N-acetyl-cysteine is a novel adjuvant to clomiphene citrate in clomiphene citrate-resistant patients with polycystic ovary syndrome.
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).


METHODS
Placebo-controlled, double-blind randomized trial.


METHODS
University-based hospital and private infertility practice.


METHODS
One hundred fifty women diagnosed with CC-resistant PCOS, aged 18-39 years undergoing therapy for infertility were included.


METHODS
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.


METHODS
Ovulation rate and pregnancy rate (PR).


RESULTS
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.


CONCLUSIONS
The NAC as an adjuvant to CC was more effective than placebo for CC-resistant patients with PCOS. It is safe and well tolerated.
Rizk
Ahmed Y
AY
Department of Obstetrics and Gynecology, Benha University, Benha, Egypt. ahmadrezk@yahoo.com
Bedaiwy
Mohamed A
MA
Al-Inany
Hesham G
HG
D000111:Acetylcysteine / Q000008:administration & dosage*; D000293:Adolescent; D000328:Adult; D002996:Clomiphene / Q000008:administration & dosage*; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D006801:Humans; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome
D005300:Fertility Agents, Female; D002996:Clomiphene; D000111:Acetylcysteine