RP06 Effects of GLP-1 receptor agonists on ovulatory function and reproductive hormonal parameters in women with polyendocrine metabolic ovarian syndrome: a systematic review

GLP-1 receptor agonist–based therapy is of interest in Polyendocrine Metabolic Ovarian Syndrome (PMOS; formerly polycystic ovary syndrome [PCOS]) because obesity and insulin resistance may worsen hyperandrogenism, anovulation, and infertility. To systematically review randomized controlled trial evidence on the effects of GLP-1 receptor agonists on ovulatory function and reproductive hormonal parameters in women with Polyendocrine Metabolic Ovarian Syndrome. PubMed was searched from database inception to February 3, 2026. Eligible English-language randomized controlled trials included women with Polyendocrine Metabolic Ovarian Syndrome diagnosed according to established PCOS diagnostic criteria used in the original randomized controlled trials and compared a GLP-1 receptor agonist, alone or in combination with metformin, with metformin or placebo, reporting reproductive hormonal, menstrual, ovulatory, or pregnancy-related outcomes. Five randomized controlled trials involving 418 participants were included. Interventions used liraglutide or exenatide over 12–32 weeks. GLP-1 receptor agonist–based therapy was associated with improvements in body weight, body mass index, waist circumference, glucose parameters, insulin resistance, increased sex hormone-binding globulin, and reduced free androgen index. Menstrual cycle frequency, regularity, and recovery improved across studies; however, ovulation was not directly or consistently assessed. Pregnancy outcomes were reported in only two heterogeneous trials and appeared favorable versus metformin alone. GLP-1 receptor agonists appear promising for improving metabolic, androgen-related, and menstrual parameters in women with Polyendocrine Metabolic Ovarian Syndrome, but current evidence remains limited for direct ovulatory and fertility outcomes.