Received October 01, 2025
Accepted October 24, 2025

Objective: To analyze reproductive outcomes associated with GLP-1 receptor agonists (GLP-1RAs) in women with polycystic ovary syndrome (PCOS) and infertility. Methods: A narrative review conducted in June 2025 using PubMed, SciELO, and LILACS, with descriptors including “GLP-1 receptor agonists,” “liraglutide,” “semaglutide,” “fertility,” “PCOS,” and “reproductive outcomes.” Forty-seven studies from 2014–2025 were included. Results: GLP-1RAs offer metabolic benefits and show potential in improving reproductive outcomes in women with PCOS. They promote menstrual regularity, ovulation, and pregnancy, particularly when combined with metformin. Liraglutide (1.2–3.0 mg/day) and exenatide (10 µg twice daily) are associated with enhanced follicular development and endometrial receptivity. These agents act on reproductive tissues, exhibiting anti-inflammatory and androgen-lowering effects. Liraglutide improves granulosa–oocyte signaling via CXCL10 suppression. One randomized trial showed pregnancy rates of 69.2% with liraglutide–metformin, versus 35.4% with metformin alone (p<0.05). Ovulation rates reached 86% with exenatide–metformin, surpassing monotherapy. Despite these benefits, GLP-1RAs are contraindicated during pregnancy due to fetal risks in animal studies. Semaglutide and tirzepatide require an 8–10 week washout before conception. Tirzepatide may also reduce oral contraceptive efficacy. Conclusion: GLP-1RAs represent a promising preconception strategy for women with PCOS and obesity-related infertility. When used with metformin, they enhance ovulatory and pregnancy outcomes. However, due to potential fetal risks, they should be discontinued before pregnancy. Personalized care is crucial to balance treatment benefits and reproductive intentions.