Cheraghi Ebrahim, Mehranjani Malek Soleimani, Shariatzadeh Mohammad Ali, Esfahani Mohammad Hossein Nasr, Ebrahimi Zahra
Medical Sciences Research Laboratory, Biology Department, Faculty of Science, Arak University, PO Box 381-5688138, Arak, Iran.
Biology Department, Faculty of Science, Arak University, PO Box 381-5688138, Arak, Iran.
Reprod Fertil Dev. 2016 Apr;28(6):723-31. doi: 10.1071/RD14182.
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.
多囊卵巢综合征（PCOS）与卵母细胞质量差有关。本研究的目的是探讨二甲双胍（MET）、N-乙酰半胱氨酸（NAC）及其联合应用对PCOS患者卵泡液参数、卵母细胞和胚胎质量的影响。设计了一项前瞻性随机安慰剂对照试验研究，纳入60名年龄在25至35岁之间接受卵胞浆内单精子注射（ICSI）的伊朗PCOS女性。将女性分为四组（每组n = 15）：（1）MET组，每天服用1500mg MET；（2）NAC组，每天服用1800mg NAC；（3）NAC + MET组；（4）安慰剂组。药物从前一周期的第3天开始给药，直至卵母细胞抽吸日（共治疗6周）。数据采用单因素方差分析进行分析，显著性设定为P<0.05。与安慰剂组相比，NAC组未成熟和异常卵母细胞数量显著减少，同时NAC组优质胚胎数量增加（P<0.05）。与安慰剂治疗组相比，NAC组和NAC + MET组丙二醛水平显著降低（P<0.02）。此外，与安慰剂组相比，NAC组、MET组和NAC + MET组瘦素水平显著降低（P<0.001）。与安慰剂治疗组相比，MET组和NAC组胰岛素和LH水平显著降低（P<0.02）。我们得出结论，NAC可改善卵母细胞和胚胎质量，可作为MET的替代药物使用。
