Ozone therapy: a potential therapeutic adjunct for improving female reproductive health

Background

Infertility affects a substantial proportion of couples worldwide, and female-factor causes range from blocked or damaged fallopian tubes to chronic inflammation of the uterine lining (endometritis), vaginal infections, pelvic adhesions (bands of scar tissue that can distort pelvic anatomy), and reduced ovarian reserve (the quantity and quality of remaining eggs). Conventional treatments do not always resolve these issues, which has prompted interest in adjunctive approaches. Ozone, a reactive form of oxygen with known antimicrobial and anti-inflammatory properties, has been proposed as one such adjunct. This review set out to gather what is currently known about ozone's effects on the female reproductive system and to identify where the evidence stands.

Study design

This is a narrative literature review, not a new experiment. The authors, a team including reproductive endocrinologists, drew together published studies examining how ozone affects different aspects of female reproduction: tubal patency (whether the fallopian tubes remain open), endometrial and vaginal health, pelvic adhesion formation, and ovarian function. The body of literature reviewed spans laboratory and animal-model research, with ozone delivered by various routes including transdermal (through the skin), intravaginal, intraperitoneal (into the abdominal cavity), and rectal insufflation in animal studies.

Findings

The authors reported that, across the studies reviewed, ozone therapy showed potential benefits for tubal occlusion (helping keep the fallopian tubes open), and appeared to offer some protection against endometritis and vaginitis in the models studied. There were also indications that ozone could help reduce the formation of pelvic adhesions. However, the review makes clear that the great majority of this evidence comes from animal models rather than human trials. Direct human data on outcomes such as oocyte (egg) quality and quantity were notably lacking.

What the authors concluded

The authors concluded that ozone therapy is a promising but still largely unproven adjunct for female reproductive health. They called specifically for prospective human studies, particularly ones assessing the impact of ozone therapy on oocyte quality and quantity in women undergoing fertility treatment, especially those with a poor prognosis due to low ovarian reserve. They also highlighted the need to establish which administration routes, such as transdermal or intravaginal ozone, are safest and most practical for human use.

Limitations of this study

As a narrative review rather than a systematic review, this paper did not follow a predefined search protocol or formal quality assessment of the studies it drew on, so selection and interpretation may be subject to bias. The underlying evidence base is dominated by animal and laboratory studies, with very limited human clinical data, so findings may not translate directly to people. Dosing, delivery method and duration of ozone exposure varied considerably between the studies reviewed, making it difficult to draw firm conclusions about an optimal protocol. Larger, controlled, prospective human studies are needed before any conclusions can be drawn about ozone's role in treating female infertility.