RETRACTED: Effect of N-acetyl-cysteine after ovarian drilling in clomiphene citrate-resistant PCOS women: a pilot study

Abstract

The aim of this randomized double-blind placebo-controlled pilot study was to evaluate N-acetyl-cysteine (NAC) as an adjunctive therapy following unilateral laparoscopic ovarian drilling (LOD) for clomiphene citrate-resistant women with polycystic ovary syndrome (PCOS). A total of 60 patients with clomiphene citrate-resistant PCOS who underwent unilateral LOD were assigned randomly to receive either NAC 1.2 g/d (group A=30) or placebo (group B=30) for 5 days starting at day 3 of the cycle for 12 consecutive cycles. The primary outcome was pregnancy rate; secondary outcomes were ovulation rates, endometrial thickness and pregnancy outcome. Baseline clinical, endocrine, and sonographic characteristics were similar in the two groups. A significant increase in both ovulation and pregnancy rates was observed in the NAC group, compared with placebo [87% versus 67% (RR 1.3; 95% CI 1.2-2.7) and 77% versus 57% (RR 1.4; 95% CI 1.1-2.7), respectively, P<0.01]. Moreover, miscarriage rates were significantly lower and live birth rates were significantly higher in the NAC group [8.7% versus 23.5% (RR 0.4; 95% CI 0.1-3.7) and 67% versus 40% (RR 1.7; 95% CI 0.3-3.5), respectively, P<0.01]. In conclusion, NAC is a novel adjuvant therapy after unilateral LOD which might help improve overall reproductive outcome.

Impact of obesity on reproductive outcomes after ovarian ablative therapy in PCOS: a collaborative meta-analysis

“…Most of the studies combined in this analysis favoured lean patients in both reproductive terms (Nasr, 2010;Palomba et al, 2010;Zhu et al, 2010, Palomba, unpublished observations, Abu Hashim et al, 2010, 2011aAmer et al, 2002Amer et al, , 2004Ott et al, 2009;Ramzy et al, 2001;Zakherah et al, 2010). This supports the link between reproductive failure after OAT and obesity in PCOS.…”

Impact of obesity on reproductive outcomes after ovarian ablative therapy in PCOS: a collaborative meta-analysis

“…Most of the studies combined in this analysis favoured lean patients in both reproductive terms (Nasr, 2010;Palomba et al, 2010;Zhu et al, 2010, Palomba, unpublished observations, Abu Hashim et al, 2010, 2011aAmer et al, 2002Amer et al, , 2004Ott et al, 2009;Ramzy et al, 2001;Zakherah et al, 2010). This supports the link between reproductive failure after OAT and obesity in PCOS.…”

Retracted: Randomized controlled trial of N‐acetylcysteine versus l‐carnitine among women with clomiphene‐citrate‐resistant polycystic ovary syndrome

“…Similarly, a systematic review of eight studies concluded that N ‐acetylcysteine led to a significant improvement in pregnancy and ovulation rates as compared with placebo . N ‐Acetylcysteine also achieved significantly higher rates of ovulation, pregnancy, and live birth as compared with unilateral laparoscopic ovarian drilling among women with CC‐resistant PCOS . Furthermore the same treatment was found to significantly increase pregnancy rates relative to metformin plus CC .…”

Evaluating the Therapeutic Potential of Antioxidants in Polyendocrine Metabolic Ovarian Syndrome (PMOS)-Associated Infertility

“……”

Impact of obesity on reproductive outcomes after ovarian ablative therapy in PCOS: a collaborative meta-analysis

“…Most of the studies combined in this analysis favoured lean patients in both reproductive terms (Nasr, 2010;Palomba et al, 2010;Zhu et al, 2010, Palomba, unpublished observations, Abu Hashim et al, 2010, 2011aAmer et al, 2002Amer et al, , 2004Ott et al, 2009;Ramzy et al, 2001;Zakherah et al, 2010). This supports the link between reproductive failure after OAT and obesity in PCOS.…”

Retracted: Randomized controlled trial of N‐acetylcysteine versus l‐carnitine among women with clomiphene‐citrate‐resistant polycystic ovary syndrome

“…Similarly, a systematic review of eight studies concluded that N ‐acetylcysteine led to a significant improvement in pregnancy and ovulation rates as compared with placebo . N ‐Acetylcysteine also achieved significantly higher rates of ovulation, pregnancy, and live birth as compared with unilateral laparoscopic ovarian drilling among women with CC‐resistant PCOS . Furthermore the same treatment was found to significantly increase pregnancy rates relative to metformin plus CC .…”

Evaluating the Therapeutic Potential of Antioxidants in Polyendocrine Metabolic Ovarian Syndrome (PMOS)-Associated Infertility

“……”

Impact of obesity on reproductive outcomes after ovarian ablative therapy in PCOS: a collaborative meta-analysis

“…Most of the studies combined in this analysis favoured lean patients in both reproductive terms (Nasr, 2010;Palomba et al, 2010;Zhu et al, 2010, Palomba, unpublished observations, Abu Hashim et al, 2010, 2011aAmer et al, 2002Amer et al, , 2004Ott et al, 2009;Ramzy et al, 2001;Zakherah et al, 2010). This supports the link between reproductive failure after OAT and obesity in PCOS.…”

Retracted: Randomized controlled trial of N‐acetylcysteine versus l‐carnitine among women with clomiphene‐citrate‐resistant polycystic ovary syndrome

“…Similarly, a systematic review of eight studies concluded that N ‐acetylcysteine led to a significant improvement in pregnancy and ovulation rates as compared with placebo . N ‐Acetylcysteine also achieved significantly higher rates of ovulation, pregnancy, and live birth as compared with unilateral laparoscopic ovarian drilling among women with CC‐resistant PCOS . Furthermore the same treatment was found to significantly increase pregnancy rates relative to metformin plus CC .…”

Evaluating the Therapeutic Potential of Antioxidants in Polyendocrine Metabolic Ovarian Syndrome (PMOS)-Associated Infertility

“……”