study the effects of n-acetyl cysteine and melatonin on the quality of oocyte and embryo in women with polycystic ovary syndrome

Introduction: polycystic ovary syndrome (pcos) is related to the presence of low-quality oocytes. this study aims to examine the impact of n-acetyl cysteine (nac), melatonin, and their combination on the parameters of follicular fluid (ff) and the quality of oocytes and embryos in women with pcos. methods: this is a prospective randomized placebo-controlled clinical trial that was conducted on 60 iranian women diagnosed with pcos who were candidates for intracytoplasmic sperm injection (icsi). they were randomly allocated into four groups of 15: melatonin (received 3 mg of melatonin daily at 22:00), nac (received 1800 mg of nac per day), nac+ melatonin, and placebo. the treatment started on the fifth day of the menstrual cycle and continued until the day of oocyte retrieval, lasting 40 days. hormonal status, sperm parameters, oocyte morphology, fertilization rate and embryo quality were assessed. the data were analyzed using one-way anova, considering a significance level of p≤0.05. results: the number of immature oocytes (1.27±0.88, p=0.006) and abnormal oocytes (2.1±1.1, p=0.001) were significantly lower in the nac compared to the placebo group (3.33±1.35 and 3.7±1.7, respectively). only the nac group showed a significantly higher number of high-quality (grade i) embryos compared to the placebo group (2.87±1.45 vs 1.53±0.83; p=0.02). insulin and luteinizing hormone (lh) levels were significantly lower in the melatonin (7±2.4 and 1.5±0.5, respectively) and nac (7.1±2.5 and 1.5±0.5, respectively) groups (p=0.01) compared to the placebo group (9.5±2.9 and 1.8±0.6, respectively).conclusion: both melatonin and nac can improve the quality of embryo and oocyte in women with pcos, but their combination has no significant positive effect.