Impact of GLP-1 and GLP-1/GIP receptor agonists before, during, and after pregnancy: a narrative review

Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) receptor agonists (GLP-1RA and GIP-RA) are a class of medications that mimic the endogenous effects of GLP-1 and have gained increasing attention due to their substantial clinical potential. Originally developed for glycemic control in individuals with type 2 diabetes mellitus (T2DM), these agents have also been widely used for obesity management and weight control. A narrative literature review was conducted to summarize the main findings available regarding the use of GLP-1RAs across three distinct phases of women's reproductive trajectory: the preconception period, pregnancy, and the postpartum. Owing to their metabolic and hormonal optimization effects, GLP-1RAs have additionally emerged as a therapeutic ally in the management of infertility associated with hormonal imbalance secondary to metabolic syndrome. However, the safety of these medications during pregnancy remains insufficiently established, largely due to the limited number of published studies to date. Similarly, their use during the postpartum period is controversial, given the same lack of robust evidence. Overall, current data are insufficient to support routine use of GLP-1RAs and GLP-1RA/GIP-RAs during pregnancy and postpartum.