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A systematic review published in Obstetrics and Gynaecology, involving eight randomised controlled trials with 910 women that compared the effects of NAC with placebo or metformin in women with PCOS, concluded: NAC had a significant improvement in pregnancy and ovulation rate as compared to placebo Both NAC and Metformin improved BMI, total testosterone, insulin, and lipid levels compared to NAC Compared with Metformin, NAC significantly reduced BMI, total testosterone Compared with Metformin or placebo, NAC significantly reduced fasting blood glucose in women with PCOS