الفهرس 
Title: Adjuvant Use of chromium & N Acetyl Cysteine in Polycystic Ovaries Syndrome for Improvement of Pregnancy Rates in Intracytoplasmic Sperm Injection Cycles
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Abstract
Background: Polycystic ovarian syndrome (PCOS) is a complex female medical condition defined as having hyperandrogenism, polycystic ovaries on ultrasound, and/or oligo- or anovulation, affecting about 6-10% of reproductive aged women.
Objective: To determine the impact of chromium & N Acetyl Csytiene supplementation, in obese infertile women suffering from PCOS, on insulin resistance and pregnancy rates in intracytoplasmic sperm insemination cycle.
Setting: In Vitro Fertilization Units at Al Galaa Teaching Hospital &Kasr Al Ainy, Faculty of Medicine, Cairo Univeristy.
Methods: A prospective randomized controlled trial included Eighty-four (84) obese aged from 20-38 with BMI (30-35) Kg/m2 diagnosed in Rotterdam criteria of PCOS as infertile polycystic ovary syndrome patients. Basal hormonal profile (FSH, LH, Prolactin, E2 and TSH) in addition to (Fasting blood sugar and Fasting serum insulin) for all involved patints were done.
Then calculation of HOMA equation for measuring of insulin resistance with cut-off value 2.1.
Interventions: Allocation of included patients into two groups was done; the first (study group) (n)=42 patients who were given chromium supplementation for two months in a dose 800-1000 micrograms per day & N Acetyl cysteine (600mg) for 2 monthes in a dose of 2 sachets per day& two months later, recalculation of HOMA equation of that group was evaluated preceding undergoing ICSI cycle and the second group (control group) (n)=42 patients who were not given any supplementations. Recruitment of all participating women of the two groups to antagonist protocol in ICSI cycle was done.
Results: Clinical pregnancy rates as a main outcome was non-significantly more frequent in the study group than in the control group. The insulin resistance as a secondary outcome was significantly decreased in the study group than in the control group.
Conclusion: In view of the aforementioned findings, we recommend that this modality of treatment be compared with the established therapeutic agents available such as metformin and COC in clinical trials. Some positive impacts of chromium and N acetyl cystiene as implied by this study, would require larger sample study. This study indicates that future studies in PCOS patients undergoing ICSI cycle, should investiate large sample size or longer duration of treatment.