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Topic: N-acetylcysteine May Induce Ovulation in Women with Polycystic Ovarian Syndrome   Keywords:  POLYCYSTIC OVARIAN SYNDROME, PCOS, FERTILITY, OVULATION - N-acetylcysteine, N-acetyl cysteine, NAC, Clomid, Clomiphene Citrate   Reference:  "N-Acetyl cysteine and clomiphene citrate for induction of ovulation in polycystic ovary syndrome: a cross-over trial," Badawy A, State O, et al, Acta Obstet Gynecol Scanda, 2007; 86(2): 218-22. (Address: Department of Obstetrics and Gynaecology, Mansoura University, Mansoura, Egypt. E-mail: ambadawy@yahoo.com ). Summary:  In a study involving 573 women with polycystic ovarian syndrome (PCOS), supplementation with N-acetylcysteine (NAC) in addition to the fertility drug, clomiphene citrate, was found to induce ovulation more effectively than treatment with clomiphene citrate alone. All of the subjects were treated with clomiphene citrate (50 mg tablets, twice a day) for one menstrual cycle, after which 470 of the subjects were treated with clomiphene citrate plus N-acetylcysteine (1,200 mg/day orally for 5 days starting on day 3 of the menstrual cycle) for another cycle. Results showed a significant improvement in ovulation after NAC was added to the treatment (52.1% versus 17.9%). The number of mature follicles was non-significantly greater in the NAC group compared to the clomiphene citrate alone group. Significant improvements in mean E2 levels (pg/ml) at the time of human chorionic gonadotropine injection, serum progesterone levels (ng/ml) on days 21-23 of the cycle, and endometrial thi ckness were found in women after receiving NAC. 11.5% of women in the NAC group became pregnant. 55.4% of the subjects were found to be insulin resistant, but no significant differences were found between insulin resistant subjects and non-insulin resistant subjects with regards to ovulation rate, number of follicles, serum E2 (pg/ml), serum progesterone (ng/ml), endometrial thickness (mm), or pregnancy rate. The authors of this study conclude that, "N-Acetyl cysteine is proved effective in inducing or augmenting ovulation in polycystic ovary patients."