 N-Acetyl Cysteine Ineffective for Clomiphene-Resistant Polycystic Ovary Syndrome
N-Acetyl Cysteine Ineffective for Clomiphene-Resistant Polycystic Ovary Syndrome
By Will Boggs, MD
NEW YORK (Reuters Health) Sept 12 - N-acetyl cysteine (NAC) does not affect glucose or insulin levels or improve ovulation rates in women with clomiphene citrate-resistant polycystic ovary syndrome (PCOS), according to a report in the August issue of Fertility and Sterility.
"I was surprised," Dr. Aboubakr Elnashar from Benha University Hospital, Egypt told Reuters Health. "There is a difference between the hormonal, cellular, and metabolic effects of the drug and its final clinical effects."
Based on early favorable results of NAC plus clomiphene citrate, Dr. Elnashar and associates compared the effects of NAC versus metformin on the hormonal profile and ovulation rate in women with clomiphene citrate-resistant PCOS.
Fasting insulin, fasting glucose, and total testosterone levels declined significantly after metformin treatment, the authors report, but only total testosterone decreased after NAC treatment.
The ovulation rate was 51.6% in the metformin group, the report indicates, but only 6.7% in the NAC group.
"Metformin alone is an effective drug for inducing ovulation in clomiphene citrate-resistant PCOS, whereas NAC alone is not," the researchers conclude. "NAC may be an adjuvant to clomiphene citrate, but not an alternative."
Dr. Elnashar plans "to compare the use of NAC in combination with clomiphene citrate and clomiphene citrate alone in women with PCOS, from the start, not in cases of clomiphene citrate-resistant PCOS."
Fertil Steril 2007;88:406-409.
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