GLP-1 Medications and Fertility: What the Science Says
Let’s discuss GLP-1s—what they are, how they work, and what role they may play in reproduction. Much of what I’ll share is pulled from a recent review in Human Reproduction Update, one of the most reputable journals in the field. The study is titled “The role of glucagon-like peptide-1 in reproduction: from physiology to therapeutic perspective,” and you can find it here!
What Exactly Is GLP-1?
GLP-1 stands for glucagon-like peptide-1, a hormone made in the intestines. When you eat, GLP-1 signals your body that you’ve had enough food and kickstarts the metabolic processes needed for digestion.
The medications people often call “GLP-1s” (think Ozempic, Wegovy, or tirzepatide) are actually GLP-1 receptor agonists—drugs that mimic the action of GLP-1, essentially making your body behave as if it has more of the hormone on board.
GLP-1 Beyond Diabetes
Originally developed as treatments for diabetes to help with insulin resistance and blood sugar regulation, GLP-1 medications are now making headlines for their impact on weight loss. People taking them often feel full sooner, eat less, and their bodies metabolize food more effectively.
But the story doesn’t stop there. GLP-1 receptors are found not just in the gut and pancreas, but also in the lungs, brain, ovaries, testes, and uterus. This means GLP-1 is influencing much more than just blood sugar—it’s interacting with reproductive organs too.
The Gut, the Brain, and Fertility
If you’ve heard me talk about the gut-brain connection before, you know this is a fascinating area. The gut is lined with neurons that communicate directly with the brain. GLP-1 plays into this communication system.
In reproduction, we often focus on the HPO axis—the hypothalamus, pituitary gland, and ovaries. This is the hormonal pathway that controls ovulation.
Here’s the short version:
The hypothalamus sends signals (GnRH) to the pituitary.
The pituitary releases FSH and LH, which stimulate the ovaries.
The ovaries grow follicles, make estrogen, and eventually release an egg.
This system is delicate, and anything that interferes with signaling—like obesity, inflammation, or PCOS—can throw it off.
How GLP-1 Impacts the Brain and Ovaries
GLP-1 appears to improve how the brain sends out GnRH, which means better FSH and LH release. That’s step one toward healthier ovulation.
In the ovaries, GLP-1:
Reduces androgen production (less excess testosterone)
Increases sex hormone-binding globulin
Improves ovulation rates
For people with PCOS, this can mean more regular cycles and better chances of ovulating.
Beyond Metabolism: Inflammation and Fibrosis
One of the most exciting findings is that GLP-1s may directly improve reproductive organ health by reducing inflammation and fibrosis.
Inflammation disrupts hormone signaling and makes it harder for embryos to implant.
Fibrosis (scarring of tissues) increases with age and makes the ovaries less responsive.
By lowering both, GLP-1s may help preserve fertility in ways unrelated to weight loss or insulin sensitivity.
What Do the Studies Show?
So far, most research has looked at women with PCOS, diabetes, or obesity. The studies are small, but they suggest:
More regular cycles
Improved ovulation
Better outcomes with IVF in some cases
Importantly, the most recent data (2024) shows no increased risk of birth defects, miscarriage, or pregnancy complications with GLP-1 exposure.
That said, current guidelines still recommend stopping GLP-1 medications two months before trying to conceive and at least a week before anesthesia for IVF egg retrievals.
Where GLP-1s Might Help in Fertility
I see two main ways GLP-1s could benefit fertility:
Improved HPO signaling – better communication between the brain and ovaries.
Reduced inflammation – systemically and directly in reproductive organs.
This makes them particularly interesting for women who are overweight, have PCOS, or have diabetes and are preparing for pregnancy or fertility treatments.
Where We Still Have Questions
We don’t yet know how GLP-1s might help women with:
Autoimmune conditions
Unexplained infertility
Normal weight but recurrent fertility struggles
It’s tempting to imagine benefits—especially from the anti-inflammatory effects—but right now, the data isn’t there.
Final Thoughts
GLP-1 medications are not just “weight loss drugs.” Their impact on the brain, ovaries, and uterus suggests a much broader role in reproductive health. While we still need more data, I think GLP-1s deserve a place in the conversation for patients with PCOS, insulin resistance, or obesity who are struggling to conceive.
