ABSTRACT
Background: Paracrine disruption of growth factors in women with polycystic ovarian syndrome [PCOS] results in production of low quality oocyte, especially following ovulation induction. The aim of this study was to investigate the effects of metformin [MET], N-acetylcysteine [NAC] and their combination on the hormonal levels and expression profile of GDF-9, BMP-15 and c-kit, as hallmarks of oocyte quality, in PCOS patients
Materials and Methods: This prospective randomized, double-blind, placebo controlled trial aims to study the effects of MET, NAC and their combination [MET+NAC] on expression of GDF-9, BMP-15 and c-kit mRNA in oocytes [10 at the germinal vesicle [GV] stage, 10 at the MI stage, and 10 at the MII stage from per group] derived following ovulation induction in PCOS. Treatment was carried out for six weeks, starting on the third day of previous cycle until oocyte aspiration. The expression of GDF9, BMP15 and c-kit were determined by quantitative real time polymerase chain reaction [RT-qPCR] and western blot analysis. Data were analyzed with one-way ANOVA
Results: The follicular fluid [FF] level of c-kit protein significantly decreased in the NAC group compared to the other groups. Significant correlations were observed between the FF soluble c-kit protein with FF volume, and rostenedione and estradiol. The GDF-9 expression in unfertilized mature oocytes were significantly higher in the NAC group com- pared to the other groups [P<0.001]. Similar difference was not observed between the MET, NAC+MET and control groups. The c-kit expression in unfertilized mature oocytes were significantly lower in the NAC group compared to the other groups [P<0.001]. Similar difference was not observed between the MET, NAC+MET and control groups [Registration number: IRCT201204159476N1]
Conclusion: We concluded that NAC can improve the quality of oocytes in PCOS