GLP-1 drugs show early promise in fertility for both sexes

Early findings suggest that GLP-1 receptor agonists, a class of medications primarily used for weight management, may improve fertility in both men and women. Two studies presented at recent medical conferences highlight potential benefits for individuals with obesity-related metabolic dysfunction, including those with polycystic ovary syndrome (PMOS) and men experiencing low testosterone levels.

A proof-of-concept analysis from the ongoing RESTORE trial examined women aged 12 to 35 who achieved at least 10% weight loss through injectable semaglutide. Researchers observed earlier-than-expected improvements in reproductive markers, including hormonal balance and menstrual regularity. These results align with the hypothesis that substantial weight loss can restore ovarian function and increase fertility in women with PMOS, a condition characterized by insulin resistance and androgen excess.

The study authors caution that the current findings are preliminary, based on a subset of participants, and require longer-term data to confirm sustained benefits.

In men, a review of five randomized controlled trials presented at ENDO 2026 found that GLP-1 drugs like semaglutide and liraglutide did not harm fertility and may improve testosterone levels and sperm quality. Weight reduction through GLP-1 therapy may restore natural hormone production without impairing spermatogenesis, unlike testosterone replacement therapy, which can suppress sperm production.

These outcomes were superior to those achieved through testosterone replacement alone, suggesting a shift in treatment approaches for men with obesity-related infertility. Werthman noted that GLP-1 therapies improve body composition, insulin resistance, and cardiovascular risk factors, all of which positively influence reproductive function.

Both research teams stressed that the evidence remains preliminary. The semaglutide study in women is an early analysis from the RESTORE trial, while the male fertility findings are based on a small number of studies with varying methodologies. Neither semaglutide nor other GLP-1 receptor agonists have been approved specifically as fertility treatments. Future studies will need to determine whether these reproductive improvements translate into higher pregnancy rates, improved live birth outcomes, and long-term benefits.

For now, the findings suggest that GLP-1 drugs may offer a dual benefit by addressing obesity and metabolic dysfunction while supporting reproductive health. However, further research is needed to disentangle the effects of weight loss from the direct mechanisms of the medication itself. As Werthman concluded, “The consistency of emerging data in both men and women raises the possibility that these medications may ultimately prove to have direct reproductive effects as well.”