Improving Reproductive Outcomes in PCOS: The Emerging Role of GLP-1 Receptor Agonists

Abstract

Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder affecting a significant proportion of women of reproductive age. It is associated with infertility, metabolic abnormalities, and hormonal imbalances, including insulin resistance and hyperandrogenism. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), such as exenatide and liraglutide, have shown promise in improving reproductive outcomes in women with PCOS. This review evaluates the potential benefits of GLP-1 RAs in enhancing fertility, with a focus on menstrual regularity, ovulation rates, pregnancy rates, and metabolic outcomes. Studies have indicated that GLP-1 RAs improve insulin sensitivity, reduce BMI, waist circumference, and testosterone levels, and contribute to higher natural pregnancy rates. Despite the promising results, the long-term safety of GLP-1 RAs, particularly during pregnancy, remains uncertain. Patients using GLP-1 RAs are advised to use contraception, as the safety profile during pregnancy is still under investigation. Further research is necessary to establish the long-term effects and safety of these medications in women with PCOS. Overall, GLP-1 RAs offer a potential therapeutic approach for improving fertility and metabolic health in women with PCOS.