Ozone therapy in pregravidar preparation for the application of assisted reproductive technology programs

Objective. Evaluation of the effectiveness of the effects of low-dose ozone therapy on the morpho-functional state of the endometrium and the hemostasis system at the stage of preliminary preparation for the use of assisted reproductive technology (ART) programs. Materials and methods. The study included 80 patients, 40 of whom made up the main group, who underwent a 7-day course of treatment with ozonated isotonic sodium chloride solution with a daily dose of 160 mcg/l as a preconceptive preparation before starting the ART program; the comparison group included 40 patients who did not receive preconceptive preparation in for various reasons. The morpho-functional state of the endometrium was assessed by three ultrasound parameters (M-echo, resistance index and maximum blood flow rate in the uterine arteries), by 5 luminescence spectroscopy indicators (indices of aerobicity, proliferation, microcirculation, the state of structure and metabolism of the endometrium). The hemostasis system was studied according to 11 criteria (platelet aggregation, prothrombin time, antithrombin III, activated partial thromboplastin time, D-dimer, international normalized ratio, plasminogen, protein C, prothrombin index, soluble fibrin-monomer complexes, fibrinogen). Results. Evidence of optimization of the morpho-functional state of the endometrium due to the antihypoxic and anticoagulant effects of ozone therapy with increased M-echo (p<0.0001) and maximum blood flow velocity (p<0.0001) in the uterine arteries, increased indices of aerobicity (p<0.0001), microcirculation (p<0.0001), regeneration (p<0.0001), optimization of the structure (p=0.035) and metabolism of the endometrium (p=0.021), hypocoagulation shifts of indicators of the hemostasis system, this led to an increase in the frequency of pregnancy in the first cycle of in vitro fertilization (IVF) after preconception preparation compared with this indicator in the control group. Conclusion. Low-dose ozone therapy, performed as a preliminary preparation, improved the morpho-functional state of the endometrium, including its anticoagulant effect, which created favorable conditions for preimplantation endometrial remodeling in women with chronic endometritis, thereby increasing the frequency of pregnancy in the first IVF cycle.