Ozone Therapy

Ozone Therapy: A Supportive Approach in Reproductive Health

Ozone therapy is a complementary treatment method with an extensive scientific literature, based on the application of medical ozone gas (O3), composed of three oxygen atoms, to the body for therapeutic purposes. With its antimicrobial, antioxidant, anti-inflammatory, and immune-regulating effects, it is receiving growing interest in the fields of gynecology and reproductive health.

In Ankara, obstetrics and gynecology specialist Prof. Dr. Melahat Atasever applies ozone therapy as a complementary support, within the framework of current scientific evidence, in cases such as recurrent pregnancy loss, infertility, and chronic pelvic infections.

What Is Ozone Therapy?

Medical ozone is a gas produced from pure oxygen for medical use and consisting of an ozone-oxygen mixture. It is produced with special devices called ozone generators. Medical ozone must never be confused with industrial ozone; industrial ozone can be produced from air or impure oxygen and may contain toxic pollutants such as nitrogen oxides.

The biological effects of ozone occur through reactive oxygen species (ROS) and lipid oxidation products (LOP), which form when it comes into contact with tissue. At low and controlled concentrations, these molecules activate the antioxidant defense system, increase mitochondrial function, regulate the immune response, and accelerate tissue repair.

High or uncontrolled doses, on the other hand, can be harmful by creating oxidative stress. For this reason, medical ozone application must always be carried out under specialist supervision and within an established dose framework.

Ozone therapy has been part of clinical practice in Europe — particularly in Germany, Spain, and Italy — for decades. In Turkey, it has been defined by the Ministry of Health as one of the complementary medicine methods.

Contributions of Ozone Therapy to Reproductive Health

Ozone therapy aims to support the functions of the reproductive organs indirectly, by improving the body’s general health.

• Increasing blood circulation: By increasing blood flow to the uterus and ovaries, it may help improve egg quality and support the thickening of the inner lining of the uterus (endometrium).
• Reducing inflammation: Conditions such as chronic inflammation of the uterine lining (chronic endometritis) in particular can prevent the embryo from attaching to the uterus. The anti-inflammatory and antimicrobial effects of ozone may support the improvement of the intrauterine environment.
• Regulation of the immune system: By modulating immune cells, ozone may help balance unfavorable immune responses that can lead to recurrent miscarriages.
• Antioxidant capacity: By combating free radicals in the body, it reduces cellular stress and supports general health.

In Which Situations Is Ozone Therapy Used in Gynecology?

Ozone Therapy in Infertility

In cases of unexplained infertility, ozone therapy is applied as a complementary measure with the aim of improving pelvic microcirculation and supporting ovarian function. There are small-scale studies suggesting it may contribute to the preservation of ovarian reserve, but definitive evidence is still awaited.

Ozone Therapy in Recurrent Miscarriage Risk

In women who have experienced recurrent pregnancy loss and in whom no explainable cause has been identified, ozone therapy is applied as a supportive measure because it may contribute to increasing uterine blood flow and establishing local immune balance. Prof. Dr. Melahat Atasever plans ozone therapy in these cases as a complementary protocol following a comprehensive evaluation.

Ozone Therapy in IVF Treatment

Before and during IVF, ozone therapy is used with the aim of supporting endometrial preparation and ovarian function. It can be considered as a complementary measure in patients with a thin endometrium, low ovarian reserve, or unsuccessful previous IVF attempts.

Ozone Therapy in Vulvovaginal Infections

Chronic and recurrent vaginal infections are one of the well-documented gynecological applications of ozone therapy. In cases of bacterial vaginosis, candida infections, HPV-related changes, and chronic cervicitis, vaginal ozone application shows antimicrobial and anti-inflammatory effects. It offers a complementary option in infections that are resistant to antibiotics or that recur frequently.

Ozone Therapy in Endometriosis

Endometriosis is a chronic disease characterized by oxidative stress, inflammation, and immune dysregulation. The antioxidant and anti-inflammatory effects of ozone therapy are being investigated as a complementary option aimed at reducing endometriosis-related pelvic pain and the inflammatory burden. Although the level of evidence in this area is still limited, research is ongoing.

Major Autohemotherapy (MAH)

This is the most frequently used systemic ozone application method. 50-200 ml of blood is drawn from the patient; this blood is treated with an ozone-oxygen mixture and returned intravenously. The procedure takes approximately 30-40 minutes and is carried out under medical supervision. Systemic antioxidant, anti-inflammatory, and immune-regulating effects are obtained through this route.

Vaginal Ozone Application

Medical ozone gas is applied into the vagina at a defined concentration. This method, which targets a local antimicrobial and anti-inflammatory effect, is preferred in cases of chronic vaginal infections and cervicitis. The procedure is brief and does not require any special preparation. An average of 8-10 sessions is planned, at 2-3 sessions per week.

Rectal Ozone Application

An ozone-oxygen mixture is delivered into the rectum and passes into the systemic circulation through the mucosa. It is used as an alternative method in patients who prefer not to have intravenous access, or in situations where MAH cannot be applied.

What Are the Advantages of Ozone Therapy?

When autologous blood is used (MAH), the risk of allergic reaction is extremely low. Because it is minimally invasive, it does not require hospitalization; it can be applied during the day, and normal life can be resumed. Its side-effect profile is quite limited compared with conventional medications.

The combination of antimicrobial, antioxidant, and immunomodulatory effects offers the clinician a flexible therapeutic tool. In Turkey, it is defined by the Ministry of Health as a complementary medicine method.

Risks and Disadvantages of Ozone Therapy

Ozone delivered at the wrong concentration or through an inappropriate route of application can cause harm. For this reason, the procedure must always be performed by an experienced and trained healthcare professional.

Lung disease (asthma, COPD), G6PD enzyme deficiency, active bleeding, and pregnancy constitute contraindications for ozone therapy.

Ozone treatment is not a treatment method approved by the FDA; the level of evidence varies according to the area of application. While strong evidence exists for some indications, others are still at the research stage.

How Long Does Ozone Therapy Take? How Many Sessions Are Applied?

Each session varies according to the application; MAH takes approximately 30-40 minutes, while vaginal application takes 10-15 minutes. For chronic vaginal infections, 8-10 sessions are usually planned; for recurrent miscarriage support or IVF preparation, an individual protocol is determined.

Sessions are planned 2-3 times per week, and the total duration is shaped according to the clinical response. Although the effect may begin to be felt after the first few sessions, the full response is usually evaluated after the course is completed.