Role of Glucagon-Like Peptide-1 Receptor Agonists in People With Infertility and Pregnancy

( Obstet Gynecol . 2025;145(3):286–296. doi: 10.1097/AOG.0000000000005825) Obesity is defined as “chronic, relapsing and treatable disease due to excess body fat that produces pathogenic structural or functional abnormalities resulting in increased patient morbidity and mortality,” and it affects nearly 50% of the American population. This includes the population of reproductive aged women between 18 and 44, with 40% to 45% of individuals in this category having been diagnosed with obesity a body mass index (BMI) of 30 or above. Severe obesity, classified as BMI 40 or higher, affects 11.5% of women and 6.9% of men, and this has significant clinical implications in terms of reproductive health. Recent evidence has shown that though BMI can be used to estimate general adiposity, it does not account for body fat distribution and a more accurate measurement associated with positive outcomes in assisted reproductive technology (ART) is waist and/or hip circumference. A new measurement tool called the body roundness index considers both body fat and percent of visceral adiposity and can reliably predict metabolic syndrome. This article is a narrative review that focuses on using these tools to optimize individualized reproductive healthcare for women with obesity, including dietary modifications, exercise, medications, and surgical options.