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Objective: The aim of this study was to evaluate the effect of N-Acetyl-Cysteine (NAC) as an adjuvant therapy to ovulation induction using the low fixed dose human menopausal gonadotropins (HMG) in cases prepared for ICSI. Design : prospective randomized controlled study. Materials and methods: The study was conducted on 40 patients. The selected cases were less than 40 years old and were diagnosed as having tubal or male factor infertility planned for ICSI. The patients were randomly divided into two equal groups: a control group and a study group, Both groups received 150 TU HMG per day from cycle clay two till the day of human chorionic gonadotropins (HCG). In addition, the study group received NAC, 1200 nig daily in throe divided doses form cycle day two till the day of HCG. Patients were monitored using serial (ransvaginal sonography. Before administration of HCG the serum level of oeslradiol and progesterone were measured. Testosterone was measured in the follicular fluid. Results : The NAC group showed a significant decrease in the HMG requirements (18.3 Vs. 20 ampoules). NAC led to a significanl increase in the final serum oeslradiol level (1375 pg/ml Vs. 793 pg/ml). The number of the retrieved oocytes was higher (non-significant) in the study group; it resulted in a significanl increase in the number of mature oocytes and higher rate of fertilization. NAC led to an insignificant drop in follicular fluid testosterone. However, these positive effects of NAC did not lead lo a significant change in the pregnancy rate. Conclusion: The use of NAC as an adjuvant to the low fixed dose gonadolropin protocol in cases prepared for ICSI improved cycle parameters but it did not result in a significant effect on follicular fluid testosterone concentration or the pregnancy rates.

THE USE OF N-ACETYL CYSTEINE AS AN ADJUVANT TO SOFT INDUCTION IN CASES PREPARED FOR ICSI IMPROVES CYCLE PARAMETERS; A RANDOMIZED CONTROLLED STUDY