Cows, n (%)

According to ultrasound measurements

Cows, n (%)

According to both methods

Cows, n (%)

Luteal cyst
Follicular cyst
Total

59(39.3)
91(60.7)
150(100)

57(38)
93(62)
150(100)

53(39.85)
80(60.15)
133(100)

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M. Probo et al. / Animal Reproduction Science 127 (2011) 135139

Table 3
Recovery rates (oestrus within 30 days), recovery time (time between treatment and oestrus) and conception rates (pregnant cows/inseminated cows) in
cows with luteal and follicular cysts after treatment with buserelin.
Group
Luteal cysts
Follicular cysts
Total
*

Cows (n/%)
53 (39.85)
80 (60.15)
133 (100)

Recovery rate (n/%)

Recovery time days (mean SD)

Inseminated (n/%)

Conception rate (n/%)

38 (71.7)
57 (71.3)
95 (71.3)

16.1 2.08
24.5 4.01*

27 (71.1)
40 (70.2)
67 (70.5)

11 (40.7)
16 (40.0)
27 (40.3)

p < 0.05.

may be due to differences in genetic and management of

the cows, mainly in productive performance.
Data from this study highlight the fact that the recovery
rate does not depend on type of cyst (luteal = 71.7%, follicular = 71.3%), whereas a statistically signicant difference
was seen in recovery times, revealing a shorter recovery
time in cows with luteal cysts (16 days vs 24 days). It is
difcult to explain the reason for the shorter recovery time
in cows with luteal cysts after buserelin treatment. It may
be hypothesised that P4 plasma concentrations in cows
with such cysts modulated their follicular growth, as shown
by Stock and Fortune (1993) in normal conditions. Similarly, Douthwaite and Dobson (2000) found the presence
of follicles with diameter >5 mm in an increased number of
animals with luteal cysts before treatment.
Another possible hypothesis, considering follicular and
luteal cysts to be different forms of the same disorder
(Opsomer et al., 1997) and particularly considering luteal
cysts to be later stages of follicular ones (Garverick, 1997),
may be ascribed to the faster healing times of luteal
cysts after treatment with buserelin and to the acceleration of an already ongoing healing process. An association
between administration of GnRH and ovarian blood ow
was observed by Acosta et al. (2003). Miyamoto et al. (2006)
and Rauch et al. (2008) used Doppler sonography to bind
an increased blood ow in luteal cysts compared with follicular ones. Suprabasal progesterone concentration blocks
the LH surge, but increases LH pulse frequency (Duchens
et al., 1994). Thus, the increased blood ow and LH pulse
frequency in luteal cysts may lead to faster cyst regression, enhancing the luteolytic process, restoring the normal
function of the hypothalamic-pituitary-ovarian axis, and
advancing healing and the appearance of oestrus.
In conclusion, the results of the present study emphasise the usefulness of GnRH to treat ovarian cysts regardless
of their type, in relation to both recovery and conception rates. Intervals from treatment to resumption of
ovarian activity were affected by the characteristics of
ovarian cysts, with a faster recovery for the luteal type.
An ultrasound examination, performed 7 days after GnRH
treatment, in the cows presenting follicular cysts should
allow to detect the animals with an adequate luteal evolution. These cows could be treated with PGF2 to improve
the recovery time.
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