Ozone sauna therapy and pulsed electromagnetic field therapy could potentially improve outcome in women with diminished ovarian reserve undergoing assisted reproductive technology.

There are limited treatment options for women with severely diminished ovarian reserve (DOR) who experience repeatedly failed in vitro fertilization (IVF) cycles and with persistently thin endometrial lining thickness (EMT) during frozen embryo transfer cycles. Therefore, a large majority of patients resort to using donor oocytes and gestational carriers. Data from existing animal and human studies suggest that ozone sauna therapy (OST) and pulsed electromagnetic field therapy (PEMF) are emerging as potential therapeutic adjuncts for female reproduction. This study was conducted to assess the fertility outcome of OST + PEMF in vivo in patients undergoing IVF/frozen embryo transfe and the effects of OST in vitro on human granulosa cell (GC) function. Forty-four women with DOR underwent their 1st IVF cycle (Cycle 1), and then were administered transdermal and intravaginal OST + PEMF, twice a week for 3 weeks, followed by a 2nd IVF cycle (Cycle 2) using the same protocol as in Cycle 1. GCs collected from another six women who underwent egg retrieval were equally split and cultured with OST (test) or placed in room temperature (control) outside the OST chamber in the same room. The results demonstrated that Cycles 1 and 2 had no significant difference in the number of days of stimulation, baseline hormones measured, number of oocytes retrieved or peak estradiol levels. However, the number of embryos formed after OST + PEMF in Cycle 2 was significantly higher than the Cycle 1. Furthermore, EMT measured in Cycle 2 demonstrated a significant increase compared to Cycle 1 and all patients reached a satisfactory EMT of approximately 7 mm. In vitro studies demonstrated that OST led to a 5-fold significant increase in the aromatase enzyme while a significant 50% reduction was noted in the side-chain cleavage enzyme in GCs. Both OST + PEMF are known for their vasodilatory, anti-inflammatory, and antioxidant actions, which could enhance endometrial receptivity and increase the number of formed embryos without increasing the number of oocytes retrieved, suggesting an improvement in oocyte quality. Finally, ozone can alter genes involved in steroidogenesis suggesting that it could improve ovarian function.

Ozone Sauna Therapy (OST) and Pulsed Electromagnetic Field Therapy (PEMF) delivered via the HOCATT machine could improve endometriosis pain along with lowering serum inflammatory markers.

PROBLEM: Endometriosis, a common and challenging condition, is a pelvic inflammatory condition that causes chronic pelvic pain (CPP) and infertility. Even though standard medical therapies and surgeries can help CPP, a large percentage of women remain symptomatic following the conventional treatments. Thus, there is a need to study new non-traditional therapeutic adjuncts in this patient population to improve their quality of life. One non-traditional therapeutic agent is Ozone Sauna Therapy (OST) which has been shown to have an anti-inflammatory action, but no studies have been performed to assess the efficacy of OST in women with endometriosis suffering with CPP. Another non-traditional therapeutic agent is Pulsed Electromagnetic Field Therapy (PEMF) where one small pilot study has shown that PEMF exposure to women with endometriosis and pelvic pain showed dramatic relief in symptoms. METHOD OF STUDY: The HOCATT machine, by delivering a combination of both OST and PEMF in one machine, has been shown to improve fertility treatment outcome via in vitro fertilization (IVF) in older women by potentially improving oocyte quality. This study was conducted to assess the effect of the HOCATT machine use on the pain scale in patients struggling with CPP due to endometriosis. In the first study, eight women with endometriosis were administered transdermal and intravaginal OST + PEMF, twice a week for 3 weeks (total of 6 sessions). Once a week, the participants were asked to fill a pain scale. In the second study, 10 women were recruited in order to evaluate the changes in serum inflammatory markers following OST + PEMF exposure after 3-week period using the HOCATT machine twice a week (total of 6 sessions). RESULTS: The participants had a mean age of 39.7 ± 1.1 years. The results showed a significant improvement in pain scale following the fourth session (p < .05) and a significant drop in serum levels of the inflammatory markers CRP (p = .0438) and IL-1ß (p = .0031) and a significant increase in serum levels of IL-8 (p = .033). CONCLUSIONS: This pilot study suggests that a combination of OST and PEMF using the HOCATT machine could potentially represent potential therapeutic adjuncts for women with inflammatory disorders such as endometriosis. There is a definite need for larger cohort studies and even randomized trials in order to better assess the efficacy of OST and PEMF in women with other inflammatory disorders.