N-Acetylcysteine improves oocyte and embryo quality in polycystic ovary syndrome patients undergoing intracytoplasmic sperm injection: an alternative to metformin

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 1500mg day(-1) MET; (2) an NAC group, administered 1800mg 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.

Conservative Nonhormonal Options for the Treatment of Male Infertility: Antibiotics, Anti-Inflammatory Drugs, and Antioxidants

“…Furthermore, it significantly improves seminal fluid volume and viscosity and increase sperm motility in humans [101]. In women suffering from polycystic ovary syndrome, NAC (administered at the doses of 1500 mg/day) has been shown to ameliorate oocyte and embryo quality, representing an alternative to metformin prescription [102]. Such findings support the therapeutic use of this compound for the treatment of human infertility.…”

Regulatory Functions of L-Carnitine, Acetyl, and Propionyl L-Carnitine in a PCOS Mouse Model: Focus on Antioxidant/Antiglycative Molecular Pathways in the Ovarian Microenvironment

“…Recently, many studies have suggested a central role for oxidative and glycative stresses in the pathogenesis of the PCOS and a decreased antioxidant capacity in patients with PCOS [4][5][6][7]. In addition, it has been demonstrated that PCOS patients consuming antioxidants present an amelioration of ovarian function and morphology, with a reduction of oxidative stress [8].…”

Supplementation of maturation medium with CoQ10 enhances developmental competence of ovine oocytes through improvement of mitochondrial function

“…For this reason, mitochondrial augmentation was suggested and recently implemented in humans (Herbert & Turnbull, 2018). In addition, recent studies suggested that antioxidant supplementation, especially with CoQ10, may improve the outcomes of ART cycles with respect to embryo quality and pregnancy outcomes (Cheraghi, Mehranjani, Shariatzadeh, Esfahani, & Ebrahimi, 2016;Luddi et al, 2016;Nashivochnikova, Krupin, & Selivanova, 2015;Safarinejad, 2012).…”