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Study breakdown

Semaglutide Plus Metformin Improves Weight and Fertility in Obese PCOS Patients

RPEP-148902026Bolek, Tomáš; Turňová, Petra; Janošova, Svetlana; Péč, Martin Jozef; Ságová, Ivana; Nagy, Norbert; Jurica, Jakub; Mokáň, Marián; Samoš, Matej
evidence
The takeaway

Combining semaglutide with metformin produced significant weight loss and improved fertility outcomes in 20 obese PCOS patients with prediabetes.

20 patients, dual benefit

Semaglutide + metformin improved both weight and fertility in obese PCOS

What the researchers found

Subcutaneous semaglutide combined with metformin produced significant weight loss and improved fertility outcomes in 20 consecutive PCOS patients with obesity and prediabetes.

Why it matters

PCOS affects 10% of women of reproductive age, and obesity worsens fertility outcomes. A treatment that addresses both weight and fertility simultaneously fills a critical gap.

How the study worked

Pilot prospective study of 20 consecutive PCOS patients with obesity and prediabetes treated with semaglutide plus metformin, evaluating weight loss and fertility outcomes.

What this study cannot tell us

Small pilot study (n=20) without a control group. Prospective but not randomized or blinded. Short follow-up for fertility outcomes.

How to read the evidence

Small pilot prospective study without control — provides encouraging preliminary data requiring larger RCT confirmation.

When this study was published

Published in 2026; explores an emerging indication for GLP-1 drugs.

The bigger picture

GLP-1 drugs may become standard preconception therapy for obese PCOS patients, addressing weight, insulin resistance, and fertility in one treatment approach.

Questions still open

  • Should semaglutide be stopped before conception or can it continue through early pregnancy?
  • Does the fertility benefit persist after semaglutide discontinuation?

Common questions

Can semaglutide help PCOS patients get pregnant?
This pilot study suggests semaglutide combined with metformin can improve both weight loss and fertility in obese PCOS patients. Larger studies are needed, and semaglutide should be stopped before pregnancy.
Why does weight loss improve PCOS fertility?
Excess weight worsens insulin resistance and hormonal imbalances in PCOS. Even modest weight loss (5-10%) can restore ovulation and significantly improve chances of conception.

Read the original research

Effect of semaglutide with metformin for weight loss and fertility in polycystic ovary syndrome (PCOS) patients with obesity: A pilot prospective study.

Clinical nutrition ESPEN, 71, 102885

View on PubMed ↗Publisher’s paper ↗

Citation

Bolek, Tomáš; Turňová, Petra; Janošova, Svetlana; Péč, Martin Jozef; Ságová, Ivana; Nagy, Norbert; Jurica, Jakub; Mokáň, Marián; Samoš, Matej. (2026). Effect of semaglutide with metformin for weight loss and fertility in polycystic ovary syndrome (PCOS) patients with obesity: A pilot prospective study.. Clinical nutrition ESPEN, 71, 102885. https://doi.org/10.1016/j.clnesp.2025.102885