N-acetyl Cysteine Treatment for Recurrent Miscarriage

Recurrent pregnancy loss is defined as 3 or more spontaneous consecutive losses in the first or early second trimester of pregnancy (<20 weeks of gestation). The American College of Obstetricians and Gynecologists have said it is one of the most common clinical problems seen in pregnant women, yet only about 50% of cases have an identifiable cause.

In a recent study, N-acetyl cysteine (NAC) + folic acid was used to evaluate it’s effectiveness in patients diagnosed with unexplained recurrent pregnancy loss (RPL).

2 groups were evaluated, one group taking 600mg of NAC + 500ug of folic acid, the other group taking 500ug folic acid alone. Treatment was started once pregnancy was confirmed.

Results show a significant increase in pregnancy viability to 20 weeks of gestation and a higher live birth rate (take-home baby rate) in the group of patients treated with NAC + folic acid. The live birth rate in the NAC + folic acid group was 56.3%, compared to 37.2% in the group being administered folic acid alone.

There are many documented causes of RPL, such as thyroid disease, diabetes, PCOS, thrombotic disorders and many more. Accumulating evidence shows that oxidative stress could be another contributing factor to RPL, especially in first trimester miscarriages. Pregnancy itself can be viewed as a state of oxidative stress due to the processes that occur and biological changes involving blood flow formation. This can be a factor in miscarriage if the body is unable to mount an effective antioxidant defence mechanism.

It has been shown that oxidative stress is associated with glutathione depletion and damage to the fetus. NAC supplementation can increase intracellular glutathione levels and is known for it’s high antioxidant qualities.

In the above study, it showed to have a favorable response in patients with RPL. It is a well-tolerated, oral treatment during pregnancy.

At TruMed, a thorough case history and work-up is always indicated for couples struggling with recurrent pregnancy loss before any treatment is initiated to ensure all contributing factors are addressed.

In good health,

Dr. Kirti Deol