Effects of intrauterine ozone insufflation in eleven subfertile mares: a case series.
Abstract: Equine persistent breeding-induced endometritis can lead to chronic uterine inflammation and fibrosis, reducing fertility. Intrauterine ozone (O₃) has recently been proposed as a potential treatment for mares unresponsive to conventional therapies. This case series describes O₃ treatment in eleven mares barren for at least one year despite multiple inseminations attempts. During the first oestrous cycle, low-volume uterine lavage and endometrial biopsy were performed, followed by 3 consecutive days of intrauterine O₂-O₃ gas insufflation. In the subsequent cycle, both procedures were repeated and mares were inseminated with fresh/fresh-cooled semen. Pregnancy was confirmed 14 days post-ovulation and was monitored until parturition. Ten/11 (90.9%) mares conceived and 9/11 (81.8%) delivered a live foal. Post-treatment biopsies showed a significant increase in CD163+ M2 macrophages, suggesting a positive influence of O₃ on endometrial tissue remodeling. These results suggest that O₃ therapy may contribute to fertility restoration in subfertile mares, but further studies are needed.
Copyright © 2026. Published by Elsevier Inc.
Publication Date: 2026-01-07 PubMed ID: 41513112DOI: 10.1016/j.jevs.2026.105778Google Scholar: Lookup
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APA
Moroni R, Fanelli D, Maltinti S, Orefice M, Rota A, Camillo F, Melanie P, Cantile C, Miragliotta V, Pirone A, Lazzarini G, Passamonti F, Marmorini P, Ori M, Panzani D.
(2026).
Effects of intrauterine ozone insufflation in eleven subfertile mares: a case series.
J Equine Vet Sci, 157, 105778.
https://doi.org/10.1016/j.jevs.2026.105778 Publication
Researcher Affiliations
- Department of Veterinary Sciences, University of Pisa, Via Livornese (SP-22), San Piero A Grado (PI) 56122, Italy. Electronic address: rebecca.moroni@phd.unipi.it.
- Department of Veterinary Sciences, University of Pisa, Via Livornese (SP-22), San Piero A Grado (PI) 56122, Italy.
- Department of Veterinary Sciences, University of Pisa, Via Livornese (SP-22), San Piero A Grado (PI) 56122, Italy.
- Unit of Cellular, Molecular and Developmental Biology, Department of Biology, University of Pisa, SS Dell'Abetone e del Brennero 4, Pisa (PI) 56123, Italy.
- Department of Veterinary Sciences, University of Pisa, Via Livornese (SP-22), San Piero A Grado (PI) 56122, Italy.
- Department of Veterinary Sciences, University of Pisa, Via Livornese (SP-22), San Piero A Grado (PI) 56122, Italy.
- Department of Veterinary Sciences, University of Pisa, Via Livornese (SP-22), San Piero A Grado (PI) 56122, Italy.
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge 2, Pisa (PI) 56124, Italy.
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge 2, Pisa (PI) 56124, Italy.
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge 2, Pisa (PI) 56124, Italy.
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge 2, Pisa (PI) 56124, Italy.
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, Perugia (PG) 06126, Italy.
- Private practitioner. Cenaia, Pisa (PI), Italy.
- Unit of Cellular, Molecular and Developmental Biology, Department of Biology, University of Pisa, SS Dell'Abetone e del Brennero 4, Pisa (PI) 56123, Italy.
- Department of Veterinary Sciences, University of Pisa, Via Livornese (SP-22), San Piero A Grado (PI) 56122, Italy.
MeSH Terms
- Female
- Animals
- Horses
- Ozone / therapeutic use
- Ozone / administration & dosage
- Horse Diseases / therapy
- Pregnancy
- Infertility, Female / veterinary
- Infertility, Female / therapy
- Insufflation / veterinary
- Insufflation / methods
- Uterus
Conflict of Interest Statement
Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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