Abstract

Polycystic ovary syndrome (PCOS) is a heterogeneous condition, affecting 5-10% of women of reproductive age, and characterized by hyperandrogenism and metabolic disorders. Obesity is a risk factor for the development of PCOS. Simultaneously, the development of PCOS can contribute towards further overweight and obesity. The association between obesity and PCOS is an implicated synergistic interaction through multiple mechanisms, leading to similar outcomes in many respects, especially insulin resistance, hyperinsulinemia, anovulation, and infertility. Evidence from studies shows that women with PCOS have lower postprandial satiety and higher postprandial hunger than weight-matched controls due to the inhibition of ghrelin in the PCOS. Ghrelin levels were found to be negatively correlated with androgen and insulin levels, as well as insulin resistance. Furthermore, GLP-1 secretion was also different in women with PCOS and without PCOS with the same body mass index. The GLP-1 receptor agonist (GLP-1 RA) has been studied in women with obesity and PCOS. Several studies have shown that GLP-1 RA affects reproductive parameters by many factors, by increasing LH (Luteinizing hormone), reducing inflammation and oxidative damage, increasing insulin sensitivity, and reducing weight significantly, decreasing testosterone, improving menstrual cycle regularity in overweight, obese women with PCOS and, as a result, increased conception rates. In the future, the GLP-1 RA may offer the opportunity to expand treatment options for infertility with PCOS, particularly in women with advanced age and/or poor ovarian reserve.