Obesity and polycystic ovary syndrome (PCOS) in women are associated with significant reproductive dysfunction, manifesting as hormonal imbalances, anovulation, and subfertility. These conditions not only impair reproductive outcomes but also contribute to a reduced quality of life. Crucially, obesity and PCOS share a bidirectional relationship. While obesity can trigger and worsen PCOS manifestations, the convergence of these two conditions has contributed significantly to the growing incidence of female infertility. This review critically examines liraglutide's mechanistic role and therapeutic potential in mediating metabolic restoration and improving the fertility outcomes in women burdened by obesity and PCOS. A literature search was conducted in original databases from inception until March 2025 in PubMed, Google Scholar, Cochrane Library, Scopus, and Web of Science using the following keywords pertinently: "GLP-1R", "liraglutide", "female reproductive system", "polycystic ovarian syndrome", "ovarian function", and "pregnancy outcomes". Accumulated evidence suggests that liraglutide promotes greater weight loss and improves reproductive outcomes in women with obesity and PCOS by regulating endocrine parameters, reducing systemic inflammation, restoring menstrual cyclicity, and supporting folliculogenesis. It improves reproductive outcomes by increasing natural conception rates and improving responses to assisted reproductive techniques (ART). However, with all the positive outcomes, the major limitations of using this drug for weight loss are the need for daily subcutaneous injections, cost, and gastrointestinal adverse effects. Long-term assessment of the sustained efficacy and impact on reproductive outcomes, including the pattern of ovulation and offspring health, is warranted. This review consolidated present findings and emphasized areas for further exploration to better inform clinical decision-making and future research directions.
