The impact of GLP 1 analogues on fertility restoration in patients with Polyendocrine Metabolic Ovarian Syndrome (PMOS) - Narrative Review

Abstract

Background. The Polyendocrine Metabolic Ovarian Syndrome (PMOS), previously named as Polycystic Ovary Syndrome (PCOS) is common endocrine and metabolic disorder. It is the main cause of female infertility. The manifestation is heterogeneous and contain coexisting hyperandrogenism, obesity, insulin resistance. The PMOS‑associated infertility treatment is multidisciplinary process involving pharmacotherapy, diet and lifestyle changes. Synthetic analogues of endogenous GLP-1 (GLP-1 Ras) are register for treatment of type 2 diabetes and obesity. Aim. This study aimed to assess the effectiveness of GLP‑1 RAs in improving reproductive outcomes in women with PMOS. Material and methods. Narrative literature review was conducted through a search of electronic databases: PubMed and Google Scholar. The search covered clinical trials, observational studies and articles from 2020–2026 and used combinations of the following keywords: “polycystic ovary syndrome”, “GLP 1 analogues”, ”infertility” and related terms. Additional articles were identified by screening reference lists of key publications. Results. Clinical study revealed that GLP-1 Ras decrease body weight as well as improve metabolic) and hormonal parameters  in patients with PMOS. GLP-1 Ras contribute to restoring the function of the hypothalamus–pituitary–ovarian axis. In addition, their improve menstrual regularity, in women with PMOS as well as pregnancy and ovulation rates. GLP‑1 RAs may enhance spontaneous and IVF pregnancy and ovulation rates and exert suppression of pro-inflammatory agents and recovering maternal-fetal immune tolerance. Conclusions. Collectively, the broad metabolic, hormonal and immunometabolic effects of GLP‑1 RAs make them a valuable therapeutic strategy for improving fertility outcomes in obese women with PMOS, although the further studies are required—particularly those assessing their safety during the preconception period.