Date of Award

Fall 12-4-2021

Degree Type


Degree Name

PhD Molecular Bioscience




Constantine Bitsaktsis, Ph.D.

Committee Member

Jessica Cottrell, Ph.D.

Committee Member

Edward Tall, Ph.D.

Committee Member

Angela Klaus, Ph.D.

Committee Member

Zaher Merhi, M.D.


IVF, oocytes, ozone, diminished ovarian reserve, OT, embryo


Women with severe diminished ovarian reserve (DOR) with multiple failed in vitro fertilization (IVF) cycles due to the poor oocyte quality or persistently thin endometrial lining thickness (EMT) have limited treatment options and usually resort to accept oocyte donation or gestational carriers. Human and animal studies on Ozone Therapy (OT) and Pulsed Electromagnetic Field Therapy (PEMF) have demonstrated promising results as a therapeutic adjunct for female reproduction. The objective of this study was to determine the outcome of OT +PEMF in both in vitro and in vivo in women who are undergoing IVF. A group of women who underwent oocyte retrieval for IVF had their granulosa cells (GC) split equally and one set was cultured with OT delivered by the HOCATT machine and the control cells were placed in the same room outside OT delivering machine. After treatment, RT-PCR was performed for genes involved in the steroidogenesis. Furthermore, another group of women who underwent IVF was clinically assessed for ovarian function and endometrial lining thickness (EMT) before (cycle 1) and after treatment (cycle 2) with OT +PEMF, using the same protocol. The results revealed a significant 50% reduction in the CYP11A gene which encodes side-chain cleavage enzyme and a significant 5-fold increase in the CYP19A1 gene which encodes the aromatase enzyme for estradiol production. In vivo studies showed that there was no significant difference in the days of the stimulation medication used, number of oocytes retrieved or peak estradiol levels in cycle 1 compared to cycle 2. However, the number of embryos formed in Cycle 2 was significantly higher than the number of embryos formed in Cycle 1. Furthermore, all subjects were able to reach a satisfactory EMT of approximately 7mm post treatment. Our data suggests that OT +PEMF can alter the genes in the steroidogenesis, improve EMT and increase the number of embryos formed without increasing the number of oocytes retrieved which is indicative of improvement in the ovarian function and endometrial receptivity. These beneficial effects may be due to the vasodilatory, anti-inflammatory, and antioxidant actions brought by OT and PEMF.

Available for download on Saturday, February 27, 2027