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A 2024 randomized controlled clinical study of 230 women with PMOS found that NAC supplementation (1.8 g/day) significantly enhanced ovulation induction efficacy when combined with sequential letrozole and urinary FSH, resulting in greater clinical pregnancy rates per cycle and cumulative pregnancy rates per patient compared with controls.[29] NAC also significantly reduced the required gonadotropin dosage and duration.[29] Two reviews of the evidence have confirmed that NAC, whether used alone or in combination with other medications, has the potential to counteract oxidative stress, reduce inflammation, and offer benefits in managing PMOS through multiple mechanisms including effects on insulin signaling pathways.[28][30] Anti-Inflammatory Supplements for PCOS/PMOS Chronic low-grade inflammation is a key feature of PMOS and can compound the insulin resistance, metabolic dysfunction, and hormonal imbalances associated with the condition