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    Ozone and Pulsed Electro-Magnetic Field Therapies Improve Endometrial Lining Thickness in Frozen Embryo Transfer Cycles. Three Case Reports

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    This case study reviewed the use of ozone therapy and pulsed electromagnetic field therapy to improve endometrial lining thickness in three patients undergoing frozen embryo transfer cycles. Two of the three patients who received six sessions of ozone sauna therapy over three weeks achieved clinical pregnancies, though one resulted in a missed abortion. The study had a small sample size and lacked a control group. Larger randomized controlled trials are still needed to validate these preliminary findings.

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    Ozone and Pulsed Electro-Magnetic Field Therapies Improve Endometrial Lining Thickness in Frozen Embryo Transfer Cycles. Three Case Reports

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    AakanshaGupta
    48 views14 pages
    This case study reviewed the use of ozone therapy and pulsed electromagnetic field therapy to improve endometrial lining thickness in three patients undergoing frozen embryo transfer cycles. Two of the three patients who received six sessions of ozone sauna therapy over three weeks achieved clinical pregnancies, though one resulted in a missed abortion. The study had a small sample size and lacked a control group. Larger randomized controlled trials are still needed to validate these preliminary findings.

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    research review on fet cycle therapy

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    Research Review

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    This case study reviewed the use of ozone therapy and pulsed electromagnetic field therapy to improve endometrial lining thickness in three patients undergoing frozen embryo transfer cycles. Two of the three patients who received six sessions of ozone sauna therapy over three weeks achieved clinical pregnancies, though one resulted in a missed abortion. The study had a small sample size and lacked a control group. Larger randomized controlled trials are still needed to validate these preliminary findings.

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    48 views14 pages

    Ozone and Pulsed Electro-Magnetic Field Therapies Improve Endometrial Lining Thickness in Frozen Embryo Transfer Cycles. Three Case Reports

    Uploaded by

    AakanshaGupta
    This case study reviewed the use of ozone therapy and pulsed electromagnetic field therapy to improve endometrial lining thickness in three patients undergoing frozen embryo transfer cycles. Two of the three patients who received six sessions of ozone sauna therapy over three weeks achieved clinical pregnancies, though one resulted in a missed abortion. The study had a small sample size and lacked a control group. Larger randomized controlled trials are still needed to validate these preliminary findings.

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    RESEARCH REVIEW

    Ozone and pulsed electro-magnetic field therapies


    improve endometrial lining thickness in frozen embryo
    transfer cycles.
    Three Case Reports

    Zaher Merhi, Rajean Moseley-La Rue, Amber Ray Moseley,


    André Hugo Smith, John Zhang

    REVIEWED BY:
    Aakansha Gupta
    15/IBT/001
    CONTENTS
    • INTRODUCTION
    • METHODOLOGY
    • CASE STUDIES
    • CONCLUSION
    • LIMITATIONS
    • SUGGESTIONS
    INTRODUCTION
    • Frozen Embryo Transfer : A frozen embryo transfer
    (FET) is a cycle in which the frozen embryos from a
    previous fresh IVF or donor egg cycle are thawed and
    then transferred back into the woman's uterus.

    • Importance of Endometrial lining Thickness in


    ART: Correct transfer depth and endometrial thickness is
    essential for the implantation, pregnancy and live delivery.
    An endometrial thickness of more than 5-7mm is required
    for the implantation where as an optimal thickness is of
    more than 9mm.
    THERAPEUTIC APPROACHES INVOLVED:
    1. OZONE: A colorless gas made up of 3 oxygen atoms. Its
    used as an alternative therapy to improve the body’s intake
    and use of oxygen & to activate the immune system. It also
    has strong bactericidal, antiviral, anti-fungal, and anti-
    protozoal actions.

    2. PEMF: Pulse-Electro Magnetic Field Therapy. PEMF which


    is a biophysical therapeutic modality therapy that uses low-
    level electromagnetic radiation to heal damaged tissues and
    bone, to relieve injury-related pain, and even to stimulate
    organs. It is an FDA approved treatment process.
    ABOUT THE RESEARCH
    • In assisted reproductive technology (ART), studies have shown that an
    endometrial lining thickness (EMT) <7 mm was found to have a
    significantly lower implantation rate compared to an EMT of ≥7
    mm.

    • The EMT is traditionally measured by a transvaginal ultrasound in the


    follicular phase of a natural FET cycle or after preparation with
    estradiol treatment in medicated FET cycles.

    • Several treatment protocols for inadequately thin endometrium


    include hormonal manipulation by estradiol (oral, vaginal,
    transdermal, or intramuscular),vasoactive agents such as low-dose
    aspirin, tocopherol (vitamin E),pentoxifylline,vaginal sildenafil,and
    others such as tamoxifen,granulocyte-colony-stimulating factor (G-
    CSF), and stem cell therapy.
    TREATMENT USED (METHODOLOGY):
    Ozone Sauna Therapy (OST) protocol using the Hyperthermic
    Ozone and Carbonic Acid Transdermal Technology (HOCATT):

    • A machine that delivers ozone transdermally (ozone 1 setting at 500


    ml/PM in our patients) and vaginally (ozone 2 setting at 200 ml/PM in
    our patients) via a silicone tube.

    • It includes a chamber, an ozone generator for cabin ozonization, an


    ozone generator for simultaneous auxiliary ozone applica- tions, a CO2
    administration device and electric CO2 regulator for a CO2 cylinder.

    • The HOCATT infuses CO2 gas into the chamber at 5 L/ PM, which will
    then mixes with the steam (H2O) in order to form Carbonic Acid
    (H2CO3).
    • Carbon far infrared ray (FIR) pads (set at 100%), together with
    steam, are used to raise body temperature. It also contains a heart
    rate monitor, an oxygen humidifier container for pure oxygen
    breathing (at 2.5 L/PM) and a Pulsed Electro-Magnetic Field
    (PEMF) stand.

    • The participant gets completely undressed and sits in the sauna


    machine, with the head out in order to avoid breathing the ozone.

    • Each participant would ideally have 2 sessions per week for 3 weeks
    (total of 6 sessions). Each session is approximately 30 minutes.
    The first session starts with 50% ozone concentration which is then
    increased to 60% ozone concentration in the second session, 70%
    ozone concentration in the third session, and 80% ozone
    concentration in the fourth, fifth and sixth sessions.
    Figure 1: HOCATT MACHINE
    Source of Image:
    https://www.google.com/search?q=HOCATT&source=lnms&tbm=isch&sa=X&ved=0ahUKEwiEsfL9
    7qzlAhWIfn0KHYVCCJAQ_AUIEygC&biw=1366&bih=657#imgrc=pqgtraVjyuvljM
    PARAMETER CASE I CASE II CASE III

    INTRODUCTIO 36 year old with 38year old healthy 37year old healthy
    N iatrogenic premature patient with severely patient undergoing
    ovarian insufficiency. diminished ovarian FET using her own
    FET via donor oocyte. reserve. FET via euploid embryos.
    donor oocyte.
    MEDICAL Controlled type 1 No significant No significant
    HISTORY diabetes, Last menses 3 medical history. medical history. A
    years ago, Terminated hysteroscopy with
    pregnancy once by dilatation and
    dilatation and curretage curretage for
    menorrhagia.
    MALE Normal Normal Normal
    PARTNER
    SEMEN
    ANALYSIS
    EXAMINATION Hysteroscopy: Ovaries Sonography: Small Sonography: Normal
    PRE- with normal uterus and ovaries with a normal ovaries & uterus with
    TREATMENT 3mm EMT. uterus with 3.5mm EMT of 2-3mm with
    EMT. Normal areas of EMT 0mm.
    hysteroscopy. Normal hysteroscopy.
    TREATMENT Evaluation of response to Exogenous Exogenous
    (MOCK exogenous hormones for 4 hormones for 2 hormones for 2
    CYCLE) weeks via estradiol 4mg- weeks , lining weeks , lining
    8mg, no significant reached 4.5mm reached 4mm
    improvement, showed maximum maximum
    5mm EST. thickness. thickness.
    OST 2 sessions of OST/week for 2 sessions of 2 sessions of
    TREATMENT 3 weeks, & oral estradiol OST/week for 3 OST/week for 3
    daily showed 7mm EMT. weeks, & oral weeks, & oral
    estradiol daily estradiol daily
    showed 6.7mm showed 6.7mm
    EMT. EMT.

    POST FET of PGS confirmed FET of Non-PGS A frozen thaw


    TREATMENT euploid blastocyst embryo tested blastocyst transfer of a
    on 6th day of progesterone. embryo was euploid blastocyst
    performed. embryo.
    RESULT Single intra-uterine Single intra-uterine Not pregnant.
    pregnancy with hormonal pregnancy. At 6
    support till 12 weeks of weeks gestation an
    gestation. ultrasound showed
    Normal Pregnancy. missed abortion.
    CONCLUSION:
    • A clinical pregnancy includes a missed abortion or a stillbirth. Given
    this definition, 2 out of 3 patients presented had a clinical pregnancy.

    • In patient #3, even though she had a euploid embryo transferred and a
    relatively thick EMT following OST, she did not get pregnant. There is
    35% probability of not achieving a clinical pregnancy with a euploid
    embryo, which is still not understood.

    • Ozone with PEMF constitute a novel experimental approach for


    women with persistently thin endometrial lining undergoing FET. It is
    a major clinical challenge among fertility patients, which frequently
    leads to using a gestational carrier as a last resort.
    LIMITATIONS:
    • The sample size was small limited to 3 cases
    only.
    • Lack of a control group.
    • Other therapy results should have been
    compared with HOCATT.
    • More studies are needed to support this
    preliminary finding.
    SUGGESTIONS:
    • Future studies should include randomized trials
    with a control group that has not been exposed
    to OST.
    • Ozone and PEMF levels can be manipulated for
    individual cases.
    • More therapies in ART can be experimented for
    EMT.

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