The Impact of GLP-1 Receptor Agonists on Women's Reproductive Health: A Review
DOI:
https://doi.org/10.12775/JEHS.2025.82.60194Keywords
GLP-1, GLP-1 receptor agonists, semaglutide, fertility, pregnancy, lactationAbstract
Introduction:
GLP-1 receptor agonists (GLP-1RAs) were originally intended for the treatment of type 2 diabetes. However, they quickly proved to be effective in weight reduction and became an option for obesity therapy. A large group of patients using GLP-1RAs are women of reproductive age struggling with obesity, PCOS, or type 2 diabetes. Unfortunately, the safety of these substances in pregnancy and their influence on fertility, fetal health, and lactation remains unclear.
Aim of the study: The aim of this review is to assess the effects of GLP-1RAs on women's reproductive health, particularly on fertility, pregnancy outcomes, teratogenicity, lactation, IVF procedures, PCOS, and sexual function. The review aims to identify both potential benefits and risks associated with GLP-1RAs therapy in women.
Materials and methods: This narrative review was conducted using PubMed and PMC databases with the following search terms: ‘’GLP-1 receptor agonists’’, ‘’GLP-1RAs gynaecology’’, ‘’GLP-1RAs pregnancy’’, ‘’GLP-1RAs fertility’’.
Conclusion: Available data suggest that GLP-1RAs may improve fertility in women, especially in patients with PCOS, by reducing body weight and improving metabolic profile. The insufficient evidence for the safe use of these drugs in pregnancy and reports of teratogenic effects in animals encourage caution. It is recommended to use effective contraception during therapy with GLP-1RAs and to discontinue these drugs several weeks before pregnancy. Further studies are necessary to determine the long-term effects of GLP-1RAs and to formulate treatment guidelines for women of reproductive age.
References
1. Riedinger CJ, Sakach J, Maples JM, Fulton J, Chippior J, O'Donnell B, et al. Glucagon-like peptide-1 (GLP-1) receptor agonists for weight management: A review for the gynecologic oncologist. Gynecol Oncol. 2024;190:1-10.
2. Duah J, Seifer DB. Medical therapy to treat obesity and optimize fertility in women of reproductive age: a narrative review. Reprod Biol Endocrinol. 2025;23(1):2.
3. Varughese MS, O'Mahony F, Varadhan L. GLP-1 receptor agonist therapy and pregnancy: Evolving and emerging evidence. Clin Med (Lond). 2025;25(2):100298.
4. Ussher JR, Drucker DJ. Glucagon-like peptide 1 receptor agonists: cardiovascular benefits and mechanisms of action. Nat Rev Cardiol. 2023;20(7):463-74.
5. Drucker DJ. Mechanisms of Action and Therapeutic Application of Glucagon-like Peptide-1. Cell Metab. 2018;27(4):740-56.
6. Baggio LL, Drucker DJ. Glucagon-like peptide-1 receptors in the brain: controlling food intake and body weight. J Clin Invest. 2014;124(10):4223-6.
7. He K, Guo Q, Zhang H, Xi W, Li J, Jing Z. Once-weekly semaglutide for obesity or overweight: A systematic review and meta-analysis. Diabetes Obes Metab. 2022;24(4):722-6.
8. Li H, Yu G, Huang Q, Yang B, Nie J, Liu Y, et al. Efficacy and safety of GLP-1RAs for people with obesity: A systematic review based on RCT and Bayesian network meta-analysis. Biomed Pharmacother. 2024;171:116150.
9. Börchers S, Skibicka KP. GLP-1 and Its Analogs: Does Sex Matter? Endocrinology. 2025;166(2).
10. Goldberg A, Graca S, Liu J, Rao V, Witchel SF, Pena A, et al. Anti-obesity pharmacological agents for polycystic ovary syndrome: A systematic review and meta-analysis to inform the 2023 international evidence-based guideline. Obes Rev. 2024;25(5):e13704.
11. Pandey S, Pandey S, Maheshwari A, Bhattacharya S. The impact of female obesity on the outcome of fertility treatment. J Hum Reprod Sci. 2010;3(2):62-7.
12. Drummond RF, Seif KE, Reece EA. Glucagon-like peptide-1 receptor agonist use in pregnancy: a review. Am J Obstet Gynecol. 2025;232(1):17-25.
13. https://www.ozempic.com/how-to-take/side-effects.html.
14. Zhou L, Qu H, Yang L, Shou L. Effects of GLP1RAs on pregnancy rate and menstrual cyclicity in women with polycystic ovary syndrome: a meta-analysis and systematic review. BMC Endocr Disord. 2023;23(1):245.
15. Gregorič N, Šikonja J, Janež A, Jensterle M. Semaglutide improved sperm morphology in obese men with type 2 diabetes mellitus and functional hypogonadism. Diabetes Obes Metab. 2025;27(2):519-28.
16. Kolding L, Henriksen JN, Sædder EA, Ovesen PG, Pedersen LH. Pregnancy Outcomes After Semaglutide Exposure. Basic Clin Pharmacol Toxicol. 2025;136(4):e70021.
17. Skov K, Mandic IN, Nyborg KM. Semaglutide and pregnancy. Int J Gynaecol Obstet. 2023;163(2):699-700.
18. Ngene NC, Moodley J. Preventing maternal morbidity and mortality from preeclampsia and eclampsia particularly in low- and middle-income countries. Best Pract Res Clin Obstet Gynaecol. 2024;94:102473.
19. Okeke IG, Camarda AR, Okeke R, Chaughtai S. Semaglutide-induced Hyperemesis Gravidarum. JCEM Case Rep. 2024;2(2):luad167.
20. Muller DRP, Stenvers DJ, Malekzadeh A, Holleman F, Painter RC, Siegelaar SE. Effects of GLP-1 agonists and SGLT2 inhibitors during pregnancy and lactation on offspring outcomes: a systematic review of the evidence. Front Endocrinol (Lausanne). 2023;14:1215356.
21. Zipursky JS, Bogler T, Maxwell C. Glucagon-like peptide-1 receptor agonists during pregnancy and lactation. Cmaj. 2024;196(43):E1413.
22. Dao K, Shechtman S, Weber-Schoendorfer C, Diav-Citrin O, Murad RH, Berlin M, et al. Use of GLP1 receptor agonists in early pregnancy and reproductive safety: a multicentre, observational, prospective cohort study based on the databases of six Teratology Information Services. BMJ Open. 2024;14(4):e083550.
23. Cesta CE, Rotem R, Bateman BT, Chodick G, Cohen JM, Furu K, et al. Safety of GLP-1 Receptor Agonists and Other Second-Line Antidiabetics in Early Pregnancy. JAMA Intern Med. 2024;184(2):144-52.
24. Larson-Meyer DE, Schueler J, Kyle E, Austin KJ, Hart AM, Alexander BM. Appetite-Regulating Hormones in Human Milk: A Plausible Biological Factor for Obesity Risk Reduction? J Hum Lact. 2021;37(3):603-14.
25. Diab H, Fuquay T, Datta P, Bickel U, Thompson J, Krutsch K. Subcutaneous Semaglutide during Breastfeeding: Infant Safety Regarding Drug Transfer into Human Milk. Nutrients. 2024;16(17).
26. Zehravi M, Maqbool M, Ara I. Polycystic ovary syndrome and infertility: an update. Int J Adolesc Med Health. 2021;34(2):1-9.
27. Benham JL, Goldberg A, Teede H, Tay CT. Polycystic ovary syndrome: associations with cardiovascular disease. Climacteric. 2024;27(1):47-52.
28. Etrusco A, Mikuš M, D'Amato A, Barra F, Planinić P, Goluža T, et al. Incretin Hormone Secretion in Women with Polycystic Ovary Syndrome: Roles of Obesity, Insulin Sensitivity and Treatment with Metformin and GLP-1s. Biomedicines. 2024;12(3).
29. Akel M, Ziq A, Kaldas P, Hamden J, Omari AR, Silanee A. Exploring the Therapeutic Potential of Glucagon-Like Peptide 1 (GLP-1) Receptor Agonists in Polycystic Ovary Syndrome. Cureus. 2024;16(11):e73687.
30. Liu X, Zhang Y, Zheng SY, Lin R, Xie YJ, Chen H, et al. Efficacy of exenatide on weight loss, metabolic parameters and pregnancy in overweight/obese polycystic ovary syndrome. Clin Endocrinol (Oxf). 2017;87(6):767-74.
31. Jensterle M, Goricar K, Janez A. Metformin as an initial adjunct to low-dose liraglutide enhances the weight-decreasing potential of liraglutide in obese polycystic ovary syndrome: Randomized control study. Exp Ther Med. 2016;11(4):1194-200.
32. Szczesnowicz A, Szeliga A, Niwczyk O, Bala G, Meczekalski B. Do GLP-1 Analogs Have a Place in the Treatment of PCOS? New Insights and Promising Therapies. J Clin Med. 2023;12(18).
33. Rubino DM, Greenway FL, Khalid U, O'Neil PM, Rosenstock J, Sørrig R, et al. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial. Jama. 2022;327(2):138-50.
34. Bednarz K, Kowalczyk K, Cwynar M, Czapla D, Czarkowski W, Kmita D, et al. The Role of Glp-1 Receptor Agonists in Insulin Resistance with Concomitant Obesity Treatment in Polycystic Ovary Syndrome. Int J Mol Sci. 2022;23(8).
35. Maslin K, Alkutbe R, Gilbert J, Pinkney J, Shawe J. What is known about the use of weight loss medication in women with overweight/obesity on fertility and reproductive health outcomes? A scoping review. Clin Obes. 2024;14(6):e12690.
36. Ng NYH, Jiang G, Cheung LP, Zhang Y, Tam CHT, Luk AOY, et al. Progression of glucose intolerance and cardiometabolic risk factors over a decade in Chinese women with polycystic ovary syndrome: A case-control study. PLoS Med. 2019;16(10):e1002953.
37. Salamun V, Jensterle M, Janez A, Vrtacnik Bokal E. Liraglutide increases IVF pregnancy rates in obese PCOS women with poor response to first-line reproductive treatments: a pilot randomized study. Eur J Endocrinol. 2018;179(1):1-11.
38. Madusudhanan R, Nambisan B, Brahmanandan M, Radha S. Study on the Prevalence and Characteristics of Metabolic Syndrome in Women of Reproductive Age Group with Polycystic Ovarian Syndrome. Journal of SAFOG with DVD. 2017;9:341-7.
39. Tveit MC, Gelfand ST, Simon JA. Glucagon-like peptide-1 agonist weight loss medications decrease sexual desire: a theoretical framework based in the serotonergic pathway. J Sex Med. 2025;22(2):215-6.
40. Chen X, Zhao P, Wang W, Guo L, Pan Q. The Antidepressant Effects of GLP-1 Receptor Agonists: A Systematic Review and Meta-Analysis. Am J Geriatr Psychiatry. 2024;32(1):117-27.
41. Lauby-Secretan B, Scoccianti C, Loomis D, Grosse Y, Bianchini F, Straif K. Body Fatness and Cancer--Viewpoint of the IARC Working Group. N Engl J Med. 2016;375(8):794-8.
42. Wise MR, Jordan V, Lagas A, Showell M, Wong N, Lensen S, et al. Obesity and endometrial hyperplasia and cancer in premenopausal women: A systematic review. Am J Obstet Gynecol. 2016;214(6):689.e1-.e17.
43. Kim JJ, Chapman-Davis E. Role of progesterone in endometrial cancer. Semin Reprod Med. 2010;28(1):81-90.
44. Hagemann AR, Hagemann IS, Mutch DG, Devor EJ, Malmrose PK, Zhang Y, et al. Enhancing Progestin Therapy with a Glucagon-Like Peptide 1 Agonist for the Conservative Management of Endometrial Cancer. Cancers (Basel). 2025;17(4).
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Marta Wolszczak, Hanna Wołodkiewicz, Jakub Szmit

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 183
Number of citations: 0