Clomiphene-acetyl cysteine combination as a new protocol to a friendly IVF cycle

Objective: N-acetyl-cysteine (NAC) has been shown to enhance the action of clomiphene citrate in ovulation induction. The objective of this study was to examine the use of NAC with clomiphene citrate for ovarian stimulation in assisted conception as a model for "Friendly IVF" Design: pilot study Materials and methods: Twenty infertile patients undergoing IVF/ICSI cycles were offered NAC, 1,200 mg/day from day 3-7 of the menstrual cycle with CC (100 mg /day) starting on day 3-7. hCG (10,000 IU) was given when leading follicle(s) were ≥ 18mm followed by ICSI. Main outcome measure(s): clinical pregnancy rate was the primary outcome and implantation rate, number of oocytes retrieved, fertilization rate were secondary outcomes Result(s): response to CC stimulation with NAC co-treatment was evident by a number of mature follicles ranging from 2-7 at the time of hCG administration. Clinical pregnancy was achieved in 4 cycles (20%). Conclusion(s): In this preliminary report, a potential benefit of NAC co-treatment with CC in young women undergoing IVF/ICSI cycles was demonstrated. This combination provides a cheap, effective way for ovulation induction in an IVF setting compatible with the concept of friendly IVF