Impact of the glucagon-like peptide-1 receptor agonist semaglutide on reproductive health of women with obesity: a review of clinical evidence

Currently, the problem of overweight and obesity has acquired global significance due to the high prevalence of these conditions and the associated multisystem pathological conditions, including reproductive disorders in both men and women. Contemporary medicine strongly recommends weight reduction to prevent metabolic complications and obesity-related comorbidities. The most effective and fundamental approach remains lifestyle modification, including a hypocaloric diet and moderate physical activity. However, a proportion of patients demonstrate resistance to such changes, necessitating the use of pharmacological agents and, in some cases, surgical treatment. Semaglutide, a glucagon-like peptide-1 receptor agonist, has demonstrated high efficacy in reducing body weight and improving glycemic control in patients with obesity and type 2 diabetes mellitus. However, data on the effects of semaglutide on the female reproductive system remain limited, as long-term clinical observations and studies under extreme conditions have been predominantly conducted in animal models. Particular attention is given to the effects of the drug in women of reproductive age, including its impact during preconception, the first trimester of pregnancy, and lactation, when both inadvertent and intentional exposure may have unpredictable consequences for the fetus and infant.

This study presents a systematic review of current evidence regarding the use of semaglutide in female patients with obesity and examines the associated risks and contraindications during specific physiological states such as pregnancy and lactation. The findings are of substantial importance for developong clinical guidelines and establishing safe therapeutic strategies, which are essential for preserving reproductive health and supporting demographic stability.