N-acetyl cysteine in ovulation induction of PCOS women underwent intrauterine insemination: An RCT

N-acetyl cysteine (NAC) was proposed as an adjuvant to clomiphenecitratefor ovulation induction in patients with polycystic ovary syndrome (PCOS)without clomiphene citrate resistance.

To evaluate the effect of NAC on pregnancy rate in PCOS patients whowere candidates for intrauterine insemination.

In this randomized clinical trial 97 PCOS women aged 18-38 years were enrolled in two groups, randomly. For the case group (n=49), NAC(1.2 gr) clomiphene citrate (100 mg) letrozole (5mg) were prescribed dailyfromthe third day of menstruation cycle for five days. The control group (n=48) had thesame drug regimen without NAC. In order to follicular development, GONAL-Fwas injected on days of 7-11 menstrual cycles in all participants. When the folliclesize was 18mm or more, HCG (10000 IU) was injected intramuscular and theintrauterine insemination was performed after 34-36 hr.

There was no significant difference between study groups regarding BMI(p=0.28), FSH level (p=0.66), LH level (p=0.67), mean endometrial thickness(p=0.14), mean number of mature follicles (p=0.20) and the pregnancy occurrence(p=0.09).

NAC is ineffective in inducing or augmenting ovulation in PCOSpatients who were candidates for intrauterine insemination and cannot berecommended as an adjuvant to CC in such patients.