Existing reproductive medicine literature often relies on theoretical extrapolationssuch as the assumption that weight loss inherently restores ovulationbut lacks systematic evaluations of hard reproductive endpoints, including natural pregnancy rates, time to pregnancy (TTP), and cumulative live birth rates in ART ( 1.4.3 Real-world decision dilemmas The friction between prevalent clinical use and existing defensive guidelines is particularly salient in the following three scenarios: Value assessment of pretreatment before ART: in obese PCOS patients with IR or MASLD, GLP-1RAs are frequently utilized as weight-loss accelerators before starting stimulation cycles
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consider using a non-oral or barrier method for 4 weeks after initiation and after each dose increase
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