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PRID-Delta vs CIDR in dairy cattle and subsequent pregnancy rate with artificial insemination

Clinical Scenario

Farmer Smith has a block calving dairy herd and six weeks into the breeding season your boss has always gone out to synchronise any cows that haven’t yet been inseminated using a progesterone based protocol. Your boss is away this year and you head out with all the packets of PRID Delta (Ceva Animal Health) you can find in the practice, unsure of how many you’ll need.  On seeing the PRID Delta's, Farmer Smith looks horrified and explains that your boss always uses CIDR (Zoetis UK Ltd).  You reassure Farmer Smith that they contain the same active ingredient; Farmer Smith agrees to let you continue as long as you are sure that the cows will still get in calf as well.  As you drive back to the practice you wonder if you should have been so confident…

3-Part Question (PICO)

In [dairy cattle] does the use of [PRID versus CIDR for oestrus synchronisation] result in a greater improvement in the [subsequent pregnancy rate from articifical insemination]?

Search Strategy and Summary of Evidence

Search Strategy

MEDLINE(R) In-Process & Other Non-Indexed Citations and MEDLINE(R) 1946 to Present using the OVID interface

(cow.mp. OR cows.mp. OR cattle.mp. OR bovine.mp. OR bovines.mp. OR bos.mp. OR bovidae.mp. OR exp Cattle/)

AND

(prid.mp. OR PRIDs.mp. OR progesterone releasing intravaginal device.mp. OR progesterone releasing intravaginal devices.mp. OR progesterone releasing intra vaginal device.mp. OR progesterone releasing intra vaginal devices.mp.)

AND

(CIDR.mp. OR CIDRs.mp. OR controlled internal drug release.mp.)

CAB Abstracts 1910 to Present using the OVID interface

(cow.mp. OR cows.mp. OR cattle.mp. OR bovine.mp. OR bovines.mp. OR bos.mp. OR bovidae.mp. OR exp cattle/ OR exp cows/ OR exp dairy cows/ OR exp Bovidae/ OR exp Bos/)

AND

(prid.mp. OR PRIDS.mp. OR progesterone releasing intravaginal device.mp. OR progesterone releasing intravaginal devices.mp. OR progesterone releasing intra vaginal device.mp. OR progesterone releasing intra vaginal devices.mp.)

AND

(CIDR.mp. OR CIDRs.mp. OR controlled internal drug release.mp.)

Search Outcome

MEDLINE

  • 14 papers found in MEDLINE search
  • 13 papers excluded as they don't meet the PICO question
  • 0 papers excluded as they are in a foreign language
  • 0 papers excluded as they are review articles/in vitro research/conference proceedings
  • 1 total relevant papers from MEDLINE

CAB Abstracts

  • 22 papers found in CAB search
  • 20 papers excluded as they don't meet the PICO question
  • 1 papers excluded as they are in a foreign language
  • 0 papers excluded as they are review articles/in vitro research/conference proceedings
  • 1 total relevant papers from CAB

Total relevant papers

1 relevant papers from both MEDLINE and CAB Abstracts

Summary of Evidence

van Werven et al (2013) Netherlands

Title:

Comparison of two intravaginal progesterone releasing devices (PRID-Delta vs CIDR) in dairy cows: Blood progesterone profile and field fertility.

Patient group:

774 Holsteins from 147 dairy farms in the Netherlands, of which 399 were given the PRID-Delta and 375 were given the CIDR

Study Type:

Randomised Controlled Trial

Outcomes:
  • Pregnancies per artificial insemination (AI) to the first service
  • Proportion of cows returning to oestrus 18-24 days after the first AI
  • Pregnancies per AI to the second service
  • Cumulative proportion of pregnant cows from both AI services
Key Results:
  • PRID-Delta (35.8%) tended (P=0.1) to produce greater pregnancies per AI to the first service when compared to CIDR (31.3%)
  • Milk progesterone concentration on the day of device insertion had a major effect on pregnancies per AI (P=0.01), with increasing milk progesterone associated with increasing pregnancies per AI in both the PRID-Delta and CIDR groups
  • More cows receiving PRID-Delta during 1st AI were detected in returning oestrus nearly 21 days after the synchonised AI as compared to cows that received CIDR (PRID-Delta = 28.3%, n=260 vs CIDR = 16.0%, n= 258, P= < 0.01)
  • The cumulative proportion of pregnant cows after the 1st synchronised AI in addition to return oestrus AI, was significantly greater in cows that received PRID-Delta (45.9%)  than in cows receiving CIDR (37.0%) at first AI (P=0.02)
  • No difference in pregnancies per AI at second AI in those cows that received PRID-Delta (55.9%) compared to those cows that received CIDR (54.7%) (P > 0.1).
Study Weaknesses:
  • No sample size calculation and no chosen effect size is given, which makes it difficult to interpret fully the tendency towards greater pregnancies per AI for the PRID-Delta group, at the first AI (P=0.1)
  • Lack of clarity on how randomisation was carried out
  • No information given on whether blinding was carried out
  • Study funding not stated although three authors are employed by CEVA who manufacture PRID-Delta, and no conflict of interest statement is given on this fact
  • Lacking in information about the dairy farms where the cows were kept, and their management strategies
  • The CIDR was used for 7 days in this study, but the licensed method of use states 9 days useage, which may have affected the results for the CIDR group
  • Within Figure 3, a denominator is given of 399 and 35.8% are stated as conceiving, however this does not quite match the wording in section 3.2 where it was stated that 260 cows did not conceive to first AI, which would be 65.2%, adding up in total to more than 100%.

 

Attachment:
Evidence appraisalEvidence appraisal

Comments

The higher pregnancy rates in the PRID-Delta group show only a tendency towards significance at P=0.1. While 0.05 is often used as an arbitrary cut-off for statistical significance, a difference which is of clinical significance may produce a p value which is higher or lower than this. The actual difference in pregnancy rates seen between the two groups is 4.5%, however the importance of this is difficult to interpret, as the effect size which would be clinically significant to the authors, and the power to detect this effect size with the sample size used, is not stated. 

Bottom line

At the present time there is not enough evidence to show a clinically significant difference in pregnancy rate when either PRID-Delta or CIDR is used. Therefore, choice of product should be based on clinical experience and individual practice guidelines.

Disclaimer

The BETs on this website are a summary of the evidence found on a topic and are not clinical guidelines. It is the responsibility of the individual veterinary surgeon to ensure appropriate decisions are made based on the specific circumstances of patients under their care, taking into account other factors such as local licensing regulations. Read small print

References

van-Werven T, Waldeck F, Souza AH, Floch S, Englebienne M (2013) Comparison of two intravaginal progesterone releasing devices (PRID-Delta vs CIDR) in dairy cows: Blood progesterone profile and field fertility. Animal Reproduction Science 138 : 143-149.

About this BET

First author:
Hannah Doit
Second author:
Natalie Robinson
Institution:

CEVM, University of Nottingham

Search last performed:
2016-07-28 15:58:00
Original publication date:
2016-07-28 15:58:00
Last updated:
2016-07-28 15:58:00
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