Liraglutide increases IVF pregnancy rates in obese PCOS women with poor response to first-line reproductive treatments: a pilot randomized study

Šalamun, Vesna; Jensterle, Mojca; Janež, Andrej; Bokal, Eda Vrtačnik

doi:10.1530/eje-18-0175

Cited by 102 publications

(98 citation statements)

References 47 publications

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“…The impact of liraglutide treatment on pregnancy rates has been seldom investigated. In a randomized, open-label pilot study on 28 women with obesity and PCOS, a 12-week preconception treatment with low-dose liraglutide (1.2 mg daily) in combination with metformin was superior to metformin alone in increasing in vitro fertilization pregnancy rates ( 97 ). An increase in the cumulative pregnancy rate was also documented, including spontaneous pregnancies after treatment in women who had been previously been resistant to lifestyle modification and first-line reproductive treatment.…”

Section: Liraglutide In Pcosmentioning

confidence: 99%

Obesity, Polycystic Ovary Syndrome, and Infertility: A New Avenue for GLP-1 Receptor Agonists

Cena

Chiovato

Nappi

2020

The Journal of Clinical Endocrinology &Amp; Metabolism

189

104

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Context Obesity is responsible for an increased risk of sub-fecundity and infertility. Obese women show poorer reproductive outcomes regardless of the mode of conception, and higher body mass index (BMI) is associated with poorer fertility prognosis. Polycystic ovary syndrome (PCOS) is one of the leading causes of infertility, and many women with PCOS are also overweight or obese. Evidence Acquisition The aim of the present narrative review is to describe the mechanisms responsible for the development of infertility and PCOS in women with obesity/overweight, with a focus on the emerging role of glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1 RAs) as a therapeutic option for obese women with PCOS. Evidence synthesis Weight reduction represents the most significant factor affecting fertility and pregnancy outcomes. Current experimental and clinical evidence suggests the presence of an underlying pathophysiological link between obesity, GLP-1 kinetic alterations, and PCOS pathogenesis. Based on the positive results in patients affected by obesity, with or without diabetes, the administration of GLP-1 RA (mainly liraglutide) alone or in combination with metformin has been investigated in women with obesity and PCOS. Several studies demonstrated significant weight loss and testosterone reduction, with mixed results relative to improvements in insulin resistance parameters and menstrual patterns. Conclusions The weight loss effects of GLP-1 RA offer a unique opportunity to expand the treatment options available to PCOS patients.

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Section: Liraglutide In Pcosmentioning

confidence: 99%

Obesity, Polycystic Ovary Syndrome, and Infertility: A New Avenue for GLP-1 Receptor Agonists

Cena

Chiovato

Nappi

2020

The Journal of Clinical Endocrinology &Amp; Metabolism

189

104

View full text Add to dashboard Cite

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“…Other PCOS therapeutic options have shown a beneficial effect on gestational outcomes in PCOS patients. The use of liraglutide, a long-acting glucagon-like peptide-1 (GLP-1) analog, in patients with PCOS revealed improved results in cycles of in vitro fertilization and coagulation disorders 43 , 44 , 45 . PCOS patients undergoing bariatric surgery typically present better metabolic control and improved inflammatory status 46 , 47 .…”

Section: Discussionmentioning

confidence: 99%

Coagulation Biomarkers in Women with Recurrent Miscarriage and Polycystic Ovarian Syndrome: Systematic Review and Meta-Analysis

Cavalcante

Sarno

Cavalcante

et al. 2019

Geburtshilfe Frauenheilkd

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Introduction Pregnant women with polycystic ovarian syndrome (PCOS) have high risk of pregnancy loss. Pathophysiological mechanisms appear to be associated with obesity, hormonal factors, or blood clotting disorders. Our aim is to perform a systematic review and meta-analysis on the relationship between coagulation disorders and risk of recurrent miscarriage (RM) in patients with PCOS and to identify coagulation biomarkers for this condition. Material and Methods PubMed and MEDLINE databases were searched for publications in English language. The search terms used included “RM”, “polycystic ovary syndrome”, “coagulation disorders”, and “thrombophilia”. Odds ratios (ORs) and 95% confidence intervals (CIs) for miscarriage in different RM groups (with and without PCOS). Results A total of 575 publications including the search terms were identified. Six studies were included for qualitative analysis, and five were included for quantitative analysis (meta-analysis). We found no association between RM and inherited thrombophilias in patients with PCOS: (1) Factor V Leiden (OR, 0.74; 95% CI, 0.38 – 1.45; p = 0.38); (2) C677T methylenetetrahydrofolate reductase polymorphism (MTHFR) (OR, 1.01; 95% CI, 0.64 – 1.59; p = 0.97); and (3) A1297C MTHFR polymorphism (OR, 1.08; 95% CI, 0.62 – 1.89; p = 0.77). Other potential biomarkers were identified, with emphasis on plasminogen activator inhibitor type 1. Conclusion Data available in the current literature revealed that there was no association between RM and inherited thrombophilias in patients with PCOS. RM patients with PCOS have a high risk of thromboembolic events.

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“…The addition of metformin to gonadotropins has shown some benefit in low-complexity treatments (timed intercourse or intaruterine insemination) but not in IVF 62, 66 . Preliminary results suggest that liraglutide at low dose can help to improve the outcome of IVF treatment in obese women with PCOS 67 .…”

Section: Advances and Challenges In Pcos Managementmentioning

confidence: 98%

Recent advances in the understanding and management of polycystic ovary syndrome

et al. 2019

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Polycystic ovary syndrome (PCOS) is a multifaceted condition characterized by chronic anovulation and excess ovarian activity, in contrast to other causes of anovulation that involve ovarian dormancy or primary insufficiency. Recent studies indicated that PCOS is associated with low-grade chronic inflammation and that women with PCOS are at increased risk of non-alcoholic fatty liver disease. The inflammatory and metabolic derangements associated with PCOS are explained in part by the coexistence of insulin resistance and obesity but are further fueled by the androgen excess. New insights into the regulation of hormones and cytokines in muscle and fat tissue support the concept that PCOS is a systemic syndrome. The therapeutic plan should be tailored to the patient phenotype, complaints, and reproductive desire. Of note, the aromatase inhibitor letrozole seems to be more effective than the reference drug clomiphene citrate to treat infertility due to PCOS. Integral management by a multidisciplinary team may help the patients to adhere to lifestyle interventions and thereby reduce body adiposity and recover their metabolic and reproductive health.

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Liraglutide increases IVF pregnancy rates in obese PCOS women with poor response to first-line reproductive treatments: a pilot randomized study

Cited by 102 publications

References 47 publications

Obesity, Polycystic Ovary Syndrome, and Infertility: A New Avenue for GLP-1 Receptor Agonists

Obesity, Polycystic Ovary Syndrome, and Infertility: A New Avenue for GLP-1 Receptor Agonists

Coagulation Biomarkers in Women with Recurrent Miscarriage and Polycystic Ovarian Syndrome: Systematic Review and Meta-Analysis

Recent advances in the understanding and management of polycystic ovary syndrome

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