title: N-acetylcysteine for polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled clinical trials.
abstract: Objective. To review the benefits and harms of N-acetylcysteine (NAC) in women with polycystic ovary syndrome (PCOS). Method. Literature search was conducted using the bibliographic databases, MEDLINE (Ovid), CINAHL, EMBASE, Scopus, PsyInfo, and PROQUEST (from inception to September 2013) for the studies on women with PCOS receiving NAC. Results. Eight studies with a total of 910 women with PCOS were randomized to NAC or other treatments/placebo. There were high risk of selection, performance, and attrition bias in two studies and high risk of reporting bias in four studies. Women with NAC had higher odds of having a live birth, getting pregnant, and ovulation as compared to placebo. However, women with NAC were less likely to have pregnancy or ovulation as compared to metformin. There was no significant difference in rates of the miscarriage, menstrual regulation, acne, hirsutism, and adverse events, or change in body mass index, testosterone, and insulin levels with NAC as compared to placebo. Conclusions. NAC showed significant improvement in pregnancy and ovulation rate as compared to placebo. The findings need further confirmation in well-designed randomized controlled trials to examine clinical outcomes such as live birth rate in longer follow-up periods. Systematic review registration number is CRD42012001902.
authors: Department of Pharmacology, SAL Institute of Pharmacy, Ahmadabad, Gujarat 380060, India.
authors: Divyesh
authors: D
authors: Thakker
authors: Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV 26506, USA.
authors: Amit
authors: A
authors: Raval
authors: Department of Biopharmaceutical Sciences, Bernard J. Dunn School of Pharmacy, Shenandoah University, Winchester, VA 22601, USA.
authors: Isha
authors: 0000-0001-6121-2398
authors: I
authors: Patel
authors: Department of Endocrinology, Post-Graduate Medical Education and Research Institute (PGIMER), Chandigarh 160012, India.
authors: Rama
authors: R
authors: Walia
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