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The effects of N-acetylcysteine on ovulation and sex hormones profile in women with polycystic ovary syndrome: a systematic review and meta-analysis

Published online by Cambridge University Press:  04 January 2023

Zahra Shahveghar Asl Open the ORCID record for Zahra Shahveghar Asl [Opens in a new window] ,
Karim Parastouei  and
Eslam Eskandari
Zahra Shahveghar Asl
Affiliation:
Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
Karim Parastouei*
Affiliation:
Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
Eslam Eskandari
Affiliation:
Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
*
*Corresponding author: Dr K. Parastouei, email parastouei@gmail.com
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Abstract

Polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases characterised by unusual levels of sex hormones and dysfunction of the ovaries. The infertility rate is high among patients with PCOS. Unusual hormonal status can lead to the inability of ovaries to release functional and mature follicles. Clinical trials on the effects of N-acetylcysteine (NAC) supplementation on ovulation and sex hormones profile in women with PCOS have been controversial. We performed a systematic review and meta-analysis to evaluate the potential effects of NAC supplementation on ovulation and sex hormones profile. PubMed, Scopus, Embase, Web of Science and Cochrane Central library international databases were searched till September 2021. Meta-analysis was performed using a random-effects approach in case of significant between-study heterogeneity. Eighteen studies, including 2185 participants, were included in the present meta-analysis. NAC significantly reduced total testosterone (TT) levels (standardised mean difference (SMD): −0·25 ng/ml; 95 % CI (−0·39, −0·10); ‘P < 0·001’, I 2 = 53·9 %, P = 0·034) and increased follicle-stimulating hormone (FSH) levels (SMD: 0·39 mg/ml; 95 % CI (0·07, 0·71); P = 0·01, I 2 = 70·9 %, P = 0·002). Oestrogen levels also increased after correcting publication bias. However, no significant effect was observed on the number of follicles, endometrial thickness, progesterone, serum luteinising hormone levels and sex hormone-binding globulin. The results indicated that NAC supplementation decreased TT levels and increased FSH levels. Overall, NAC supplementation might be effective in the improvement of reproductive system function in patients with PCOS.

Keywords

N-acetylcysteinePolycystic ovary syndromeMeta-analysisSex hormones
Type
Systematic Review and Meta-Analysis
Information
British Journal of Nutrition , Volume 130 , Issue 2 , 28 July 2023 , pp. 202 - 210
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Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of The Nutrition Society

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