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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
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Obstetrics and Gynegology2026№6

The incretin system and female reproductive function: receptor distribution, molecular mechanisms and new therapeutic prospects

DOI
https://dx.doi.org/10.18565/aig.2025.272

Dora S.V., Khalimov Yu.Sh., Bezhenar V.F., Lisker A.V., Shvets Z.V., Volkova A.R., Kolyabina A.B., Murzina O.S.

Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, St. Petersburg, Russia

The widespread use of glucagon-like peptide-1 (GLP-1) receptor agonists in the treatment of type 2 diabetes and obesity in women of reproductive age highlights the importance of investigating their potential impact on fertility. This review summarizes the current evidence on the role of the incretin system in the regulation of female reproductive function. The most convincing data obtained from patients with polycystic ovary syndrome (PCOS) demonstrate the ability of GLP-1 receptor agonists to reduce insulin resistance and hyperinsulinemia that can be associated with the restoration of a regular menstrual cycle, an increase in the frequency of ovulatory cycles and a higher likelihood of pregnancy. The effects on the reproductive system are due to both systemic improvement in metabolism and weight loss, and to direct action on tissues expressing GLP-1 receptors (the hypothalamic-pituitary axis, the ovaries and endometrium). Direct mechanisms include modulation of steroidogenesis, increased endometrial receptivity, and a reduction in inflammation and oxidative stress.
The safety of using GLP-1 receptor agonists during the periconceptional period remains a matter of debate. Despite data obtained from preclinical studies on potential embryotoxicity, available clinical observations have not revealed a statistically significant increase in the risk of congenital malformations following accidental exposure to the drug during the first trimester of pregnancy. Nevertheless, current guidelines recommend discontinuing treatment before conception.
Conclusion. To expand the clinical use of GLP-1 receptor agonists in gynecological and reproductive medicine, further research is needed to investigate their effectiveness in women without PCOS, to develop standardized protocols for periconceptional safety and to assess the potential of new generations of incretin-based drugs.

Authors’ contributions. Dora S.V., Khalimov Yu.Sh., Bezhenar V.F. – conception and design of the review; Lisker A.V., Shvets Z.V., Kolyabina A.B., Murzina O.S. – search and analysis of literary sources; Dora S.V., Shvets Z.V., Lisker A.V., Volkova A.R. – writing the text; Khalimov Yu.Sh., Bezhenar V.F., Volkova A.R. – editing and critical revision of the content; Dora S.V., 
Khalimov Yu.Sh., Bezhenar V.F., Lisker A.V., Shvets Z.V., Volkova A.R., Kolyabina A.B., Murzina O.S. – approval of the final version.
Conflicts of interest. Authors declare lack of the possible conflicts of interest.
Funding. The study was conducted without sponsorship.
Generative Artificial Intelligence. Artificial intelligence tools were not used in the preparation of this article.
For citation: Dora S.V., Khalimov Yu.Sh., Bezhenar V.F., Lisker A.V., Shvets Z.V., Volkova A.R., Kolyabina A.B., Murzina O.S. The incretin system and female reproductive function: receptor distribution, 
molecular mechanisms and new therapeutic prospects.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (6): 39-46 (in Russian)
https://dx.doi.org/10.18565/aig.2025.272

Keywords

glucagon-like peptide-1 receptor agonists
semaglutide
liraglutide
fertility
infertility
menstrual cycle
polycystic ovary syndrome
insulin resistance
obesity
diabetes mellitus
steroidogenesis
endometrial receptivity
periconceptional period
Full text (in Russian)

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Received 15.12.2025

Accepted 05.06.2026

About the Authors

Svetlana V. Dora, Dr. Med. Sci., Professor, Department of Faculty Therapy, Pavlov First Saint Petersburg State Medical University, Ministry of Health of the Russian Federation, 197022, Russia, St. Petersburg, L’va Tolstogo str., 6-8, doras2001@mail.ru, https://orcid.org/0000-0002-8249-6075
Yuri Sh. Khalimov, Dr. Med. Sci., Professor, Head of the Department of Faculty Therapy, Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, 197022, Russia, St. Petersburg, L’va Tolstogo str., 6-8, yushkha@gmail.com, https://orcid.org/0000-0002-7755-7275
Vitaly F. Bezhenar, Dr. Med. Sci., Professor, Head of the Department of Obstetrics, Gynecology and Reproductology, Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, 197022, Russia, St. Petersburg, L’va Tolstogo str., 6-8, bez-vitaly@yandex.ru, https://orcid.org/0000-0002-7558-7657
Anna V. Lisker, PhD, Head of Endocrinology Department, Clinical Endocrinology Center, Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, 197022, Russia, St. Petersburg, L’va Tolstogo str., 6-8, a.lisker@mail.ru, https://orcid.org/0000-0003-4295-1202
Zlata V. Shvets, PhD student in Endocrinology, Department of Faculty Therapy, Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, 197022, Russia, St. Petersburg, L’va Tolstogo str., 6-8, +7(911)848-73-75, shvetszlata31@gmail.com, https://orcid.org/0009-0007-9218-8133
Anna R. Volkova, Dr. Med. Sci., Professor, Department of Faculty Therapy, Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, 197022, Russia, St. Petersburg, L’va Tolstogo str., 6-8, volkovaa@mail.ru, https://orcid.org/0000-0002-5189-9365
Alexandra B. Kolyabina, Resident in Endocrinology, Department of Faculty Therapy, Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, 197022, Russia, St. Petersburg, L’va Tolstogo str., 6-8, kolyabinas@yandex.ru, https://orcid.org/0009-0003-3136-3509
Olga S. Murzina, Student, Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, 197022, Russia, St. Petersburg, L’va Tolstogo str., 6-8, olyamurzinaa@yandex.ru, https://orcid.org/0009-0005-4712-7871
Corresponding author: Zlata V. Shvets, shvetszlata31@gmail.com

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