Skip to main content
. 2017 Jul 28;2017(7):CD007807. doi: 10.1002/14651858.CD007807.pub3
Methods Prospective randomised placebo‐controlled pilot trial
Participants Infertile Iranian women with PCOS, aged from 25 ‐ 35 years, undergoing ICSI treatment (N = 80)
Inclusion criteria: Women who met the Rotterdam criteria for PCOS
Exclusion criteria: Hypersensitivity to either MET (metformin) or NAC, infertility factors other than anovulation, male infertility, pelvic organic pathologies, congenital adrenal hyperplasia, thyroid dysfunction, Cushing’s syndrome, hyperprolactinaemia, androgen‐secreting neoplasia, diabetes mellitus, consumption of medications affecting carbohydrate metabolism and hormonal analogues other than progesterone 2 months prior to enrolment in the study and severe hepatic or kidney disease
Interventions 4 groups (n = 20 in each, 5 dropouts from each)
1. Placebo oral rehydration salts; 3 times a day
2. Metformin 500 mg: 1 tablet 3 times a day
3. NAC 600 mg: 1 tablet 3 times a day
4. Metformin 500 mg: 1 tablet 3 times a day + NAC 600 mg: 1 tablet 3 times a day
All treatments were administered for 6 weeks
Outcomes Oocyte and embryo quality
Endocrine parameters
Clinical pregnancy
Side effects
Notes Iran, study ran from July 2012 to February 2013
Need to clarify primary and secondary outcomes
Author emailed regarding RoB, live birth and miscarriage information; no reply
Funded by institutional grant
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk State "random" but method not described
Allocation concealment (selection bias) Unclear risk Not stated
Blinding (performance bias and detection bias) All outcomes High risk Double‐blinded placebo‐controlled, but the placebo group received oral rehydration salts, which are usually in solution, while the treatments were tablets
Incomplete outcome data (attrition bias) All outcomes High risk Dropouts accounted for, but > 25% dropout
Selective reporting (reporting bias) Low risk Outcomes reported
Other bias Low risk No other bias found