Objective : Evaluation of the effect on N-Acetyl cyslcinc (NAC) as an adjuvant therapy to ovulalion induction using clomiphene citrate (CC) in cases prepared for Intra-cytoplasmic - sperm injection (ICSI). Design : Prospective randomized controlled study.
Material and Methods : Forty infertile women (male factor or lubal factor infertility) were included in the study in two equal groups (20 each) selected at random (Group I): controls: receiving 50mg CC tablets twice daily from day 2-6 of the cycle, (Group II): study group: receiving, in addition to the same dose of CC, Acctyl cysteinc (1200 mg tds/day) from day 2 to day 8 of the cycle. The patients were monitored using serial transvnginal ultrasound, and serum E2, FSH and progesterone were measured as well as urinary LH levels. The two groups were compared regarding the outcomes which included th enumber and qualtiy of oocytcs, fertilization, embryo-transfer, and pregnancy and aholion rales.. Results : There were no statistically significant differences between the two groups regarding the outcomes (fertilization, embryo transfer, pregnancy rates, abortion rates, cleavage and oocyte maturity and quality). However, there was a trend (non-significant) towards an increase in mitotic figures in granulosa cells of the group receiving NAC. Conclusion: Despite the lack of statistical significance between the outcome data of the two groups, iherc was a trend towards an increase in pregnancy and abortion rates as well as mitotic figures in granulosa cells in the NAC group. A larger number of cases would probably provide more meaningful conclusions.