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This review highlights the importance of energy and protein nutrition of the dam on embryo production and embryo development. Fertility is reduced by greater negative energy balance post-partum as manifest by reductions in fertility and embryo quality associated with lower body condition score (BCS) but particularly with greater postpartum loss of BCS. In addition, excessive energy intake, particularly from high carbohydrate diets can reduce fertilization and embryo quality in some but not all circumstances. High protein diet s have been found to reduce embryo quality by day 7 after breeding, possibly due to greater blood urea nitrogen, however this negative effect is not observed in all studies. Sufficient circulating concentrations of amino acids, particularly rate-limiting amino acids such as methionine and lysine are critical for optimal milk production. The rate-limiting amino acids may also impact embryonic development, perhaps through improved amino acid profiles in the uterine lumen. Methionine may also have direct epigenetic effects in the embryo by methylation of DNA. Future studies are needed to replicate previously observed positive and negative effects of energy, excess protein, and amino acid supplementation in order to provide further insight into how embryonic development can be rationally manipulated using nutritional strategies.

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RESUMEN

This review highlights the importance of energy and protein nutrition of the dam on embryo production and embryo development. Fertility is reduced by greater negative energy balance post-partum as manifest by reductions in fertility and embryo quality associated with lower body condition score (BCS) but particularly with greater postpartum loss of BCS. In addition, excessive energy intake, particularly from high carbohydrate diets can reduce fertilization and embryo quality in some but not all circumstances. High protein diet s have been found to reduce embryo quality by day 7 after breeding, possibly due to greater blood urea nitrogen, however this negative effect is not observed in all studies. Sufficient circulating concentrations of amino acids, particularly rate-limiting amino acids such as methionine and lysine are critical for optimal milk production. The rate-limiting amino acids may also impact embryonic development, perhaps through improved amino acid profiles in the uterine lumen. Methionine may also have direct epigenetic effects in the embryo by methylation of DNA. Future studies are needed to replicate previously observed positive and negative effects of energy, excess protein, and amino acid supplementation in order to provide further insight into how embryonic development can be rationally manipulated using nutritional strategies.(AU)

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Circulating concentration of progesterone (P4) is determined by a balance between P4 production, primarily by corpus luteum (CL), and P4 metabolism, primarily by liver. The volume of large luteal cells in the CL is a primary factor regulating P4 production. Rate of P4 metabolism is generally determined by liver blood flow and can be of critical importance in determining circulating P4 concentrations, particularly in dairy cattle. During timed AI protocols, elevations in P4 are achieved by increasing number of CL by ovulation of accessory CL or by supplementation with exogenous P4. Dietary manipulations, such as fat supplementation, can also be used to alter circulating P4. Elevating P4 prior to the timed AI generally decreases double ovulation an d can increase fertility to the timed AI. This appears to be an effect of P4 during the follicular wave that produces the future ovulatory follicle, possibly by altering the oocyte and subsequent embryo. Near the time of AI, slight elevations in circulating P4 can dramatically reduce fertility. The etiology of slight elevations in P4 near AI is inadequate luteolysis to the prostaglandin F2 α (PGF) treatment prior to timed AI. After AI, circulating P4 is critical for embryo growth and establishment and maintenance of pregnancy. Many studies have attempted to improve fertility by elevating P4 after timed AI. Combining results of these studies indicated only marginal fertility benefits of <5%. In conclusion, previous research has provided substantial insight into the effects of supplemental P4 on fertility and there is increasing insight into the mechanisms regulating circulating P4 concentrations and actions. Understanding this prior research can focus future re search on P4 manipulation to improve timed AI protocols.

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RESUMEN

Circulating concentration of progesterone (P4) is determined by a balance between P4 production, primarily by corpus luteum (CL), and P4 metabolism, primarily by liver. The volume of large luteal cells in the CL is a primary factor regulating P4 production. Rate of P4 metabolism is generally determined by liver blood flow and can be of critical importance in determining circulating P4 concentrations, particularly in dairy cattle. During timed AI protocols, elevations in P4 are achieved by increasing number of CL by ovulation of accessory CL or by supplementation with exogenous P4. Dietary manipulations, such as fat supplementation, can also be used to alter circulating P4. Elevating P4 prior to the timed AI generally decreases double ovulation an d can increase fertility to the timed AI. This appears to be an effect of P4 during the follicular wave that produces the future ovulatory follicle, possibly by altering the oocyte and subsequent embryo. Near the time of AI, slight elevations in circulating P4 can dramatically reduce fertility. The etiology of slight elevations in P4 near AI is inadequate luteolysis to the prostaglandin F2 α (PGF) treatment prior to timed AI. After AI, circulating P4 is critical for embryo growth and establishment and maintenance of pregnancy. Many studies have attempted to improve fertility by elevating P4 after timed AI. Combining results of these studies indicated only marginal fertility benefits of <5%. In conclusion, previous research has provided substantial insight into the effects of supplemental P4 on fertility and there is increasing insight into the mechanisms regulating circulating P4 concentrations and actions. Understanding this prior research can focus future re search on P4 manipulation to improve timed AI protocols.(AU)

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Eleven infants of diabetic mothers with hypertrophic cardiomyopathy have been followed for 30 to 40 months. All infants presented with cardiorespiratory distress and were found to have disproportionate septal hypertrophy on echocardiogram. Cardiac catheterization was done in four infants; three had significant subaortic obstruction. One infant had remarkable improvement after treatment with propranolol. Two infants who received digoxin did poorly and responded favorably to cessation of therapy. The natural history of HCM-IDM appears to be benign, with a resolution of symptoms within two to four weeks and a resolution of septal hypertrophy within two to 12 months. Most of the infants need only supportive care; if pharmacologic intervention is deemed necessary, propranolol appears to be the drug of choice. The natural history of this entity is that of spontaneous regression of symptoms and septal hypertrophy irrespective of therapy.

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