N-acetyl-cysteine as adjuvant therapy in female infertility: a systematic review and meta-analysis
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Nagita Devi
und
Dipika Bansal
Abstract
Objectives
The objective of this study is to explore the efficacy and safety of N-acetyl-cysteine (NAC) as adjuvant therapy in female infertility.
Content
We performed a systematic literature search of PubMed, Cochrane Library, Embase, and Ovid databases through April 2019 for Randomized Controlled Trials (RCTs) evaluating the effectiveness and safety of NAC as adjuvant therapy in female infertility. The outcomes assessed were rates of ovulation, pregnancy, miscarriage and multiple pregnancy, presented as pooled odds ratio with 95% confidence interval (CI) using the random-effects model. Heterogeneity and inconsistency of the measurements were identified through Cochrane’s Q statistic and I2 statistic. We also performed a sensitivity analysis, publication bias (using funnel plot and Begg’s test), and subgroup analysis.
Summary
Fifteen RCTs recruiting 2330 female receiving NAC were included. The pooled estimate showed the statistically insignificant improvement in outcomes; clinical pregnancy rate 1.55 (95% CI 0.98–2.47; I2=68%; p<0.01), ovulation rate 1.77 (95% CI 0.76–4.14; I2=90%; p<0.01), multiple pregnancy rate 0.83 (95% CI 0.34–1.99; I2=10%; p=0.31) and miscarriage rate 0.76 (95% CI= 0.37, 1.53; I2=0%; p=0.69) . NAC was found less efficacious and safe than metformin in all outcomes. Overall, NAC showed statistically insignificant (OR=0.98–2.47).
Outlook
NAC can be an effective adjuvant in PCOS related and unexplained female infertility. The effect could be more profound in women with high BMI, insulin resistance, and oxidative stress. However, the findings need further confirmation in well-designed randomized controlled trials to examine clinical outcomes such as live birth rate in more extended follow-up periods.
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Research funding: None funded.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Supplementary Material
The online version of this article offers supplementary material (https://doi.org/10.1515/jbcpp-2020-0107).
© 2020 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
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- N-acetyl-cysteine as adjuvant therapy in female infertility: a systematic review and meta-analysis
- Climate change and declining fertility rate in Malaysia: the possible connexions
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Artikel in diesem Heft
- Frontmatter
- Reviews
- N-acetyl-cysteine as adjuvant therapy in female infertility: a systematic review and meta-analysis
- Climate change and declining fertility rate in Malaysia: the possible connexions
- Original Articles
- Potential anti-toxic effect of d-ribose-l-cysteine supplement on the reproductive functions of male rats administered cyclophosphamide
- Environmental and climatic impact on the infection and mortality of SARS-CoV-2 in Peru
- Prophylactic intravenous paracetamol use in extremely premature infants for patent ductus arteriosus
- Evaluation of heart rate variability, blood pressure and lipid profile alterations from dual transceiver mobile phone radiation exposure
- Strain specific response of mice to IMQ-induced psoriasis
- Curcumin exerts hepatoprotection via overexpression of Paraoxonase-1 and its regulatory genes in rats undergone bile duct ligation
- Zinc oxide nanoparticles with green tea extract complex in the pancreas of rats against monosodium glutamate toxicity
- Phenolic constituents and inhibitory effects of the leaf of Rauvolfia vomitoria Afzel on free radicals, cholinergic and monoaminergic enzymes in rat’s brain in vitro
- Protective and curative role of vitamin D and hormones on the cadmium-induced inhibition of proliferation of human osteoblast cells
- The effect of bee pollen on reproductive and biochemical parameters in methotrexate-induced testicular damage in adult rats
- Histomorphometric study on effects of monosodium glutamate in liver tissue of Wistar rats
- Diligent profiling of preclinical safety of the silk protein sericin
