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

BACKGROUND AND AIMS: Polycystic ovary syndrome (PCOS) and obesity increase the risk of infertility, preterm birth and birth of a hypertrophic neonate. Effective weight loss can improve this disorder. The aim of this study was to evaluate the effect of subcutaneous semaglutide in combination with metformin for the treatment of PCOS patients with obesity and prediabetes. PATIENTS AND METHODS: We prospectively enrolled 20 consecutive PCOS patients with obesity and prediabetes, (mean age 32 years) with BMI 34.8 ± 4.3 kg/m2, on combination therapy with metformin 1000 mg daily and subcutaneous semaglutide 0.25-0.5 mg weekly. Patients were followed up for 6 months. All patients were clinically examined and human body composition (lean mass, fat) as well as weight were measured by bioelectrical impedance analysis InBody 370. RESULTS: There was a significant weight reduction after 5 months of therapy (98.4 ± 15.5 vs. 85.5 ± 16.6 kg, p < 0.05), and a reduction was observed in BMI (34.8 ± 4.3 vs. 30.2 ± 4.7 kg/m2, p < 0.05). Similarly, there was also a significant reduction of fat mass (41.3 ± 10.8 vs. 32.3 ± 10.3, p < 0.05), but no impact of therapy on lean mass (31.1 ± 4.5 vs. 29.1 ± 5.1 kg, p = 0.56). Within the follow-up period, a significant improvement in fertility was observed, with 60 % of the patients treated achieving pregnancy. All resulting pregnancies culminated in the delivery of eutrophic neonates. CONCLUSION: In this study, we demonstrated a significant efficacy of combined treatment with subcutaneous semaglutide and metformin in effective weight reduction and improving fertility in patients with obesity, prediabetes and PCOS.