Table 2. Evidence-Based Recommendations for Preconception Use
Reference	Population	Intervention	Comparison	Duration of Use	Expected Outcome
Nylander et al., 2017	72 women with PCOS	Liraglutide 1.8 mg/day	Placebo	26 weeks	Improved bleeding pattern; increased SHBG; decreased free testosterone and ovarian volume
Elkind-Hirsch et al., 2021	55 women with obesity and PCOS	Liraglutide 3 mg/day	Placebo	32 weeks	Reduction in free androgen index, increased SHBG levels, and higher menstrual frequency
Salamun et al., 2018	28 women with obesity and PCOS	Liraglutide 1.2 mg/day + Metformin 1000 mg BID	Metformin 1000 mg BID	12 weeks	Higher IVF pregnancy rate (85.7% vs. 28.6%); higher cumulative pregnancy rate at 12 months (69% vs. 36%); occurrence of spontaneous pregnancies
Elkind-Hirsch et al., 2008	60 women with overweight / obesity and PCOS	1) Exenatide 10 μg BID; 2) Exenatide 10 μg BID + Metformin 1000 mg BID	Metformin 1000 mg BID	24 weeks	Increased menstrual regularity and ovulation rate (86% with EXE+MET vs. 50% EXE and 29% MET); decreased FAI; increased SHBG
Liu et al., 2017	176 women with overweight / obesity and PCOS	Exenatide 10 μg BID	Metformin 1000 mg BID	12 weeks	Higher spontaneous pregnancy rate (EXE 43.6% vs. MET 18.7%)