Targeting metabolism to protect fertility and healthy pregnancy with SGLT2 inhibitors and GLP-1RAs

Metabolic disease is a global health epidemic with detrimental effects on reproduction. The rising use of sodium glucose co-transporter 2 inhibitors and glucagon-like peptide-1 receptor agonists has introduced new treatment options, but there is little data examining their impact on reproductive safety and efficacy during pregnancy. This review summarizes how these medications may impact hormonal regulation, limit pregnancy complications, and prevent the progression of gestational diabetes into type II diabetes post-partum. Due to safety concerns, clinical data on the use of these medications during pregnancy is limited to retrospective studies of inadvertent exposure, and the limited data on possible teratogenic effects warrants further analysis, especially considering the promising results observed in pre-clinical studies.