N-acetyl-cysteine and the control of oxidative stress during in vitro ovarian follicle growth, oocyte maturation, embryo development and cryopreservation

Oxidative stress is generated by an imbalance between reactive oxygen species (ROS) formation and cellular defense mechanisms. To reduce cellular damage caused by ROS in vivo or in vitro, N-acetyl-cysteine (NAC) is converted into metabolites that have the capacity of stimulating synthesis of glutathione (GSH) which functions directly as free radical scavengers. The NAC antioxidant potential evaluated to the greatest extent is the indirect action of NAC, as a precursor of GSH, with glutathione being the primary antioxidant in cells. During long-term preantral follicle culture, NAC has a synergic action with FSH and an important function in sustaining preantral follicle growth and follicle-cell viability in vitro. The NAC inclusion in in vitro maturation medium for cumulus-oocyte complexes (COC) leads to protection of oocytes from damage induced by heat stress, reductions in ROS, and increases in cumulus cell expansion. Developing embryos are susceptable to oxidative stress because of susceptability to cellular structure damage and not having well-developed defense mechanisms. Results from various indicate there are beneficial effects of NAC on embryonic development by increasing GSH biosynthesis and regulating cell proliferation. In addition, NAC is also an effective antioxidant during cryopreservation of ovarian follicles, oocytes and embryos, because inclusion of NAC in preservation medium leads to improvements in mitochondrial function and cell viability, and reductions in ROS and cellular apoptosis. In this review, there is evaluation of mechanisms of action of NAC and beneficial effects during in vitro culture of preantral follicles, as well as oocyte maturation, embryonic development and cryopreservation.