Ozone Therapy in Reproductive Medicine

Ozone therapy has become well-established for reproductive conditions in horses and farm animals, offering an effective alternative to antibiotics for uterine infections and helping improve fertility outcomes.

Applications in reproduction

Ozone is used for various reproductive conditions:

In Horses

• Endometritis — acute and chronic uterine infections affecting fertility
• Post-breeding inflammation — managing the normal inflammatory response
• Persistent mating-induced endometritis — mares that don’t clear fluid normally
• Problem breeders — supporting uterine health in mares with repeated failures

In Cattle, Sheep & Goats

• Retained placenta — accelerating clearance and preventing infection
• Metritis — treating post-calving uterine infections
• Endometritis — subclinical or clinical uterine inflammation
• Repeat breeders — cows failing to conceive
• Prevention — routine post-partum treatment to reduce problems

Why use ozone for uterine conditions?

Ozone offers significant advantages in reproductive medicine:

• No withdrawal period — critical for dairy operations
• Reduced antibiotic resistance
• Effective against resistant bacteria — when antibiotics have failed
• Supports tissue healing — not just antimicrobial
• Stimulates angiogenesis — demonstrated in equine studies to enhance uterine blood supplyto enhance uterine blood supply

Mechanism in Uterus

Intrauterine ozone:

1. Direct bactericidal action against uterine pathogens (Strep., E. coli, Arcanobacterium)
2. Stimulation of endometrial angiogenesis (↑VEGF)
3. Enhanced local immune response (neutrophil activation)
4. Modulation of inflammatory cytokines
5. Improved endometrial regeneration.

Studies show comparable efficacy to antibiotic protocols.

How is it administered?

Intrauterine ozone can be given as:

• Ozonated saline lavage — flushing the uterus with ozone-saturated saline
  
• Ozone gas insufflation — introducing O₂-O₃ mixture directly
  
• Ozone foam — commercial preparations for standardised dosing

Treatment is typically performed during routine reproductive examinations.

Treatment Protocol Examples

Mares: Uterine lavage with ozonated saline (2-3L) or insufflation with O₂-O₃ (100-150ml at 20-40 μg/ml), 1-3 treatments 24-48h apart.

Cattle: Intrauterine infusion of ozonated saline or gas, often single treatment post-calving or for diagnosed endometritis. Can be combined with PGF2α protocols.

What does the research say?

Strong research base supports reproductive applications:

Horses

Kohne et al. (2023) Comparison of systemic trimethoprim-sulfadimethoxine treatment and intrauterine ozone application as possible therapies for bacterial endometritis in equine practice (Frontiers in Veterinary Science, 10, 1102149. https://doi.org/10.3389/fvets.2023.1102149)

Ávila et al. (2022) — Effectiveness of Ozone Therapy in The Treatment of Endometritis in Mares (Journal of Equine Veterinary Science)

Camargo Ferreira et al. (2021) — Endometrial angiogenesis induced by uterine insufflation with an oxygen-ozone gas mixture in mares (Reproduction in Domestic Animals)

Donato et al. (2023) Safety and Effects of a Commercial Ozone Foam Preparation on Endometrial Environment and Fertility of Mares (Journal of Equine Veterinary Science, 121, 104222. https://doi.org/10.1016/j.jevs.2023.104222)

Mazzuchini et al. (2022) Safety of Uterine Lavage with Ozonated Saline in Mares (Archives of Veterinary Science, 27(1). https://doi.org/10.5380/avs.v1i1.81197)

Farm Animals

Djuricic et al. (2012) Intrauterine ozone treatment of retained fetal membrane in Simmental cows (Animal Reproduction Science, 134(3-4), 119-124. https://doi.org/10.1016/j.anireprosci.2012.08.023)

Escandon et al. (2020) Intrauterine therapy with ozone reduces subclinical endometritis and improves reproductive performance in postpartum dairy cows managed in pasture-based systems, 52, 3649-3655. https://doi.org/10.1007/s11250-020-02298-3)

Djuricic et al. (2015) The intrauterine treatment of the retained foetal membrane in dairy goats by ozone: novel alternative to antibiotic therapy (Reproduction in Domestic Animals, 50(2), 236-239. https://doi.org/10.1111/rda.12475)

Ogata & Nagahata (2000) IIntramammary application of ozone therapy to acute clinical mastitis in dairy cows (Journal of Veterinary Medical Science, 62(7), 681-686. https://doi.org/10.1292/jvms.62.681)

Benefits for farm practice

Practical advantages on farm:

• No milk withdrawal — can continue milking
• No meat withdrawal — animals can be sold normally
• Reduced antibiotic use — meets retailer/organic requirements
• Effective where antibiotics have failed
• Portable equipment available for on-farm use