N-Acetylcysteine improves oocyte and embryo quality in polycystic ovary syndrome patients undergoing intracytoplasmic sperm injection: an alternative to metformin
Ebrahim Cheraghi A , Malek Soleimani Mehranjani B E , Mohammad Ali Shariatzadeh B , Mohammad Hossein Nasr Esfahani C and Zahra Ebrahimi D
+ Author Affiliations
- Author Affiliations
A Medical Sciences Research Laboratory, Biology Department, Faculty of Science, Arak University, PO Box 381-5688138, Arak, Iran.
B Biology Department, Faculty of Science, Arak University, PO Box 381-5688138, Arak, Iran.
C Department of Reproductive and Development at Reproductive Biomedicine Research Center, Royan Institute of Biotechnology, ACECR, Isfahan 8159358686, Iran.
D Obstetrics and Gynecology Unit, Fellowship of Infertility, Infertility Treatment Center, Qom 3713189934, Iran.
E Corresponding author. Email: M-soleimani@araku.ac.ir
Reproduction, Fertility and Development 28(6) 723-731 https://doi.org/10.1071/RD14182
Submitted: 31 May 2014 Accepted: 17 September 2014 Published: 13 November 2014
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 1500 mg day–1 MET; (2) an NAC group, administered 1800 mg 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.
Additional keywords: fertilisation rate, follicular fluid, ovulation induction.
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