The adjuvant effect of metformin and N-acetylcysteine to clomiphene citrate in induction of ovulation in patients with Polycystic Ovary Syndrome.
OBJECTIVE
To assess the adjuvant effect of metformin and N-acetylcysteine (NAC) to clomiphene citrate (CC) in induction of ovulation in Polycystic Ovary Syndrome (PCOS) patients.


METHODS
120 women with PCOS were randomly divided into three equal groups: group I received CC only, group II received CC plus NAC and group III received CC plus metformin.


RESULTS
There was a significant difference between group II and other two groups regarding average number of ovulatory follicles >18 mm (2.25 versus 1.75 and 1.89, respectively), but no significant difference between the three study groups regarding number of intermediate follicles 14-18 mm (4, 10 and 4, respectively). There was no significant difference between the three study groups regarding occurrence and laterality of ovulation, pregnancy rate per cycle but a significant difference between group II and other two groups regarding pregnancy rate per patient (20% versus 10% and 10%, respectively, p value 0.05). There was a highly statistically significant difference between group II and other two groups regarding peak endometrial thickness (7.3 ± 1.1 versus 5.4 ± 0.6 and 5.3 ± 0.6, respectively).


CONCLUSIONS
NAC as an adjuvant to CC for induction of ovulation improves ovulation and pregnancy rates in PCOS patients with beneficial impacts on endometrial thickness.
a Obstetrics and Gynecology Department , Kasr Aini Hospital Cairo University , Cairo , Egypt.
Ahmed M
AM
Maged
a Obstetrics and Gynecology Department , Kasr Aini Hospital Cairo University , Cairo , Egypt.
Heba
H
Elsawah
a Obstetrics and Gynecology Department , Kasr Aini Hospital Cairo University , Cairo , Egypt.
Aly
A
Abdelhafez
a Obstetrics and Gynecology Department , Kasr Aini Hospital Cairo University , Cairo , Egypt.
Ahmed
A
Bakry
a Obstetrics and Gynecology Department , Kasr Aini Hospital Cairo University , Cairo , Egypt.
Walaa Ai
WA
Mostafa
D000111:Acetylcysteine / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D002996:Clomiphene / Q000494:pharmacology / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy* / Q000209:etiology; D008687:Metformin / Q000494:pharmacology / Q000627:therapeutic use*; D010060:Ovulation / Q000187:drug effects; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000188:drug therapy*; D011247:Pregnancy; D018873:Pregnancy Rate; D016896:Treatment Outcome
D005300:Fertility Agents, Female; D002996:Clomiphene; D008687:Metformin; D000111:Acetylcysteine
Clomiphene citrate; N-acetylcysteine; Polycystic Ovary Syndrome; induction of ovulation; metformin