The Impact of GLP-1 Receptor Agonists on Reproductive Function in Women with Obesity and Metabolic Disorders: A Narrative Review

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.