Effects of the main GLP-1 receptor agonists on polycystic ovary syndrome and female fertility: a review
- Obstetrics & Gynecology International Journal
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Raisa Arruda de Oliveira
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Abstract
Female infertility constitutes an important public health issue and is frequently associated with metabolic and endocrine disorders, such as obesity, insulin resistance, and polycystic ovary syndrome (PCOS). In recent years, glucagon-like peptide-1 (GLP-1) receptor agonists have been widely used in the treatment of obesity and have increasingly been investigated for their potential effects on female fertility. The aim of this study was to conduct a narrative review of the literature regarding the effects of the main GLP-1 receptor agonists currently used worldwide on female fertility, with emphasis on women with PCOS. A literature search was performed in the PubMed and LILACS databases, including studies published over the last five years in English, Portuguese, and Spanish. Clinical trials, observational studies, case reports, and systematic reviews evaluating the effects of liraglutide, semaglutide, and exenatide on metabolic, hormonal, molecular parameters, and reproductive outcomes were included. The findings indicate that GLP-1 receptor agonists promote significant improvements in metabolic and hormonal profiles, including reductions in body weight, insulin resistance, and hyperandrogenism, which are central factors in the pathophysiology of PCOS-related infertility. Furthermore, recent evidence suggests potential direct effects on the ovarian and endometrial microenvironment, contributing to the restoration of ovulation, menstrual cyclicity, and increased clinical pregnancy rates in certain contexts. It is concluded that GLP-1 receptor agonists represent promising tools for metabolic and endocrine optimization in the preconception period; however, they do not act as direct fertility-inducing agents, and further large-scale, long-term randomized studies are required to clarify their impact on final reproductive outcomes.
Keywords
GLP-1 receptor agonists, female fertility, polycystic ovary syndrome, obesity, reproductive health


