The adjuvant effect of metformin and N-acetylcysteine to clomiphene citrate in induction of ovulation in patients with Polycystic Ovary Syndrome

Abstract

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.

Chinese abstract

目的：评估多囊卵巢综合症（PCOS）患者采用枸橼酸氯米芬（CC）促排卵过程中，二甲双胍和N-乙酰半胱氨酸的辅助作用。

实验设计：120名PCOS女性随机分为三组：组I仅接受CC治疗，组II接受CC+NAC治疗，组III接受CC+二甲双胍。

结果：组II与其它两组在直径＞18mm的卵泡数均值方面有显著差异（分别为2.25、1.75、1.89），但三组在中等大小卵泡（14–18mm）的数目方面无显著差异（分别为4、10、4）。三组在排卵发生和哪侧排卵，以及周期妊娠率均无明显差异，但组II在患者妊娠率方面显著不同于其它两组（分别为20%、10%、10%，p=0.05）。组II和其他组在子宫内膜峰值厚度方面有显著统计学差异（分别为7.3 ± 1.1、5.4 ± 0.6和5.3 ± 0.6）。

结论：NAC作为CC促排卵的辅助用药可提高PCOS患者的排卵率和妊娠率，且对子宫内膜厚度有良好的影响。

• Clomiphene citrate
• induction of ovulation
• metformin
• N-acetylcysteine
• Polycystic Ovary Syndrome

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.