Ozone Therapy as a New Noninvasive Treatment Method in Gynecological Procedures: A Systematic Review

Introduction — Due to the specific nature of ovarian follicle reservation, the female reproductive system (FRS) is a sensitive organ. Among female pathologies, polycystic ovary syndrome (PCOS), characterized by impaired secretion of sex hormones, is the most common. Ozone therapy (OT) is a new noninvasive treatment for FRS pathologies. OT is currently an effective procedure for PCOS. The objective of this systematic review was to explain PCOS pathologies and gain a deeper understanding of the biological features of OT in the treatment of FRS pathologies, particularly PCOS. Methods — All articles on the therapeutic role of OT for FRS, with a particular focus on PCOS, were collected without length restrictions (as of August 29, 2024). After developing MeSH-based keywords, the search strategy was defined as follows: ((‘female reproduction’ OR ‘female reproductive system’) AND (‘polycystic ovary syndrome’ OR ‘PCOS’ OR ‘PCO’) AND (‘treatment’) AND (‘ozone’ OR ‘O3’ OR ‘ozone therapy’ OR ‘O3 therapy’)). Valid PubMed, Scopus, WoS, ScienceDirect, and ISC databases were used, references were imported into EndNote X8 Citation Manager, and duplicate studies were merged. Primary screening and secondary screening were performed, and eligible articles were included in the data extraction. Results — The initial search yielded 134 articles, and 85 duplicate studies were merged. Studies that did not meet the inclusion/exclusion criteria were excluded through primary and secondary screenings. As a result, 13 eligible articles were selected for data categorization. Conclusion — OT serves as an adjuvant treatment method that improves oxygen metabolism, modulates the immune system, and promotes tissue repair. OT is potentially effective in suppressing inflammation, chronic pain, and infections in PCOS.