The Impact of GLP-1 Receptor Agonists on Reproductive Function in Women with Obesity and Metabolic Disorders: A Narrative Review
DOI:
https://doi.org/10.12775/QS.2026.54.70814Keywords
Obesity, GLP-1 receptor agonists, Female fertility, Polycystic ovary syndrome (PCOS), Insulin resistance, Hyperandrogenism, Ovulation, Hormonal profile, Preconception care, Pregnancy outcomesAbstract
Background: Obesity and related metabolic disorders, including insulin resistance and polycystic ovary syndrome (PCOS), impair female fertility and increase the risk of adverse obstetric outcomes. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a class of anti-obesity medications effective in promoting weight loss and improving metabolic control.
Aim: To summarize current evidence on the effects of GLP-1 receptor agonists on female reproductive function, particularly in PCOS and the preconception period.
Materials and Methods: A literature search was performed using the PubMed database to identify relevant studies published in English within the last 10 years. The selected studies were analyzed to summarize current evidence regarding the potential role of GLP-1 RAs in preconception care and female fertility.
Results: GLP-1 receptor agonists promote weight loss, improve insulin sensitivity, and reduce androgen levels. In women with PCOS, treatment has been associated with improved menstrual regularity and increased ovulation rates, and may enhance endometrial receptivity. Current evidence does not indicate a clear increase in congenital malformations after first-trimester exposure; however, discontinuation before planned conception is recommended due to limited safety data.
Conclusions: GLP-1 receptor agonists may improve metabolic health and reproductive outcomes in women with obesity and PCOS. However, most studies focus on surrogate outcomes, while evidence for definitive endpoints-particularly live birth rates-remains limited. Further prospective studies are needed to clarify their role in preconception care.
References
1. Schon SB, Cabre HE, Redman LM. The impact of obesity on reproductive health and metabolism in reproductive-age females. Fertil Steril. 2024;122(2):194-203. https://doi.org/10.1016/j.fertnstert.2024.04.036
2. Amiri M, Ramezani Tehrani F. Potential Adverse Effects of Female and Male Obesity on Fertility: A Narrative Review. Int J Endocrinol Metab. 2020;18(3):e101776. https://doi.org/10.5812/ijem.101776
3. Chandrasekaran S, Neal-Perry G. Long-term consequences of obesity on female fertility and the health of the offspring. Curr Opin Obstet Gynecol. 2017;29(3):180-187. https://doi.org/10.1097/gco.0000000000000364
4. Silvestris E, de Pergola G, Rosania R, Loverro G. Obesity as disruptor of the female fertility. Reprod Biol Endocrinol. 2018;16(1):22. https://doi.org/10.1186/s12958-018-0336-z
5. 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. https://doi.org/10.1186/s12958-024-01339-y
6. Liu QK. Mechanisms of action and therapeutic applications of GLP-1 and dual GIP/GLP-1 receptor agonists. Front Endocrinol (Lausanne). 2024;15:1431292. https://doi.org/10.3389/fendo.2024.1431292
7. Raza FA, Altaf R, Bashir T, Asghar F, Altaf R, Tousif S, Goyal A, Mohammed A, Mohammad MF, Anan M, Ali S. Effect of GLP-1 receptor agonists on weight and cardiovascular outcomes: A review. Medicine (Baltimore). 2024;103(44):e40364. https://doi.org/10.1097/md.0000000000040364
8. Janus C, Vistisen D, Amadid H, Witte DR, Lauritzen T, Brage S, Bjerregaard AL, Hansen T, Holst JJ, Jørgensen ME, Pedersen O, Færch K, Torekov SS. Habitual physical activity is associated with lower fasting and greater glucose-induced GLP-1 response in men. Endocr Connect. 2019;8(12):1607-1617. https://doi.org/10.1530/ec-19-0408
9. Cena H, Chiovato L, Nappi RE. Obesity, Polycystic Ovary Syndrome, and Infertility: A New Avenue for GLP-1 Receptor Agonists. J Clin Endocrinol Metab. 2020;105(8):e2695-e2709. https://doi.org/10.1210/clinem/dgaa285
10. Houston EJ, Templeman NM. Reappraising the relationship between hyperinsulinemia and insulin resistance in PCOS. J Endocrinol. 2025;265(2):e240269 https://doi.org/10.1530/joe-24-0269
11. Ennab F, Atiomo W. Obesity and female infertility. Best Pract Res Clin Obstet Gynaecol. 2023;89:102336. https://doi.org/10.1016/j.bpobgyn.2023.102336
12. Hoek A, Wang Z, van Oers AM, Groen H, Cantineau AEP. Effects of preconception weight loss after lifestyle intervention on fertility outcomes and pregnancy complications. Fertil Steril. 2022;118(3):456-462. https://doi.org/10.1016/j.fertnstert.2022.07.020
13. Drucker DJ. Efficacy and Safety of GLP-1 Medicines for Type 2 Diabetes and Obesity. Diabetes Care. 2024;47(11):1873-1888. https://doi.org/10.2337/dci24-0003
14. 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. https://doi.org/10.1016/j.clinme.2025.100298
15. Bader S, Bhatti R, Mussa B, Abusanana S. A systematic review of GLP-1 on anthropometrics, metabolic and endocrine parameters in patients with PCOS. Womens Health (Lond). 2024:20:17455057241234530. https://doi.org/10.1177/17455057241234530
16. Siamashvili M, Davis SN. Update on the effects of GLP-1 receptor agonists for the treatment of polycystic ovary syndrome. Expert Rev Clin Pharmacol. 2021;14(9):1081-1089. https://doi.org/10.1080/17512433.2021.1933433
17. Goldberg AS, Boots CE. Treating obesity and fertility in the era of glucagon-like peptide 1 receptor agonists. Fertil Steril. 2024;122(2):211-218. https://doi.org/10.1016/j.fertnstert.2024.05.154
18. Jensterle M, Janez A, Fliers E, DeVries JH, Vrtacnik-Bokal E, Siegelaar SE. The role of glucagon-like peptide-1 in reproduction: from physiology to therapeutic perspective. Hum Reprod Update. 2019;25(4):504-517. https://doi.org/10.1093/humupd/dmz019
19. Papaetis GS, Kyriacou A. GLP-1 receptor agonists, polycystic ovary syndrome and reproductive dysfunction: Current research and future horizons. Adv Clin Exp Med. 2022;31(11):1265-1274. https://doi.org/10.17219/acem/151695
20. Imbroane MR, LeMoine F, Nau CT. Preconception glucagon-like peptide-1 receptor agonist use associated with decreased risk of adverse obstetrical outcomes. Am J Obstet Gynecol. 2025;233(2):116.e1-116.e7. https://doi.org/10.1016/j.ajog.2025.01.019
21. Ma R, Ding X, Wang Y, Deng Y, Sun A. The therapeutic effects of glucagon-like peptide-1 receptor agonists and metformin on polycystic ovary syndrome: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2021;100(23):e26295. https://doi.org/10.1097/md.0000000000026295
22. Austregésilo de Athayde De Hollanda Morais B, Martins Prizão V, de Moura de Souza M, Ximenes Mendes B, Rodrigues Defante ML, Cosendey Martins O, Rodrigues AM. The efficacy and safety of GLP-1 agonists in PCOS women living with obesity in promoting weight loss and hormonal regulation: A meta-analysis of randomized controlled trials. J Diabetes Complications. 2024;38(10):108834. https://doi.org/10.1016/j.jdiacomp.2024.108834
23. Marinelli S, Napoletano G, Straccamore M, Basile G. Female obesity and infertility: outcomes and regulatory guidance. Acta Biomed. 2022;93(4):e2022278. https://doi.org/10.23750/abm.v93i4.13466
24. Wen Z, Li X. Association between weight-adjusted-waist index and female infertility: a population-based study. Front Endocrinol (Lausanne). 2023;14:1175394. https://doi.org/10.3389/fendo.2023.1175394
25. Zheng L, Yang L, Guo Z, Yao N, Zhang S, Pu P. Obesity and its impact on female reproductive health: unraveling the connections. Front Endocrinol (Lausanne). 2024;14:1326546. https://doi.org/10.3389/fendo.2023.1326546
26. Armstrong A, Berger M, Al-Safi Z. Obesity and reproduction. Curr Opin Obstet Gynecol. 2022;34(4):184-189. https://doi.org/10.1097/gco.0000000000000794
27. Kong L, Ding X, Wang Q, Xie R, Sun F, Zhou N, Li C, Chen X, Qian H. Association between cardiometabolic index and female infertility: A population-based study. PLoS One. 2024;19(12):e0313576. https://doi.org/10.1371/journal.pone.0313576
28. Saad Alfaiz A. GLP-1 receptor agonists and preconception planning: bridging the gap between obesity treatment and reproductive safety, a narrative review. Ann Med Surg (Lond). 2025;87(12):8597-8603. https://doi.org/10.1097/ms9.0000000000004189
29. Minis E, Stanford FC, Mahalingaiah S. Glucagon-like peptide-1 receptor agonists and safety in the preconception period. Curr Opin Endocrinol Diabetes Obes. 2023;30(6):273-279. https://doi.org/10.1097/med.0000000000000835
30. Pavli P, Triantafyllidou O, Kapantais E, Vlahos NF, Valsamakis G. Infertility Improvement after Medical Weight Loss in Women and Men: A Review of the Literature. Int J Mol Sci. 2024;25(3):1909. https://doi.org/10.3390/ijms25031909
31. Tavares ACM, Martins MYM, de Souza GF, Lima EM, Rocha CA, de Souza LC, Simões JML, de Araújo NO, Cavalcante MB. Immunological effects of GLP-1 analogs on female reproduction: Therapeutic perspectives for infertility and recurrent pregnancy loss. J Reprod Immunol. 2025;169:104538. https://doi.org/10.1016/j.jri.2025.104538
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Copyright (c) 2026 Emilia Muraszewska, Łukasz Muraszewski, Patrycja Kwitowska, Małgorzata Pyjecka, Eryk Ubysz, Agata Król, Edyta Lewandowska, Cezary Łuczyński, Maciej Paczkowski, Mariusz Wręczycki

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