Is PCOS creating problems for your fertility? Maybe you have been “trying to conceive”, but wonder how you can call it “trying” when you aren’t sure when you are ovulating, or if your period is even going to come this month. Perhaps that isn’t the issue for you, or it is a part of the problem, but you have gotten pregnant only to have it end in an early miscarriage. Well, do I have some good news for you…

Scientists are constantly proving that simply taking antioxidants can improve your chance of getting pregnant and staying pregnant by making your cells healthier. One specific nutrient being studied for the role it can play in the fertility health of women with PCOS and those experiencing recurrent miscarriage is N-acetylcysteine (NAC).

What are Antioxidants, Oxidative Stress and Free Radicals?
Oxidative stress (damage to cells) caused by scavenging free radicals within the body is linked to many diseases associated with infertility like polycystic ovarian syndrome (PCOS) and reproductive dysfunction, including, but not limited to: menstrual cycle irregularities, anovulation, hormonal imbalance, decreased egg health and recurrent miscarriage.

What is NAC?
N-acetylcysteine (NAC) is an antioxidant and anti-inflammatory that helps the body make the protein glutathione. Glutathione is a powerful antioxidant that fights free radical damage and protects the body from oxidative stress, while supporting a healthy immune system.

What the Research is Saying
Studies show promise for the use of NAC by women with the following fertility related issues:

• PCOS with poor response to Clomid
• insulin-resistant PCOS
• unexplained recurrent miscarriage

NAC is also known to be able to support the body in detoxifying from daily exposure to common toxins. See more on this below…

Polycystic Ovarian Syndrome (PCOS)

NAC + Clomid: Women with PCOS are often prescribed the medication Clomid to help force ovulation. Another procedure that may be suggested is ovarian drilling which medically removes the string-of-pearl-like cysts that line the ovaries. For women who have had ovarian drilling and have not responded to Clomid alone (are clomiphene citrate resistant), a combination of NAC and Clomid may be suggested. Here’s why…

NAC when taken with Clomid has in studies significantly:

• encouraged ovulation
• improved progesterone levels mid-luteal phase
• improved endometrial lining thickness
• increased pregnancy rates
• lowered chances of miscarriage

NAC & Insulin Resistance: A 2011 report published in the European Journal of Obstetrics, Gynecology and Reproductive Biology showed that female study participants who took NAC, responded equally as well as those who took Metformin alone. The women who took NAC showed positive weight changes (reduced BMI), improved fasting insulin levels and free testosterone which resulted in reduced hirsutism and regular monthly menstrual periods.

Recurrent Miscarriage Prevention

In a controlled study from 2008, 80 participants with a history of recurrent miscarriage took NAC and folic acid and another aged-matched group of 86 participants took folic acid alone. Results of the study showed that taking NAC along with folic acid “caused a significantly increased rate of continuation of a living pregnancy up to and beyond 20 weeks… and was associated with a significant increase in the take-home baby rate as compared with participants taking folic acid alone.”

Detoxification

NAC boosts Glutathione production in the body. Glutathione is known to be the only detoxifier of the:

• toxic packaging materials styrene and polystyrene that are found in the molded outside housing of a computer and plastic parts on the inside of vehicles, plastic cups, toys, hair dryers, kitchen appliances and styrofoam
• colorless gas methyl bromide used as a pesticide against spiders, mites, fungi, weeds, insects, nematodes, and rodents (In 2005, methyl bromide production and use was largely stopped because of its ability to destroy the ozone layer)
• chemical methyl chloride that is used to make conventional decaffeinated coffee

Supplementing NAC

Through my research for this article, I learned that many studies of NAC have been performed on animals and NAC was given in varying doses. NAC is available over the counter, but it would be best, if you are interested in trying NAC, to work with your healthcare provider to determine the best dose for your needs.

NAC does not come without caution. In terms of reproductive and developmental toxicity of orally administered NAC, no one agrees how much NAC is a toxic dose. Several sources share that consuming too much NAC when not needed can contribute to infertility by causing oxidative stress, rather than prevent it.

Michael T. Murray, N.D, is one source who shares in his text the Encyclopedia of Nutritional Supplements that, “While supplementing the diet with high doses of NAC may be beneficial in cases of extreme oxidative stress (i.e. AIDS), it may be an unwise practice in healthy individuals. The reason? One study indicated that when NAC was given orally to 6 healthy volunteers at a dose of 1.2 grams per day for 4 weeks, followed by 2.4 grams per day for an additional 2 weeks, it actually increased oxidative damage by acting as a pro-oxidant.”

Famed Dr. Joseph Mercola also shares a caution about taking NAC that is, “Researchers at the University of Virginia Health System have discovered troubling side effects of N-acetylcysteine (NAC)… NAC can form a red blood cell-derived molecule called nitrosothiol that fools your body into thinking there’s an oxygen shortage, which can lead to pulmonary arterial hypertension (PAH).” (Note: this was a study on rats.)

In my opinion, this is evidence enough that NAC should be used respectfully. Have you supplemented with NAC? If so, please share your experience in the comments area down below.

References:
– Amin AF, Shaaban OM, Bediawy MA. Reprod Biomed Online. N-acetyl cysteine for treatment of recurrent unexplained pregnancy loss. (2008 Nov;17(5):722-6). Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/18983759
– Grassi, A. (2012, August 3). Introducing PharmaNAC: A High Quality NAC Supplement. Retrieved from http://www.pcosnutrition.com/links/blogs/introducing-pharmanac-a-high-quality-nac-supplement.html
– Grassi, A. (2014, March 18). The 4 Best Supplements for Fertility. Retrieved from http://www.pcosnutrition.com/links/blogs/the-4-best-supplements-for-fertility.html
– Haas, E. M., & Levin, B. (2006). Staying healthy with nutrition: The complete guide to diet and nutritional medicine. Berkeley: Celestial Arts.
– Mercola, J. (2007, September 25). This Common Antioxidant Supplement Could Cause You Loads of Trouble. Retrieved from http://articles.mercola.com/sites/articles/archive/2007/09/25/this-common-antioxidant-supplement-could-cause-you-loads-of-trouble.aspx
– Murray, M. T. (1996). Encyclopedia of nutritional supplements: The essential guide for improving your health naturally. Rocklin, CA: Prima Pub.
– Oner G, Muderris II. Clinical, endocrine and metabolic effects of metformin vs N-acetyl-cysteine in women with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2011 Aug 8. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21831508
– Supplements and Miscarriage‎ ‎ N-Acetyl Cysteine. (n.d.). Retrieved from https://sites.google.com/site/miscarriageresearch/supplements-and-miscarriage/n-acetyl-cysteine
– National Pesticide Information Center. Methyl Bromide. Retrieved from http://npic.orst.edu/factsheets/MBgen.pdf