title: N-Acetylcysteine improves oocyte and embryo quality in polycystic ovary syndrome patients undergoing intracytoplasmic sperm injection: an alternative to metformin.
abstract: Polycystic ovary syndrome (PCOS) is associated with low-quality oocytes. The aim of the present study was to investigate the effects of metformin (MET), N-acetylcysteine (NAC) and their combination on follicular fluid parameters, oocytes and embryo quality in PCOS patients. A prospective randomised placebo-controlled pilot study on 60 Iranian women with PCOS (aged 25-35 years) undergoing intracytoplasmic sperm injection (ICSI) was designed. Women were divided into four groups (n=15 in each): (1) an MET, administered 1500mg day(-1) MET; (2) an NAC group, administered 1800mg day(-1) NAC; (3) an NAC + MET group; and (4) a placebo group. Drugs were administered from the 3rd day of previous cycle until the day of oocyte aspiration (6 weeks treatment in total). Data were analysed by one-way ANOVA, with significance set at P<0.05. The number of immature and abnormal oocytes decreased significantly in the NAC compared with placebo group, with a concomitant increase in the number of good-quality embryos in the NAC group (P<0.05). Malondialdehyde levels decreased significantly in the NAC and NAC + MET groups compared with the placebo-treated group (P<0.02). In addition, there were significant decreases in leptin levels in the NAC, MET and NAC + MET groups compared with the placebo group (P<0.001). Insulin and LH levels were significantly lower in the MET and NAC groups compared with the placebo-treated group (P<0.02). We concluded that NAC improves oocyte and embryo quality and could be administered as an alternative to MET.
authors.affiliation: Medical Sciences Research Laboratory, Biology Department, Faculty of Science, Arak University, PO Box 381-5688138, Arak, Iran.
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Cheraghi
authors.affiliation: Biology Department, Faculty of Science, Arak University, PO Box 381-5688138, Arak, Iran.
authors.forename: Malek Soleimani
authors.initials: MS
authors.lastname: Mehranjani
authors.affiliation: Biology Department, Faculty of Science, Arak University, PO Box 381-5688138, Arak, Iran.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Shariatzadeh
authors.affiliation: Department of Reproductive and Development at Reproductive Biomedicine Research Center, Royan Institute of Biotechnology, ACECR, Isfahan 8159358686, Iran.
authors.forename: Mohammad Hossein Nasr
authors.initials: MH
authors.lastname: Esfahani
authors.affiliation: Obstetrics and Gynecology Unit, Fellowship of Infertility, Infertility Treatment Center, Qom 3713189934, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Ebrahimi
mesh_terms: D000046:Academic Medical Centers; D000111:Acetylcysteine / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D000975:Antioxidants / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004477:Ectogenesis / Q000187:drug effects*; D005260:Female; D015571:Follicular Fluid / Q000187:drug effects; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D007247:Infertility, Female / Q000209:etiology / Q000517:prevention & control*; D007492:Iran; D008687:Metformin / Q000009:adverse effects / Q000627:therapeutic use; D054315:Oocyte Retrieval; D009865:Oocytes / Q000187:drug effects / Q000473:pathology; D009866:Oogenesis / Q000187:drug effects*; D010062:Ovulation Induction; D010352:Patient Dropouts; D010865:Pilot Projects; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D020554:Sperm Injections, Intracytoplasmic
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000975:Antioxidants; D007004:Hypoglycemic Agents; D008687:Metformin; D000111:Acetylcysteine