1120260

research-article2022
JDMXXX10.1177/87564793221120260Journal of Diagnostic Medical SonographyBagley et al

Literature Review
Journal of Diagnostic Medical Sonography

The Role of Transrectal Sonography in

2023, Vol. 39(1) 50­–60
© The Author(s) 2022
Article reuse guidelines:
Pregnancy Diagnosis in Cattle sagepub.com/journals-permissions
DOI: 10.1177/87564793221120260
https://doi.org/10.1177/87564793221120260
journals.sagepub.com/home/jdm

Jennifer Elaine Bagley, MPH, RDMS, RVT1 ,

Michelle P. Richter, BS, BSMIRS, RDMS2,
and Taylor Jo Lane, BSMIRS3

Abstract
Objective: A reproduction management strategy is an essential component of any cattle production operation.
Options include palpation per rectum, transrectal sonography, or biochemical blood tests. To determine the best
method, veterinary costs must be weighed against operational costs of maintaining open cattle.
Materials and Methods: An online literature search using PubMed, Medline, CINAHL, EBSCO, and Google Scholar
was completed to find relevant articles regarding pregnancy detection in cattle, costs of reproductive management in
cattle, and pregnancy loss in cattle. Priority was given to original research articles pertaining to palpation per rectum,
transrectal ultrasound, fetal gender, and pregnancy loss.
Results: Transrectal sonography can detect a pregnancy up to 15 days earlier than palpation per rectum and has
sensitivities and specificities as high as 97% when performed between days 21 and 35 post artificial insemination.
Conclusion: Cattle producers can be confident that transrectal sonography is a useful tool in the beef and dairy cattle
industry. Its use facilitates reproductive management decisions, such as re-breeding or culling, thus reducing expenses,
and increasing profitability.

Keywords
transrectal ultrasound, palpation per rectum, heifer, cow, cattle, pregnancy loss in cattle, fetal gender identification

The beef cattle industry has 3 categories or phases of help improve profitability, and more producers are look-
development: cow-calf producers, stockers, and feedlot/ ing to sonography as a technology tool to improve their
finishing. Commercial beef cow-calf producers focus on reproductive management operations. Sonographic tech-
producing a calf to sell and retaining a small percentage nology may help the producer manage pregnancy diagno-
of the calves to replace older cows. In the beef industry, sis that aids in better, more cost-effective management
producers sell calves to backgrounding or stocker opera- decisions. This literature review compares transrectal
tions between 7 and 12 months of age. The expectation is sonography to palpation per rectum to determine which
for a cow to produce a calf for sale once every 12 months, technique best predicts pregnancy in cattle.
and to produce 5 to 6 calves over the time of ownership.1,2
In the dairy industry, the focus is to add more cows to the
Materials and Methods
heard to increase milk production, or to sell a bull calf, or
low producing cow at market for beef. In both cattle An online literature search using PubMed, Medline,
industries, accurate pregnancy diagnosis is crucial to cre- CINAHL, EBSCO, and Google Scholar to find relevant
ate income and a consumer product for market. articles regarding pregnancy detection in cattle, costs of
Cattle industry profits depend on the selling prices at
the time the cattle are sent to market. Beef and dairy 1
University of Oklahoma Health Sciences Center, Oklahoma City,
cattle producers do not control market prices. Timing to OK, USA
market can impact profit; dairy cattle prices are highest 2
Saint Francis Healthcare System, Tulsa, OK, USA
3
between March and May while beef cattle tend to sell at Stillwater Medical Center, Stillwater, OK, USA
higher prices in the fall.3 Managing the breeding cycle Received June 17, 2022, and accepted for publication July 27, 2022.
to optimize the timing to sell at market is an essential
Corresponding Author:
component of cattle production.3 In addition to market Jennifer Elaine Bagley, MPH, RDMS, RVT, 4502 E. 41 Street 2D35,
prices, producers consider operational costs and effi- Tulsa, OK 74135, USA.
ciency to maximize profits. Advancing technology may Email: [email protected]
Bagley et al 51

reproductive management in cattle, and pregnancy loss

in cattle. Priority was given to original research articles
pertaining to palpation per rectum, transrectal sonogra-
phy, fetal gender identification, and pregnancy loss.
Sixteen research studies that included the accuracy or
safety of transrectal palpation, chemical assay, or tran-
srectal sonography were analyzed. An additional 22
research or review articles were included for their rele-
vance to the background on the cattle industry and
reproduction management.

Bovine Reproductive Cycle

An understanding of the bovine reproduction cycle allows
producers to manage their herds. Heifers are female cattle
that have not produced a calf while a cow has produced at
least one calf. The reproductive anatomy includes vagina, Figure 1. Example of cattle in chute in preparation for
cervix, uterus, uterine horns, oviducts (fallopian tubes) either artificial insemination or a sonography exam. In the
and ovaries. At 9 to 15 months, a heifer should enter her foreground are equipment and supplies for vaccinations and
other testing. Because it is labor intensive and expensive to
first heat, also known as estrus.4 Dairy cattle tend to enter round up a herd, producers will attempt to do as many tasks
estrus earlier than beef cattle.4 At this time, the heifer as possible with the cattle in the chute.
should then enter estrus about every 21 to 28 days, and
like humans, this cycle is regulated hormonally.
A bovine gestation period is approximately 283 Breeding includes planned artificial insemination (AI)
days.4 At day 0, ovulation occurs, and the dominant fol- as well as putting cows and heifers in the pasture with
licle is present.5 The corpus luteum develops at days 1 bulls.2,5,8 There are usually 2 cycles of AI, with exposure
to 2 and enlarges through days 15 to 16 and produces to bulls in between. Heifer breeding should begin about
progesterone.5 At this time,5 if there is not a pregnancy, 30 days earlier than cows.9 Additionally, best practices in
progesterone production decreases, and the corpus management include pregnancy verification that occurs
luteum dissolves by day 18. Once fertilization occurs, at some interval following the second AI and is at least 30
the corpus luteum continues to produce progesterone. days after the planned breeding cycle concludes.1,9
After fertilization, embryogenesis6,7 occurs between 24 There are time and labor costs associated with preg-
hours and days 5 to 6. At day 7 of estrus, the embryo nancy testing. Corralling the herd occurs multiple times:
implants.6,7 By day 18 to 22, the placenta attaches, and the once for synchronizing estrus in the herd (insertion of a
heartbeat is established around 22 days.7 At 45 days gesta- hormone device), twice for AI, and once for pregnancy
tion, the uterine horn is enlarged and prominent. The uter- checking. The producer confines each cow to a chute, one
ine horn is fluid filled, enlarged, and pulled over the pelvic at a time, for the procedures. Figure 1 provides an exam-
brim of the cow at 60 days gestation.1 At 90 days gesta- ple of placing a cow in a chute after the herd has been
tion, both uterine horns are swollen and positioned deep corralled. Each time corral occurs, the producer incurs
into the cow’s body cavity.1 At 120 days gestation, the costs of time, money, or both.
uterine characteristics are similar, but the fetus is larger.1 At the point of pregnancy testing, the producer sepa-
rates cattle into a pregnant and non-pregnant (aka open).
Pregnant cattle are placed on a pregnancy support plan,
Need for Reproduction Management Strategy and the producer’s focus turns to management decisions
The reproductive strategy varies for dairy versus beef for the open cattle. Choices for managing this group
cattle. The beef cattle production profits are tied to mar- include re-breeding in the same breeding season, holding
ket pricing, and beef cattle producers must strictly man- for the second breeding season, or culling from the herd,
age herd reproduction.1 Beef cattle producers have the that is, selling for beef. Open heifers pose a risk to the
following goals for calving: a calving interval of no more producer, as failure to get pregnant suggests they have
than 12 months, weaning calves at 5 to 9 months, and a low fertility and a low probability of meeting the long-
planned 90-day (or less) breeding period.2,5,8 The goals term calving needs.10 Artificial insemination, pregnancy
are to achieve 100% pregnancy in the herd so that approx- testing, and other maintenance costs can be up to $900
imately 10% of the cattle will be kept to replace aging per year per head.1,9,11,12 Early culling decisions can
and ailing cows, while the remaining 90% will be sold. increase income1,8,13 as much as 20%.
52 Journal of Diagnostic Medical Sonography 39(1)

pregnancy.16,17 The supplies that are needed include a

reproductive sleeve (see Figure 2) that covers the palpa-
tor’s arm and a lubricant. There are no other major equip-
ment costs for transrectal palpation, and the success of
the technique depends on the skill of the palpator. A vet-
erinarian will charge between 3 and 5 dollars per head
plus a visiting fee.1,13,18 The producer can perform this
examination which reduces costs.
A second reproductive monitoring strategy is bio-
chemical assay testing or milk progesterone sampling.1,9,17
Biochemical tests can yield up to 93% to 99% accuracy,
whereas milk progesterone testing is most accurate at
predicting non-pregnant status.1 The costs range from
$2.50 to $3.50 per head.1,13 Additional costs may include
needles, syringes, and vials. Biochemical testing yields
the best results when performed around day 30 post-
breeding.19 False positives may result from either early
pregnancy loss, or recent parturition.1,9,19,20 Cross-
contamination and delay in receiving results are the pri-
mary limitations.1,9 Because of the delay in results, most
large-scale producers do not recognize cost-savings with
Figure 2. The veterinarian has his arm covered in a the biochemical or milk progesterone tests.9
reproductive sleeve up to his shoulder. He is inserting his The third, technique to determine pregnancy in cattle
arm, up to his mid-bicep, deep into the rectum. The arm is TRUS, which includes a transducer inserted into the
must go into the rectum this deep because the pregnancy rectum.1,8,15,18,19 Either a veterinarian or a trained pro-
is deep in the pelvis. This position poses more risk for
ducer performs the procedure which confirms pregnancy
musculoskeletal injury due to the awkward position, as well
as safety risks if the cow were to move quickly, jerk, or kick and can estimate gestational age. In some states, veteri-
during the rectal palpation. narians are the only group of people who can charge for
these sonographic services.18 When properly trained, pro-
ducers can accurately detect pregnancies with TRUS at
Pregnancy Detection Techniques 45 days post conception, but experienced veterinarians
There are 3 techniques for pregnancy verification: tran- can accurately detect pregnancy as early as 25 days post-
srectal ultrasonography (TRUS), palpation per rectum conception.19 The cost1,13of ultrasound equipment sys-
(PPR), or laboratory blood chemistry testing. All tech- tems ranges from $7,000 to $16,000. The cost combined
niques incur veterinary, supply, time, and labor costs. The with the knowledge and training needed, is why veteri-
most cost-effective technique often depends on the accu- narians tend to be the primary purchaser.1,13,21 Additional
racy of the technique, the size of the operation, whether supplies needed to perform TRUS include reproductive
the producer can perform some of the techniques, and if sleeve (see Figure 2) and lubricant. For pregnancy status
they can join with other producers to share equipment and verification, veterinarians charge between $3 and $10
veterinary costs.1 The best technique is the one that opti- dollars per head plus a visiting fee.13,18 If the producer
mizes pregnancy detection, can be performed rapidly, requests more information, such a fetal age or fetal sex,
incurs minimal expenses, and the decision may be unique the fees will increase.13,18
to each operation.
The oldest and most widely used technique to verify
Ultrasonography in the Cattle Industry
pregnancy in cattle is the palpation per rectum (PPR)
technique.14,15 In Figure 2, there is an example of the PPR There are differences in the systems used in cattle opera-
technique. At 60 days, PPR is considered accurate.1,9 The tions compared to that used in human diagnostic sonog-
technique requires palpation and recognition the follow- raphy. Because the producer will scan multiple cattle in
ing structures: a membrane, the amniotic sac, and the one session, the system must be portable and durable
placentomes.1 A palpator may be able to determine preg- (see Figure 3). Scanning usually occurs outdoors, where
nancy by noting the size and location of the uterine horns access to electrical outlets is not practical as well as no
as well as detecting changes in the uterine tone.1 Palpation ability to control lighting conditions. These systems need
per rectum can provide information regarding pregnancy to run on long-life battery power and have quick recharg-
status, predicted calving dates, and can predict twin ing capabilities. Lastly, because they are used outdoors,
Bagley et al 53

Figure 3. Example of a portable, battery-operated system

used in cattle operations.

they must be sturdy enough to survive extreme weather

conditions.22 There is not usually a hard copy record of
Figure 4. Example of scanning. Note the system is mounted
the sonogram, and data obtained is more often recorded
on the side of the chute (straight arrow) using carabiner clips
via the producer’s own record management system, or and cords. Note the distance from the cow’s rectum to the
by marking the cattle pregnant or open and sorting them ultrasound equipment system. The veterinarian is using a
into those groups at the time of diagnosis.19 Figure 4 is transducer mounted on a repro arm (not shown) to aid in
an example of a portable battery-operated unit mounted minimizing the reach of his shoulder and arm.
on the side of the chute.
The overall goal for imaging is different from a diag- hand and transducer. The linear transducer lays face down
nostic medical exam for a human patient. The primary in the palm of the hand with the leading edge at the tip of
aim when performing sonography is to have quick identi- the middle finger, pointer, and ring fingers along the side
fication of pregnant or open cattle and rapid throughput. and thumb at the back edge, forming a cone shape to help
The producer does not judge the sonographic image for stabilize the transducer while scanning. The producer
quality, and fetal anomalies are not a concern because the pushes their hand gently into the rectum while holding
process of AI removes genetic abnormalities from the the transducer. The examiner has risks for injury in this
gene pool. An ultrasound equipment system that is dedi- procedure due to how far they insert their arm into the
cated to cattle operations has limited presets and controls rectum to bring a deeply located uterus into the trans-
such as depth and brightness (see Figure 5). There are no ducer field of view.
measuring calipers, instead the image will also include an The repro arm is an alternative form of transrectal
overlay grid pattern set in centimeter increments which is scanning (see Figure 7). A convex transducer is embed-
used to measure size/depth (see Figure 6). Cleanliness is ded on the end of repro arm (see Figure 8), and the opera-
not important, and equipment disinfection typically tor holds the repro arm while inserting it into the rectum.
occurs only when blood is present on the reproductive The producer may find this technique more challenging
sleeve. It is common for the systems to be exposed to dirt because of his inability to feel and locate the reproductive
and bovine body fluids (see Figure 6). tract as one would with palpation. Advantages of the
The operator will choose between a linear or convex technique include less operator strain or injury because
real time B mode ultrasound transducer based on the cho- their arm is not held in an awkward position for extended
sen TRUS method. The linear probe is inserted into the time. Additionally, the repro arm technique decreases
rectum with the scanner’s arm similar to the PPR tech- total exam time and allows for hundreds of cattle to be
nique (see Figure 4), whereas convex transducers are examined in a day. Figure 9 demonstrates the use of the
used with an extension arm, also called a repro arm (see repro arm while scanning.
Figure 7). When using the linear transducer, the operator The bladder is an anechoic landmark, with the uterus
dons a reproductive sleeve on their arm (see Figure 2), located superiorly. The sonographic appearance of a
holds the transducer in their hand and applies lube to their bovine uterus is an echogenic rosette in transverse plane.
54 Journal of Diagnostic Medical Sonography 39(1)

Figure 5. Ultrasound equipment system control panel. This Figure 7. The veterinarian has a repro arm in his left hand.
panel includes controls for: depth and brightness. This control The transducer is mounted on the end of it. The repro arm
panel will also determine the size of the on-screen grid used is inserted into the rectum. The length of the arm allows
for measuring. the scanner to position himself away from the cattle’s hind
quarters which prevents him from being kicked. The repro
arm is advantageous over rectal palpation because the
scanner’s arm is not inserted into the rectum, which protects
it from awkward positions if the cow suddenly jerks, kicks, or
moves. Note the reproductive sleeve worn on the left arm.

Figure 6. The grid overlay on the screen display. The

operator sets this grid in centimeter increments and to
determine depth and distance. Distance measurements can be
used to determine gestational age if the producer requests it.
Age determinations and more complex exams require extra
veterinary fees. The dirt and debris seen on the bottom of
the screen is common.
Figure 8. The curvilinear transducer is embedded into the
end of the repro arm.
Bagley et al 55

Figure 9. Scanning with repro arm. Note the examiner’s

position and distance from the cow’s rectum while scanning
with the repro arm (white arrow). The examiner’s scanning
arm is more protected with this technique as well as reduced
risk of being kicked or having his arm twisted if he were
scanning via the arm in the rectum or performing rectal Figure 11. The uterine horn is located between the white
palpation. Note the reproductive sleeve on the left arm goes arrows.
all the way up to the shoulder. The green arrow is pointing
to the ultrasound equipment screen. The white arrowhead
indicates the ultrasound equipment system control panel. pregnancy include visualization of any of the following:
The blue arrow is pointing to the hydraulics that are used to anechoic round area in the uterine horns, fluid in the
operate the chute. uterus, cotyledons/placentomes (see Figure 12) and/or an
amnion, or the presence of fetus.19,21 Evidence of preg-
nancy include identification of any fetal parts such as
visualization of snout (see Figure 13), skull (see Figure
13), spine (see Figure 14), extremities (see Figure 15),
orbits (see Figure 16), abdomen (see Figure 17), thorax
(see Figure 17), and so on. An open cow will present with
a bladder, and no evidence of pregnancy (see Figure 18).
Incorrect pregnancy diagnoses can be due to an accumu-
lation of proestrus or estrus fluid within the uterus, patho-
logical fluid, or embryonic loss.19 A transrectal sonogram
can be done as early as 20 days postbreeding to confirm
pregnancy.19,22 Waiting 30 to 45 days after breeding is
preferred because it reduces possible damage to the
young fetus and is more accurate.1,9,19,22

Accuracy of Pregnancy PPR and TRUS

Monitoring Techniques
A bovine fetus can be seen as early as 9 to 13 days via
Figure 10. Pregnant uterus (thin white arrow). The thick TRUS in the research setting20,23,24; however, it is more
white arrow is pointing to the bladder, and the arrowhead is common to see a fetal pole around 20 to 25 days gesta-
pointing to artifact in the bladder. tion.19 On days 10 to 16, Kastelic et al25 accurately pre-
dicted pregnancy 50% of the time, but improved accuracy
Figure 10 is an example of the bladder and the pregnant to 100% when performing TRUS on days 20 and 22.
uterus. The examiner locates the uterus and scans each Pieterse et al,26 made a pregnancy diagnosis with TRUS
uterine horn (see Figure 11) and scans laterally out to the 21 to 25 days after artificial insemination with a sensitiv-
ovaries looking for signs of a pregnancy.19,21 The signs of ity and specificity of 44.8% and 82.3%, respectively, but
56 Journal of Diagnostic Medical Sonography 39(1)

Figure 12. The cotton ball like structures are placenta

cotelydons.

Figure 14. The fetal spine is indicated with the white arrow.

Figure 13. The fetal skull (white arrow) and the fetal snout
are shown (blue arrow).

sensitivity and specificity increased to 97.7% and 87.7%,

respectively, when TRUS was performed 26 to 33 days
Figure 15. The fetal extremities are indicated with the white
post-insemination. Nation et al15 performed TRUS at 28
arrows.
and 35 days after AI and correctly identified 96% of the
pregnant cows and 97% of the non-pregnant cows, result-
ing in an overall accuracy of 96.5%. days gestation and remained at 94% starting 23 days after
Romano et al23 found sensitivity of detecting preg- gestation. The overall sensitivity was 89.2% for cows and
nancy with TRUS increased from 74.5% at 24 days gesta- 96.8% for heifers, and specificity was 93% for cows and
tion to 100% at 29 days gestation, and that specificity 93.4% for heifers.23 Badtram et al27 compared intra-oper-
plateaued at 96.6% on day 26 of gestation in cows. In ator variability at days 16 to 22, 16 to 31, and 23 to 31. At
heifers, the sensitivity increased from 50% at 21 days the earliest TRUS, the accuracy was 49% for operator A,
gestation to 100% at 26 days gestation.23 TRUS specific- and 51% for operator B, and that in the subsequent scans
ity for the group of heifers23 increased from 87.5% at 21 they had similar accuracies of 63% and 64% for the 16 to
Bagley et al 57

Figure 16. The fetal eye/orbit is indicated with the white

arrow.

Figure 18. An open cow is shown. The thick white arrow is

pointing to the bladder. The thin white arrow is pointing to
the uterus which does not have any evidence of pregnancy.

Performing PPR in a similar period of 21 to 35 days,

Gowan et al28 demonstrated a sensitivity of 76% and
specificity of 75%, but when performed between 36 and
42 days, sensitivity and specificity improved to 83%
and 95%, respectively. Karen et al29 demonstrated an
accuracy of 37.5% and a specificity of 91% days 31 to
35, and that accuracy improved to 94% and sensitivity
to 96% at days 46 to 50. At days 51 to 55, both accuracy
and sensitivity29 were 100%. Day et al30 found that sen-
sitivity varied among palpators, 29% to 64%, but that
specificity is much less varied, ranging between 99%
and 100%. Day et al30 reported overall accuracy rates
Figure 17. The fetal abdomen is indicated with the blue for veterinarian-palpators to be 95% to 97%. Mathews
arrow and thorax is shown with the white arrows pointing to and Morton31 was 81% accurate at predicting calving
fetal ribs.
date within a 10-day window, while 7% calved later
than that window. Experienced veterinarians can achieve
31 day scans, and 73% for both at the final 23 to 31 day around a 96% accuracy in predicting pregnancy via PPR
scans.27 There were no statistical differences between the and can predict the calving date within a 10-day window
operators.27 The sensitivity27 for detection pregnancy with an 89% accuracy.27,30,31
was highest for cows at 23 to 31 days, 73% and the high- Minimizing pregnancy loss is a key component of the
est specificity was found in heifers at days 16 to 22 at reproductive management strategy. Romano et al32 and
86%. Badtram et al27 determined that accuracy for both Fosgate and Smith33 have implied that PPR has an ele-
was greatest at days 23 to 31. Brownlie et al21 deter- vated risk of embryonic loss that ranges from 6.4% with
mined that TRUS could predict calving date within 10 PPR between 34 and 50 days, and 3.6% when performed
days with 90.3% of cows calving within 10 days of their between 35 and 41 days. Alexander et al34 had similar
predicted calving date. When TRUS is performed at 40 findings with embryonic loss of 5.3% from between days
days or later, it is 100% accurate and ranges around 94% 30 and 45 and a recheck at day 60. Early studies have
accuracy when used between 26 and 33 days of gesta- been criticized for faulty methodology, including lack of
tion.19,21,23,26,27 Table 1 summarizes the sensitivity, spec- control groups.16,35 More recent studies have demon-
ificity, and accuracy of TRUS. strated that PPR does not contribute to a higher pregnancy
58 Journal of Diagnostic Medical Sonography 39(1)

Table 1. The Sensitivity, Specificity, and Accuracy of Transrectal Sonography in Diagnosing Pregnancy in Cows and Heifers at
Varied Dates Post Insemination.

Number of Cows Days After Sensitivity Specificity Accuracy

Study or Heifers (n) Conception (%) (%) (%)
Badtram et al27 55(cows) 16–22 23 76 47
16(heifers) 16–22 44 86 63
159(cows) 16–31 54 69 62
41 (heifers) 16–31 61 77 66
104 (cows) 23–31 73 66 69
25 (heifers) 23–31 68 66 68
Brownlie et al21 83,104 (cows) — — — 90.3%
Nation et al15 497 (cows) 28–35 96 97 97
497 (cows) 91 96 83 91
Pietrese et al26 148 (cows) 21 45 82% 65
33 97 88% 93
Romano et al23 1079 (cows) 25 96 88 92
321 (heifers) 21 50 88 68

loss compared to doing nothing or doing TRUS.16,24,34,35 calving time. Blood assay and progesterone monitoring
Pregnancy loss with TRUS was reported between 4.2% are inexpensive techniques that accurately predict non-
and 6.5% when sonography was performed at 25 to 30 pregnant status, but they incur a time delay for results,
days post breeding and then rectally palpated 60 days which may limit opportunities for rebreeding.9 The pref-
later.30 However, Baxter and Ward36 and Ball and Logue37 erable monitoring technique is one that is used early in
demonstrated that TRUS use does not increase pregnancy pregnancy, has instant results, allows time for re-breeding
loss rates. if it is desired, and is accurate.
Both PPR and TRUS can be used early in the breeding
season with day 45 the optimal day for PPR1 and as early
Discussion as day 25 for TRUS.1 Pregnancy detection by palpation
For the producer, knowing pregnancy status in the herd can be performed as early as 40 days, but is unable to
is a primary business goal, as financial viability of an detect fetal structures or a heartbeat.1 Because TRUS has
operation depends on this knowledge. Herd efficiency a high accuracy for pregnancy detection, can be per-
improves when the AI or breeding to pregnancy diagno- formed rapidly on a large scale, and can diagnose a preg-
sis window is 30 to 90 days.1–3,12,13 Accuracy rates of nancy earlier in the breeding season, there may be more
both TRUS15,20–30 and PPR17,27–31 are close to 96%, which benefits to TRUS compared to PPR.
does not answer the question of which is the best repro- The earlier the heifer is bred in the season, the earlier
ductive monitoring technique. The important financial she will calve, the longer postpartum window before
decisions are related to open cattle. When a cow or heifer rebreeding and subsequently her calf will be larger than
is open, the producer can rebreed her and reduce the those born later in the calving season, providing more
number of days that she is open, hold her to the next pounds per calf at weaning time.2,13,15 Heifers that calve
breeding cycle, or cull her from the herd to reduce man- earlier in the calving season also have a superior lifetime
agement and feeding costs. Pregnancy testing should productivity, therefore increasing efficiency for the pro-
wait until at least 30 days postbreeding to increase accu- ducer.2,13,15 Increasing herd efficiency increases the num-
racy and efficiency but waiting much longer will dimin- ber of cattle in the industry that will become either
ish opportunities to rebreed.19,20,24 reproducing cows or products for beef and dairy con-
Since the important cost decisions are based on the sumption. The best pregnancy detection technique
open cow or heifer, it is tempting to prioritize the repro- depends on the business model and herd size. TRUS can
ductive monitoring techniques that have the best specific- detect the fetal heart at 22 days of gestation, is highly
ity. If specificity alone were considered, then PPR might accurate, and can be performed quickly. Therefore, TRUS
be considered the superior technique, because it has been is a desirable method for identifying early pregnancy. In
shown to achieve 100% specificity.28 This high specific- large cattle operations, the increase in efficiency and
ity28 occurs late in the cycle, around day 50, which may early pregnancy detection with TRUS can offset the addi-
not allow enough time for rebreeding or will lengthen the tional costs.
Bagley et al 59

Additional uses of TRUS that are beyond the scope ORCID iD

this review include the opportunity to perform ovarian Jennifer Elaine Bagley https://orcid.org/0000-0002-5660-8555
monitoring, allowing for more knowledge about the
natural heat cycles for the herd.8 Ovarian follicle mon- References
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monitoring with TRUS could alert the producers to pdf. Accessed June 6, 2022.
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not widespread in the industry, and more research may GA: Heifer calving date positively influences calf
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with a particular fetal gender.19 Monitoring male- Buckeye Dairy News 7(1). Ohio Dairy Industry Resource
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osu.edu/newsletter/buckeye-dairy-news/volume-7-issue-1/
presents as an opportunity for improved reproductive
when-best-time-market-cull-cows#:~:text=Data%20
management.8,18–20,22,38 There is a paucity of research from%20the%20USDA%20over, March%2C%20April%
on TRUS cost-effectiveness, which could cause pro- 2C%20and%20May. Accessed June 8, 2022.
ducers to hesitate to add TRUS to their operations. 4. United States Food and Drug Administration: The cattle
More versatility with the technology provides opportu- estrous cycle and FDA-Approved animal drugs to control and
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