Comparison of the efficacy between NAC and metformin in treating PCOS patients: a meta-analysis

Gynecol Endocrinol. 2020 Mar;36(3):204-210. doi: 10.1080/09513590.2019.1689553. Epub 2019 Nov 21.


Our aim is to evaluate the clinical effectiveness and safety by comparing N-acetyl-cysteine (NAC) with metformin administrated by polycystic ovary syndrome (PCOS) patients. Systematic review and meta-analysis of randomized clinical trials (RCTs). MEDLINE, EMBASE, Web of Science and China National Knowledge Infrastructure were searched for studies. 10 studies were considered eligible for inclusion. NAC significantly reduced BMI and total testosterone, there was no significant difference in pregnancy rate, serum LH level, fasting insulin, and LH/FSH ratio. In conclusions, NAC may be considered as an alternative supplement to metformin, but large-scale randomized controlled trials are needed to assess the efficacy and safety of NAC in PCOS patients.

Keywords: N-acetyl-cysteine (NAC); metformin; polycystic ovary syndrome (PCOS).

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Acetylcysteine / therapeutic use*
  • Body Mass Index
  • Female
  • Follicle Stimulating Hormone / blood
  • Free Radical Scavengers / therapeutic use*
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Insulin / blood
  • Luteinizing Hormone / blood
  • Metformin / therapeutic use*
  • Polycystic Ovary Syndrome / blood
  • Polycystic Ovary Syndrome / drug therapy*
  • Pregnancy
  • Pregnancy Rate
  • Testosterone / blood
  • Treatment Outcome


  • Free Radical Scavengers
  • Hypoglycemic Agents
  • Insulin
  • Testosterone
  • Luteinizing Hormone
  • Follicle Stimulating Hormone
  • Metformin
  • Acetylcysteine