NAC Improved Response to Clomid in Women with PCOS

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Nelson Vergel

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Fertil Steril. 2005 Feb;83(2):367-70.
N-acetyl-cysteine is a novel adjuvant to clomiphene citrate in clomiphene citrate-resistant patients with polycystic ovary syndrome.

Rizk AY1, Bedaiwy MA, Al-Inany HG.


Abstract
OBJECTIVE:
To evaluate the effect of N-acetyl-cysteine (NAC), a mucolytic drug with insulin sensitizing properties, as an adjuvant therapy in subjects with polycystic ovary syndrome (PCOS) resistant to clomiphene citrate (CC).

DESIGN:
Placebo-controlled, double-blind randomized trial.

SETTING:
University-based hospital and private infertility practice.

PATIENT(S):
One hundred fifty women diagnosed with CC-resistant PCOS, aged 18-39 years undergoing therapy for infertility were included.

INTERVENTION(S):
The patients were assigned randomly to receive either NAC 1.2 g/d (group I) or placebo (group II) with CC 100 mg/d for 5 days starting at day 3 of the cycle.

MAIN OUTCOME MEASURE(S):
Ovulation rate and pregnancy rate (PR).

RESULT(S):
Combination of CC and NAC significantly increased both ovulation rate and PR in women with CC-resistant PCOS (49.3% vs. 1.3% and 21.3% vs. 0%, respectively). No cases of ovarian hyperstimulation syndrome (OHSS) were reported in the NAC group; two cases of miscarriage (12.5%) were reported.

CONCLUSION(S):
The NAC as an adjuvant to CC was more effective than placebo for CC-resistant patients with PCOS. It is safe and well tolerated.
 
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