title: N-Acetylcysteine as an adjuvant to clomiphene citrate for successful induction of ovulation in infertile patients with polycystic ovary syndrome.
abstract: OBJECTIVE
  The aim of this study was to evaluate the effect of oral N-acetylcysteine (NAC) administration as an adjuvant to clomiphene citrate (CC) on induction of ovulation outcomes in patients with polycystic ovary syndrome (PCOS).
  
  
  METHODS
  In this placebo-controlled double-blind randomized clinical trial, 180 PCOS infertile patients were randomly divided into two groups for induction of ovulation. Patients in group 1 received CC 100 mg/d plus NAC 1.2 g/d and patients in group 2 received CC plus placebo for 5 days starting at day 3 of the cycle. On the 12th day of the menstrual cycle in the presence of at least one follicle with an 18-20-mm diameter in ultrasound evaluation, 10,000 U hCG was injected intramuscularly and timed intercourse was advised 36 h after hCG injection. Serum β-hCG level was measured on the 16th day after hCG injection.
  
  
  RESULTS
  The number of follicles >18 mm and the mean endometrial thickness on the day of hCG administration were significantly higher among the CC+NAC group (P-value = 0.001). The ovulation and pregnancy rates were also significantly higher in the CC+NAC group (P-value = 0.02 and 0.04, respectively). No adverse side-effects and no cases of ovarian hyperstimulation syndrome were observed in the group receiving NAC.
  
  
  CONCLUSIONS
  NAC as a safe and well-tolerated adjuvant to CC for induction of ovulation can improve the ovulation and pregnancy rates in PCOS patients. It may also have some beneficial impacts on endometrial thickness.
authors.affiliation: IVF Center, Infertility and Reproductive Health Research Center, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Saghar
authors.initials: S
authors.lastname: Salehpour
authors.forename: Azadeh Akbari
authors.initials: AA
authors.lastname: Sene
authors.forename: Nasrin
authors.initials: N
authors.lastname: Saharkhiz
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Sohrabi
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Moghimian
mesh_terms: D000111:Acetylcysteine / Q000627:therapeutic use*; D000277:Adjuvants, Pharmaceutic; D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy* / Q000209:etiology; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D011247:Pregnancy; D055815:Young Adult
chemical_list: D000277:Adjuvants, Pharmaceutic; D005300:Fertility Agents, Female; D016166:Free Radical Scavengers; D002996:Clomiphene; D000111:Acetylcysteine