N-acetyl-cysteine in anovulatory women: The impact of postcoital test

Objective: N-acetyl-cysteine (NAC), a mucolytic drug with insulin sensitizing properties, has been proved useful as an adjuvant therapy in subjects with polycystic ovary syndrome (PCOS) resistant to clomiphene citrate (CC). The objective is to determine the possible beneficial mucolytic effect of NAC on patients with poor post-coital tests.
Design: Prospective, controlled pilot study.
Materials and methods: Thirty-nine women diagnosed with CC-resistant PCOS, aged 17 – 42 years undergoing therapy for infertility were included. All women were given NAC (1.2 g/d) and with CC 100 mg/d for 5 days starting at day 3 of the cycle. They were divided according to the results of their priori post-coital test into: good post-coital test (Group I: N=11) and poor post-coital test (group II: N=28).
Main Outcome Measure(s): Clinical pregnancy rate (CPR).
Result(s): There were no demographic differences (i.e. age, period of infertility, weight, previous use of CC) between the two groups, nor differences in the cycle characteristics (i.e. cycle length, ovulation induction, number of follicles produced). In addition, there was no statistical difference between the two groups pertaining the clinical pregnancy rate (P = 0.24).
Conclusion: The sample size of the present study is not large enough to withdraw firm conclusions, but we may assume that the effect of NAC as an adjuvant to CC appears not to be related to its mucolytic effect.

Keywords
N-acetyl-cysteine, polycystic ovary syndrome, clomiphene citrate resistance, post-coital test, pregnancy