FOLLICULAR FLUID HOMOCYSTEINE WITH ACETYL CYSTEINE SUPPLEMENTED OVARIAN STIMULATION: CORRELATION WITH OOCYTE YIELD AND ICSI CYCLE OUTCOME.

Objective:- to evaluate the impact of N-Acetyl cysteine supplementation during controlled ovarian hyperstimulation on follicular fluid homocysteine and to correlate the results with ICSI cycle parameters particularly oocyte yield and cycle outcome in terms of clinical pregnancy rates. Subjects and Methods:- 90 women prepared for ICSI using long agonist protocol randomized to receive N-Acetyl cysteine or placebo during stimulation. Results:-Mean follicular fluid homocysteine level was 4.4mg/L in supplemented group versus 6.6 mg/L in non-supplemented group and this was statistically significant. (p<0.0001) Number of oocytes retrieved and clinical pregnancy rates were also significantly higher in supplemented group. (19 versus 12 and 73% versus 49%) (p<0.001, and <0.03 respectively) Conclusion:-Supplementing long agonist controlled ovarian hyperstimulation with 600 mg of oral NAC improved oocyte yield and increased clinical pregnancy rates in ICSI cycles. This favorable impact is correlated, and probably partially explained by reducing follicular fluid homocysteine.