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Weight-Lowering Drugs and Natural Female Fertility-A Systematic Review and Meta-Analysis.
Shaikha Jabor Alnaimi1,2, Dana Muwafag Alsugeir3, Li Wei1
1Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
Clinical Obesity
|June 17, 2026
Summary
Weight-lowering drugs show potential for improving female fertility in overweight or obese women. Orlistat and semaglutide demonstrated positive effects on ovulation and pregnancy rates in clinical trials.
Area of Science:
- Reproductive Endocrinology
- Pharmacology
- Obesity Medicine
Background:
- Overweight and obesity significantly impair female fertility globally.
- The impact of weight-lowering drugs on natural fertility remains unclear.
- Existing research lacks comprehensive data on drug effects on conception and live birth rates.
Purpose of the Study:
- To systematically review and meta-analyze the effects of weight-lowering drugs on female fertility.
- To evaluate impacts on ovulation, conception, pregnancy, and live birth rates.
- To compare drug efficacy against lifestyle modifications and other medications.
Main Methods:
- Systematic review and meta-analysis of interventional and observational studies.
- Searched MEDLINE, Embase, CINAHL, CENTRAL, and ClinicalTrials.gov for relevant literature.
- Included seven clinical trials (n=575) evaluating orlistat and semaglutide.
Main Results:
- Orlistat was associated with higher ovulation rates compared to lifestyle modifications in four trials.
- No significant difference in ovulation rates was found between orlistat and metformin.
- Orlistat and semaglutide (added to metformin) showed increased pregnancy rates in select studies.
Conclusions:
- Weight-lowering drugs, including orlistat and semaglutide, may positively influence ovulation and pregnancy rates in women with overweight or obesity.
- Further adequately powered studies are needed to assess the effects of newer agents on natural pregnancy and live birth rates.
- Current evidence suggests a potential benefit, but more research is required to confirm efficacy and safety for fertility outcomes.
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