N-acetyl cysteine for treatment of recurrent unexplained pregnancy loss

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      Pregnancy could be associated with a state of oxidative stress that could initiate and propagate a cascade of changes that may lead to pregnancy wastage. This process of oxidative stress may be suppressed by the antioxidant effect of N-acetyl cysteine (NAC). The current study aimed to evaluate the effect of NAC therapy in patients diagnosed with unexplained recurrent pregnancy loss (RPL). The study was a prospective controlled study performed in the Women's Health Centre, Assiut University, Egypt. A group of 80 patients with history of recurrent unexplained pregnancy loss were treated with NAC 0.6 g + folic acid 500 μg/day and compared with an aged-matched group of 86 patients treated with folic acid 500 μg/day alone. NAC + folic acid compared with folic acid alone caused a significantly increased rate of continuation of a living pregnancy up to and beyond 20 weeks [P < 0.002, relative risk (RR) 2.9, 95% confidence interval (CI) 1.5–5.6]. NAC + folic acid was associated with a significant increase in the take-home baby rate as compared with folic acid alone (P < 0.047, RR 1.98, 95% CI 1.3–4.0). In conclusion, NAC is a well-tolerated drug that could be a potentially effective treatment in patients with unexplained RPL.


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      Professor Amin obtained his medical degree in 1985 from Assiut Medical School, Egypt, and received specialty training at the same University leading to MSc and PhD degrees in Obstetrics and Gynaecology. His current position is Professor of Obstetrics and Gynaecology at the Assiut Medical School. In 1991, he received a Diploma in Endoscopic Surgery from Kiel University, Germany. He obtained the International Journal of Gynecology and Obstetrics prize paper award for best clinical research article from a developing country in 2003, and in 2007 Assiut University awarded him a distinction prize in the field of Medical Science. He has more than 50 international and national publications.