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PCOS and GLP-1 agonists — reproductive outcomes data

MeganSA_TX Sat, Mar 28, 2026 at 6:28 AM 17 replies 787 viewsPage 1 of 4

MeganSA_TX

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Mar 28, 2026 at 6:28 AM#1

Read the primary source rather than the write-up and the two do not agree, so here is what is actually in it.

The class is not used in pregnancy, and the practical points are a washout before conception and the fact that reduced appetite is not contraception. Improved insulin sensitivity in PCOS can restore ovulation, so fertility frequently increases as a side effect — people conceive unexpectedly on these drugs, which is a reason to sort contraception out at the start rather than after.

Where I think it is weakest: the comparator does most of the work in how this gets reported, and it is not the comparator most people think they are citing.

The narrow version of the question is what the washout thinking is before trying to conceive, and why nobody mentions that fertility often increases as a side effect. Practical detail welcome, however dull — the duller the better.

Note on sourcing:
Figures above are from the primary publication rather than the press summary. If a number here disagrees with one you have, post yours and we will work out which of us is reading a secondary source.

42 12PharmD_Rodriguez, julia.endo, JessicaM_2024 and 39 others

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InsuranceTom

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Mar 28, 2026 at 6:35 AM#2

MeganSA_TX said:
The class is not used in pregnancy, and the practical points are a washout before conception and the fact that reduced appetite is not contraception.

MeganSA_TX said:
...everyone should be on fertility and pregnancy...

I understand the enthusiasm, but "everyone" is too broad. Contraindications exist: personal/family history of MTC or MEN2, history of pancreatitis, pregnancy/breastfeeding, and certain GI conditions.

Beyond contraindications, clinical judgment matters. A 22-year-old with BMI 28 and no comorbidities has a different risk-benefit calculation than a 55-year-old with BMI 38 and metabolic syndrome.

Let's advocate for ACCESS without advocating for UNIVERSAL use. They're different things.

41 11lucas_SP_BR, lisa_labSD, adam_van and 38 others

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Dr.AddMedPHL

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Mar 28, 2026 at 6:42 AM#3

MeganSA_TX said:
The class is not used in pregnancy, and the practical points are a washout before conception and the fact that reduced appetite is not contraception.

I do not accept the framing. The question has been narrowed to the version that has a tidy answer, and the part that was dropped is the part the OP actually asked about.

40 10mike.trainer_LA, sarah_nash92, FitDadDave and 37 others

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Dr.CardioMD

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Mar 28, 2026 at 6:49 AM#4

Answering the narrow version, because the broad one does not have a single answer. It is worth asking what the claim would look like if it were false. If nothing would look different, it is not a claim about the world and no amount of discussion will settle it.

39 9roxy_nash, tony_orlando, Dr.NephBHM_UK and 36 others

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