GLP-1 Medications and Fertility: What Women With PCOS Should Know

GLP-1 medications have transformed the conversation around weight management. Now, researchers are asking another question: could these medications also affect fertility?

Written and medically reviewed by Dr. Courtney Ranieri, ND, a licensed naturopathic doctor registered with the College of Naturopaths of Ontario (Reg. #3726). Last reviewed July 2026.

From Ozempic and Wegovy to Mounjaro and Zepbound, GLP-1 medications have become a major topic in health news. Much of the conversation focuses on weight loss and blood sugar regulation, but their potential effects on reproductive health are attracting increasing attention.

For women with polycystic ovary syndrome (PCOS), in particular, this is an area worth watching.

So, what do we know, what is still being studied, and what should you consider if you are thinking about pregnancy?

Why are researchers looking at GLP-1 medications and fertility?

GLP-1 receptor agonists are medications that act on pathways involved in blood sugar regulation, appetite, and digestion. Depending on the medication, they may be prescribed for type 2 diabetes, chronic weight management, or other approved indications.

Their relevance to reproductive health comes partly from the relationship between insulin resistance, metabolic health, and ovulation.

PCOS is a hormonal and metabolic condition that can involve irregular ovulation, elevated androgen levels, and insulin resistance. Not everyone with PCOS has insulin resistance, and the condition can look very different from one person to another.

In some women, insulin resistance contributes to higher insulin levels, which can influence ovarian androgen production and interfere with normal ovulatory function.

This is where GLP-1 medications have attracted interest.

By improving certain aspects of metabolic health and supporting weight management in appropriate patients, these medications may indirectly influence reproductive function in some women with PCOS.

However, that does not mean GLP-1 medications are established fertility treatments.

What does the latest research tell us?

Interest in this topic is growing. In October 2026, researchers published new work examining preconception incretin-based therapy in people with PCOS, while a recent review highlighted the need for better evidence on how GLP-1 medications affect women's reproductive health.

Researchers are investigating several potential connections:

1. Insulin resistance and metabolic health

For women with PCOS and insulin resistance, improving metabolic health may help address one contributor to reproductive dysfunction. GLP-1 medications can improve glucose regulation, and some can support substantial weight loss when clinically appropriate.

2. Ovulation and menstrual cycles

Some studies suggest that GLP-1 treatment may be associated with improvements in menstrual regularity or ovulatory function in certain women with PCOS. However, much of the evidence remains limited, and more robust trials are needed to determine which patients may benefit and how these medications compare with established treatments.

3. Pregnancy outcomes

Researchers are also examining whether metabolic improvements before conception could influence fertility and pregnancy outcomes.

It is important to distinguish between a medication improving metabolic markers, a person ovulating more regularly, and a treatment being proven to increase live birth rates. These are different outcomes, and evidence for one does not automatically establish the others.

At present, GLP-1 medications should not be considered proven fertility drugs.

Does this mean GLP-1 medications could help you get pregnant?

Not necessarily.

For some women with PCOS, addressing insulin resistance and other metabolic factors may form part of a broader preconception plan. But fertility depends on many factors, including age, ovulation, ovarian reserve, sperm health, fallopian tube function, uterine factors, and medical history.

A medication that helps one person may not be appropriate for another.

There is also an important practical consideration: GLP-1 medications are not recommended for use during pregnancy, and pregnancy planning needs to be discussed with the prescribing clinician before treatment begins or continues.

The appropriate discontinuation period varies by medication. For example, semaglutide product information recommends stopping at least two months before a planned pregnancy. Other medications have different instructions, so patients should follow the guidance for their specific prescription.

Some GLP-1 medications can also affect the reliability of oral contraceptives, particularly during treatment initiation or dose escalation. Tirzepatide has specific precautions in this regard, so anyone using it should discuss contraception with their prescriber.

Do not stop or change a prescribed medication without speaking with your healthcare provider.

What if you have PCOS and are trying to conceive?

If pregnancy is your goal, the best next step is to develop a plan based on your individual circumstances rather than focusing on one medication or one laboratory result.

Depending on your history, this may include:

• Assessing ovulation: Understanding whether you are ovulating regularly and whether further fertility investigation is appropriate.
• Reviewing metabolic health: Considering glucose regulation and other relevant risk factors, particularly if you have signs of insulin resistance.
• Reviewing medications: Ensuring that your current medications and supplements are appropriate for your preconception timeline.
• Considering evidence-based fertility treatments: For anovulatory infertility associated with PCOS, letrozole is an established first-line pharmacological option in appropriate patients, under medical supervision.
• Building a sustainable preconception routine: Nutrition, movement, sleep, and other health behaviours can support overall wellbeing, without requiring perfection or restrictive routines.

If you are working with a fertility clinic, medication decisions should be coordinated with your reproductive specialist and prescribing clinician.

What about supplements and natural approaches?

Because PCOS can involve several overlapping factors, it is understandable to look for additional ways to support metabolic and reproductive health.

Nutrition, regular physical activity, sleep, and individualized care can all play a role in a comprehensive plan.

Some supplements, including inositol, are frequently discussed in the PCOS community. However, current evidence does not establish that inositol improves fertility outcomes for everyone with PCOS, and international PCOS guidance highlights uncertainty around its benefits for ovulation, pregnancy, and live birth.

Supplements should not replace appropriate fertility evaluation or proven treatment options. If you are trying to conceive, review all supplements with your healthcare provider, particularly if you are undergoing fertility treatment or could become pregnant.

The bottom line

GLP-1 medications are changing how we approach metabolic health, and their potential relationship with fertility is an important area of emerging research.

For women with PCOS, the connection between insulin resistance, ovulation, and reproductive health makes this an especially interesting topic. But promising early findings are not the same as proof that these medications improve fertility or increase live birth rates.

If you are navigating PCOS, irregular cycles, or fertility concerns, you deserve an individualized plan that considers your goals, medical history, and the evidence behind your options.

At Somewhere Health, we take a whole-person approach to reproductive health, helping you understand the factors that may be influencing your symptoms and work alongside your medical team to make informed decisions.

About the author

Dr. Courtney Ranieri, ND is a board-licensed naturopathic doctor and the founder of Somewhere Health. She earned her Doctor of Naturopathic Medicine at the Canadian College of Naturopathic Medicine in Toronto and holds an Honours Bachelor of Science from the University of Western Ontario. Her clinical focus spans hormonal health, fertility, digestion, and women's health, with advanced training in pelvic floor therapy and integrative fertility care.

Book a visit with Dr. Courtney

This article is for educational purposes only and does not replace medical advice. GLP-1 medications require individualized prescribing and should not be used during pregnancy. Discuss fertility plans, contraception, and medication changes with your prescribing clinician.

Further reading

• New research: Preconception incretin therapy in PCOS — Journal of Clinical Endocrinology & Metabolism, October 2026
• GLP-1 medications and fertility in PCOS — Cell Metabolism, October 2026
• 2023 International Evidence-Based Guideline for PCOS

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