Symptoms and General Pathology

All Conditions

Nutritional and Metabolic Diseases

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Neoplasms

Gland and Hormone Related Diseases

Syndrome

Weight Loss

Obesity

Infertility

Infertility, Female

Polycystic Ovary Syndrome

Insulin Resistance

Body Weight

Overweight

Overnutrition

Nutrition Disorders

Body Weight Changes

Genital Diseases

Urogenital Diseases

Cysts

Ovarian Cysts

Ovarian Diseases

Adnexal Diseases

Genital Diseases, Female

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Gonadal Disorders

Endocrine System Diseases

All Drugs and Chemicals

Hypoglycemic Agents

Gastrointestinal Agents

Androgens

Insulin

Insulin, Globin Zinc

Metformin

Glucagon-Like Peptide 1

Liraglutide

Glucagon

Glucagon-Like Peptide-1 Receptor Agonists

Incretins

Hormones

Hormone Antagonists

Metformin XR (extended-release) was initiated with a dose of 750 mg once per day for 2 week and increased to 1500 mg once per day for up to 12 weeks. Start injection liraglutide 0.6 mg subcutaneously (SC) 1week daily (QD), then titrated in increments of 0.6 mg once daily every 1 to 3 weeks to a final dose of 3.0 mg liraglutide SC daily for up to 12 weeks.

Metformin XR (extended-release) was initiated with a dose of 750 mg once per day for 2 week and increased to 1500 mg once per day for up to 12 weeks

Metformin XR (extended-release) was initiated at 750 mg once daily and increased to 1500 mg once daily after 2 week. Concomitantly, Liraglutide was initiated at a subcutaneous dose of 0.6 mg once daily for 1 week, then titrated in increments of 0.6 mg once daily every 1 to 3 weeks to a maintenance dose of 3.0 mg once daily for up to 12 weeks

Liraglutide + Metformin

Metformin XR (extended-release) was initiated at 750 mg once daily and increased to 1500 mg once daily after 2 week

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age and one of the leading causes of infertility. PCOS and obesity affect up to 12.5% - 48.3% Asian women, increase incidence of impaired glucose tolerance, type 2 diabetes and aggravate insulin resistance, cause ovulatory dysfunction and menstrual disorders, and negatively impact outcomes of Assited Reproductive Technology (ART), with higher miscarriage rate when receiving ART. Weight loss decrease insulin resistance and hyperandrogenism, improve ovulation rate and menstrual cycle, significantly higher conception and live birth rates. Weight loss prior to IVF procedures has been associated with significantly improved pregnancy rates (PR) and live birth rates. Furthermore, a decreased number of IVF cycles required to achieve a pregnancy has also been reported after weight loss interventions. Based on the principles of fetal programming, improving a lifestyle before conception might lead to improved longterm health of the offspring. Studies on the effect of anti-obesity medication combined with lifestyle changes on body weight and composition and metabolic - endocrine parameters and pregnancy rate in obese women diagnosed with PCOS are lacking. There is a growing need to develop pharmacologic interventions to improve metabolic function in women with polycystic ovary syndrome (PCOS).

The drug, liraglutide 3.0 mg was approved for chronic weight management in management in obese adults with an initial BMI of 30 kg/m2 or greater or in overweight adults BMI of 27 kg/m2 or greater with at least one weight-related co-morbid condition as an adjunct to a reduced-calorie diet and increased physical activity. Liraglutide is an acylated human glucagon-like peptide -1 (GLP-1) analog that binds to and activates the GLP-1 receptor. It lowers body weight through decreased caloric intake while stimulating insulin secretion and reducing glucagon via a glucose-dependent mechanism. For obesity management, patients may lose weight with GLP-1 receptor agonists due to other unique actions. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) can slow gastric emptying and increase satiety. While predictors of weight loss success for the general population are available (protein intake, weight loss medications), predictors of weight loss success may differ between normal and hyperandrogenic women. Glucagon-like peptide 1 agonists are linked with dose dependent weight lowering potential in different obesity related populations. The weight loss effects of GLP-1RAs previously demonstrated in diabetic and obese non-diabetic patients, offer a unique opportunity to expand the medical options available to patients with PCOS. Metformin was recommended for women with PCOS and obesity (BMI ≥ 25 kg/m2) or at metabolic risks and shown beneficial effects on menstrual disorders, anovulation, hyperandrogenism, and cardiovascular abnormalities.

The aim of this study was to evaluate the impact of liraglutide in combination with metformin compared to metformin alone on weight reduction, the multifaceted metabolic - endocrine disturbances, and oocyte and embryo quality, IVF PRs and cumulative PRs (IVF and spontaneous pregnancies) in infertile obese women with PCOS who had been previously poor responders to weight reduction with lifestyle modification.

Liraglutide and Metformin Combination on Weight Loss, Metabolic - Endocrine Parameters and Pregnancy Rate in Women With PCOS, Obesity and Infertility

Effectiveness of the Combination Liraglutide and Metformin on Weight Loss, Metabolic - Endocrine Parameters and Pregnancy Rate in Women With Polycystic Ovarian Syndrome, Obesity and Infertility

Treatment impact on change in body weight after 12 weeks of treatment.

Treatment effect on reducing body weight expressed as percent body weight loss from baseline

Treatment effect on loss of waist circumference (abdominal adiposity) with drug treatment

Change in central adiposity with treatment as measured by waist-to-hip ratio. A reduction in ratio indicates a decrease in truncal fat.

Treatment effect on loss of central adiposity as determined by Waist-to Height Ratio. The lower the ratio indicates less abdominal adiposity.

Treatment effect on reduction of fat mass (kg)

Treatment effect on reduction of percent body fat by BIA

Treatment effect on reduction of visceral fat level by BIA

Treatment effect on fasting glucose prior to an oral glucose tolerance test (OGTT)

Treatment effect on glucose measured at 120 minutes of an oral glucose tolerance test (OGTT)

Treatment effect on fasting insulin prior to an oral glucose tolerance test (OGTT)

Treatment effect on insulin measured at 120 minutes of an oral glucose tolerance test (OGTT)

Treatment effect on the HOMA-IR which is an insulin resistance measured derived from fasting blood glucose and insulin . The higher the number the more insulin resistant.

The SI OGTT is a measure of peripheral insulin sensitivity derived from the insulin and glucoses measured during an OGTT. A increase in SI OGTTindicates greater insulin sensitivity

Treatment impact on improving total cholesterol levels

Impact of treatment on HDL levels after 12 weeks of treatment

Drug effect of TRG levels after treatment

Treatment impact on improving LDL-C after treatment

Treatment impact on systolic blood pressure

Treatment impact on reducing diastolic blood pressure

Drug treatment impact on normalization of cycle frequency (cycle every 28-30 days). All cycle data is expressed as number of menses annualized to one year.

Drug treatment effect on free androgen levels as calculated as FAI= total testosterone (T) concentrations divided by sex hormone binding globulin (SHBG) levels. A higher score indicates a worse outcome (more androgenic).

Drug treatment effect on total testosterone concentrations

Treatment efficacy in reducing adrenal hyperandrogenism

Treatment efficacy in reducing ovary volume

Treatment effect on spontaneous pregnancy rate

Treatment effect on Assisted Reproductive Therapy Pregnancy Rate

Treatment effect on Cumulative Pregnancy Rate

Drug treatment impact on total dosage GNT

Drug treatment impact on No. of retrieved oocytes/patient

Drug treatment impact on No. of mature (MII) oocytes/patient

Drug treatment impact on fertilization rate

Drug treatment impact on oocyte degeneration rate

Drug treatment impact on No. of embryos on day 5/patient

Drug treatment impact on No. of blastocysts/patient

Drug treatment impact on blastulation rate

Drug treatment impact on No. of transferred embryos

Drug treatment impact on pregnancy rate per cycle

Drug treatment impact on pregnancy rate per ET

Drug treatment impact on implantation rate

Drug treatment impact on No. of cancelled fresh Embryo Transfer (ET because of hyperstimulation risk

Drug treatment impact on cryopreservation

Drug treatment impact on No. of cryopreserved embryos/patient

Drug treatment impact on Ectopic Pregnancy Rate

Drug treatment impact on Gestational Diabetes Mellitus Rate

Drug treatment impact on Gestational hypertensive disorder (GHD) Rate

Drug treatment impact on gestational age at birth

Drug treatment impact on Type of Delivery Method

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