Effect of Semaglutide on Obese Female Patients with Polycystic Ovarian Disease: A Retrospective Observational Study and Systematic Review

Aim: This study aimed to evaluate the effects of semaglutide on weight loss, metabolic parameters, hormonal profiles, and menstrual regularity in obese female patients with polycystic ovarian syndrome (PCOS) through a retrospective observational analysis and systematic review of existing literature. The primary objective was to assess changes in body mass index (BMI) and secondary outcomes including insulin resistance (HOMA-IR), testosterone levels, and ovulation rates. We hypothesized that semaglutide would induce significant weight reduction and improve PCOS-related symptoms in this population. Materials and Methods: Medical records of 85 women (BMI >30 kg/m²) diagnosed with PCOS per Rotterdam criteria, treated with semaglutide (oral 7 and 14 mg) between June 2024 to January 2025 at a tertiary care center in Jabalpur, India, were reviewed retrospectively. Data extracted: baseline and post-treatment BMI, waist circumference, fasting glucose, insulin, HbA1c, total testosterone, and menstrual cycle regularity. For the systematic review, PubMed, Cochrane, and Scopus were searched (up to Oct 2025) for studies on semaglutide/GLP-1 agonists in obese PCOS women, following PRISMA guidelines. Randomized controlled trials (RCTs), observational studies, and meta-analyses were included; quality assessed via Newcastle-Ottawa Scale. Results: In our cohort (n=85, mean age 32.4±5.6 years, baseline BMI 36.2±4.1 kg/m²), semaglutide led to mean weight loss of 12.4 kg (95% CI: 10.8-14.0) at 6 months, BMI reduction to 30.1±3.8 kg/m² (p