TDNet Discover

Background: Polycystic Ovary Syndrome affects 8–13% of reproductive-aged women and is the leading cause of infertility in this group. Conventional treatments, from ovulation induction to IVF, are costly, invasive, and emotionally burdensome. While lifestyle changes and medications remain first-line, supplements like inositol and N-acetylcysteine show promise for improving insulin sensitivity and oocyte quality. However, limited definitive evidence has thus far precluded their inclusion in standard guidelines. Purpose: This research sought to evaluate whether the addition of inositol or N-acetylcysteine to ovulation induction therapy improves pregnancy outcomes in women with PCOS, compared to ovulation induction alone. Methods: A systematic review was conducted from October to December 2024. Three researchers independently searched databases with set terms and criteria. Eligible peer-reviewed randomized control trials (RCT), systematic reviews, and meta-analyses on polycystic ovary syndrome (PCOS) infertility were quality assessed via National Heart, Lung, and Blood Institute (NHLBI) tools; only “good” studies were included. Three high-quality studies were finalized for synthesis. v Results: Three studies from 2014 to 2018 met inclusion criteria. Combination therapies with myo-inositol, N- acetylcysteine (NAC), and folic acid improved ovulation and menstrual regularity, especially in insulin-resistant women. Myo-inositol alone induced ovulation in 62% of patients, increasing to 89% with clomiphene, alongside improvements in body mass index (BMI) and insulin resistance linked to pregnancy. Another study reported enhanced ovulation, oocyte quality, and fertilization with myo-inositol plus folic acid. Pregnancy rates ranged from 15% to 49%, with no serious adverse events. Conclusion: Inositol-based therapies, particularly when combined with N-acetylcysteine, folic acid, or clomiphene citrate, demonstrate promising improvements in ovulation, metabolic health, and pregnancy outcomes, all while maintaining a favorable safety profile. Incorporating such supplements could provide a less invasive, more cost-effective approach to managing PCOSrelated infertility. Further large-scale, controlled trials are warranted to confirm these findings and guide clinical practice.