Volume 15, Issue 4 (6-2017)                   IJRM 2017, 15(4): 203-208 | Back to browse issues page


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Behrouzi Lak T, Hajshafiha M, Nanbakhsh F, Oshnouei S. N-acetyl cysteine in ovulation induction of PCOS women underwent intrauterine insemination: An RCT. IJRM. 2017; 15 (4) :203-208
URL: http://journals.ssu.ac.ir/ijrmnew/article-1-817-en.html
1- Department of Obstetrics and Gynecology, Urmia Reproductive Health Research Center, Urmia, Iran
Abstract:   (570 Views)
Background: N-acetyl cysteine (NAC) was proposed as an adjuvant to clomiphenecitratefor ovulation induction in patients with polycystic ovary syndrome (PCOS)without clomiphene citrate resistance.
Objective: To evaluate the effect of NAC on pregnancy rate in PCOS patients whowere candidates for intrauterine insemination.
Materials and Methods: 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.
Results: 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).
Conclusion: 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.
Full-Text [PDF 101 kb]   (357 Downloads) |   |   Full-Text (HTML)  (56 Views)  
Type of Study: Original Article |

References
1. Hendriks ML, König T, Soleman RS, Korsen T, Schats R, Hompes PG, et al. Influence of ovarian manipulation on reproductive endocrinology in polycystic ovarian syndrome and regularly cycling women. Eur J Endocrinol 2013; 169: 503-10. [DOI:10.1530/EJE-13-0334]
2. Shi Y, Wei D, Liang X, Sun Y, Liu J, Cao Y, et al. Live birth after fresh embryo transfer vs elective embryo cryopreservation/frozen embryo transfer in women with polycystic ovary syndrome undergoing IVF (FreFro-PCOS): study protocol for a multicenter, prospective, randomized controlled clinical trial. Trials 2014; 15: 154. [DOI:10.1186/1745-6215-15-154]
3. Maharjan R, Nagar PS, Nampoothiri L. Effect of Aloe barbadensis Mill. formulation on Letrozole induced polycystic ovarian syndrome rat model. J Ayurveda Integr Med 2010; 1: 273-279. [DOI:10.4103/0975-9476.74090]
4. Nam H, Kim CH, Cha MY, Kim JM, Kang BM, Yoo HW. Polycystic ovary syndrome woman with heterozygous androgen receptor gene mutation who gave birth to a child with androgen insensitivity syndrome. Obstet Gynecol Sci 2015; 58: 179-182. [DOI:10.5468/ogs.2015.58.2.179]
5. Bagheri M, Sohrabvand F, Lankarani M, Zandieh Z, Haghollahi F, Shariat M. Comparison of Biomedical Variables in PCOS Patients with Normal Iranian Women. J Family Reprod Health 2015; 9: 5-11.
6. Hendawy SF, Samaha HE, Elkholy MF. Letrozole versus Clomiphene Citrate for Induction of Ovulation in Patients with Polycystic Ovarian Syndrome Undergoing Intrauterine Insemination. Clin Med Insights Reprod Health 2011; 5: 11-16. [DOI:10.4137/CMRH.S6598]
7. Kuang H, Li Y, Wu X, Hou L, Wu T, Liu J, et al. Acupuncture and clomiphene citrate for live birth in polycystic ovary syndrome: study design of a randomized controlled trial. Evid Based Complement Alternat Med 2013; 2013: 527303. [DOI:10.1155/2013/527303]
8. Tang T, Lord JM, Norman RJ, Yasmin E, Balen AH. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. Cochrane Database Syst Rev 2010; 1:CD003053. [DOI:10.1002/14651858.CD003053.pub4]
9. Farquhar C, Lilford RJ, Marjoribanks J, [DOI:10.1002/14651858.CD001122.pub3]
10. Tang T, Lord JM, Norman RJ, Yasmin E, Balen AH. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. Cochrane Database Syst Rev 2012; 5:CD003053 [DOI:10.1002/14651858.CD003053.pub5]
11. El-Gharib MN, Mahfouz AE, Farahat MA. Comparison of letrozole versus tamoxifen effects in clomiphen citrate resistant women with polycystic ovarian syndrome. J Reprod Infertil 2015; 16: 30-35.
12. Holzer H, Casper R, Tulandi T. A new era in ovulation induction. Fertil Steril 2006; 85: 277-284. [DOI:10.1016/j.fertnstert.2005.05.078]
13. Nik Hussain NK, Ismail M, Mohd M, Yeu Cp, Rmli R , Wan Mohammad MW, et al.Randomized contralled trial of letrozole versus Chlomiphene citrate for induction of ovulation in polycystic ovarian syndrome (PCOS): A Malaysian experience. Open J Obstet Gynecol 2013; 3: 11-17. [DOI:10.4236/ojog.2013.35A2003]
14. Dorota Magdalena Radomska-Leoeniewska, Piotr Skopi-ski. N-acetylcysteine as an anti-oxidant and anti-inflammatory drug and its some clinical applications. Centr Eur J Immunol 2012; 37: 57-66.
15. Salehpour S, Tohidi M, Akhound MR, Amirzargar N. N Acetyl Cysteine, A novel Remedy for Poly Cystic Ovarian Syndrome. Int J Fertil Steril 2009; 3: 66-73.
16. Kilic-Okman T, Kucuk M. N-acetyl-cysteine treatment for polycystic ovary syndrome. Int J Gynaecol Obstet 2004; 85: 296-297. [DOI:10.1016/j.ijgo.2004.03.002]
17. Roshanayee Y, Comprehensive information official agents of Iran and the world. 3PrdP Ed. Tehran, Roshan book; 2014: 11.
18. Badawy A, State O, Abdelgawad S. N-Acetyl cysteine and clomiphene citrate for induction of ovulation in polycystic ovary syndrome: A cross-over trial. Acta Obstet Gynecol Scand 2007; 86: 218-222. [DOI:10.1080/00016340601090337]
19. Salehpour S, Sene AA, Saharkhiz N, Sohrabi MR, Moghimian F. N-Acetylcysteine as an adjuvant to clomiphene citrate for successful induction of ovulation in infertile patients with polycystic ovary syndrome. J Obstet Gynaecol Res 2012; 38: 1182-1186. [DOI:10.1111/j.1447-0756.2012.01844.x]
20. Rotterdam ESHRE/ASRM-Sponsored PCOS Con-sensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004; 81(1): 19-25 [DOI:10.1016/j.fertnstert.2003.10.004]
21. Thakker D, Raval A, Patel I, Walia R. N-acetylcysteine for polycystic ovary syndrome: a
22. Rizk AY, Bedaiwy MA, Al-Inany HG, N-acetyl-cysteine is a novel adjuvant to clomiphene citrate in clomiphene citrate-resistant patients with polycystic ovary syndrome. Fertil Steril 2005; 83: 367-370. [DOI:10.1016/j.fertnstert.2004.07.960]
23. Nasr A. Effect of N-acetyl-cysteine after ovarian drilling in clomiphene citrate-resistant PCOS women: a pilot study. Reprod Biomed Online 2010; 20: 403-409. [DOI:10.1016/j.rbmo.2009.12.012]
24. Millea PJ. N-acetylcysteine: multiple clinical applications. Am Fam Physician 2009; 80: 265-269.
25. Oner G, Muderris II. Clinical, endocrine and metabolic effects of metformin vs N-acetyl-cysteine in women with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol 2011; 159: 127-131. [DOI:10.1016/j.ejogrb.2011.07.005]
26. Amin AF, Shaaban OM, Bediawy MA. N-acetyl cysteine for treatment of recurrent unexplained pregnancy loss. Reprod Biomed Online 2008; 17: 722-726. [DOI:10.1016/S1472-6483(10)60322-7]
27. Abu Hashim H, Anwar K, El-Fatah RA. N-acetyl cysteine plus clomiphene citrate versus metformin and clomiphene citrate in treatment of clomiphene-resistant polycystic ovary syndrome: a randomized controlled trial. J Womens Health (Larchmt) 2010; 19: 2043-2048. [DOI:10.1089/jwh.2009.1920]
28. Cheraghi E, Mehranjani MS, Shariatzadeh MA, Esfahani MH, Ebrahimi Z.N-Acetylcysteine improves oocyte and embryo quality in polycystic ovary syndrome patients undergoing intracytoplasmic sperm injection: an alternative to metformin. Reprod Fertil Dev 2016; 28: 723-731. [DOI:10.1071/RD14182]
29. Maged AM, Elsawah H, Abdelhafez A, Bakry A, Mostafa WA. The adjuvant effect of metformin and N-acetylcysteine to clomiphene citrate in induction of ovulation inpatients with Polycystic Ovary Syndrome. Gynecol Endocrinol 2015; 31: 635-638. [DOI:10.3109/09513590.2015.1037269]
30. Amini L, Tehranian N, Movahedin M, Ramezani Tehrani F, Ziaee S. Antioxidantsand management of polycystic ovary syndrome in Iran: A systematic review ofclinical trials. Iran J Reprod Med 2015; 13: 1-8.

Add your comments about this article : Your username or Email:
CAPTCHA

© 2019 All Rights Reserved | International Journal of Reproductive BioMedicine

Designed & Developed by : Yektaweb