OBJECTIVES: 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. STUDY DESIGN: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.
RCT Entities:
OBJECTIVES: 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. STUDY DESIGN: 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 PCOSpatients with beneficial impacts on endometrial thickness.
Authors: M F Costello; M L Misso; A Balen; J Boyle; L Devoto; R M Garad; R Hart; L Johnson; C Jordan; R S Legro; R J Norman; E Mocanu; J Qiao; R J Rodgers; L Rombauts; E C Tassone; S Thangaratinam; E Vanky; H J Teede Journal: Hum Reprod Open Date: 2019-01-04
Authors: Rui Wang; Bobae V Kim; Madelon van Wely; Neil P Johnson; Michael F Costello; Hanwang Zhang; Ernest Hung Yu Ng; Richard S Legro; Siladitya Bhattacharya; Robert J Norman; Ben Willem J Mol Journal: BMJ Date: 2017-01-31