# Role of semaglutide in restoring ovulation in youth and adults with polycystic ovary syndrome

> **NIH NIH R01** · UNIVERSITY OF COLORADO DENVER · 2023 · $541,072

## Abstract

Polycystic ovary syndrome (PCOS), one of the most common endocrinopathies in women, presents with
anovulation in adolescence and reproductive dysfunction is worsened by excess weight. Females with PCOS
also have lowered insulin sensitivity (IS), which integrates obesity and reproductive abnormalities. Obesity as
well as excess testosterone and insulin are risk factors for endometrial carcinoma, secondary to the lack of
ovulatory cycles with excess hormonal stimulation of the endometrium. Despite the high prevalence and
gravity of comorbidities associated with PCOS, widely effective therapeutic options are lacking. Glucagon-like
peptide-1 receptor agonists (GLP-1 RA) increase post-prandial insulin secretion and modulate gut and
hypothalamic hormone responses to suppress appetite and cause weight loss. GLP-1 RA are approved to treat
diabetes, and in higher doses, obesity. Limited data on older and less potent GLP-1 RA, such as exenatide or
liraglutide, in women with PCOS are promising with improved menstrual frequency and lowered serum
testosterone. Our initial results following 4 months of treatment with a more potent and oral formulation GLP-
1 RA, semaglutide, in adolescents with PCOS and obesity demonstrated lower post-prandial glucose, a shifted
insulin curve to a more normal pattern with a resultant improved oral disposition index. The trial is too short
of duration to assess reproductive dysfunction, although there is a trend for decreased serum testosterone and
nearly half had improved menses frequency compared to the 4 months prior to the trial. Adolescents have
lower IS than adults, and youth with diabetes or obesity respond less to GLP-1 RA than adults. Work is needed
on the role of longer-term, more potent GLP-1 RA treatment in women with PCOS + obesity, especially across
the reproductive lifespan. Further, there is a gap in understanding the underlying features predictive of GLP-1
RA response, limiting the ability to include GLP-1 RA in a personalized therapy plan for PCOS.
 Our overarching hypothesis is that weight loss and metabolic improvements are required to improve
reproductive health in individuals with PCOS. The aims of this application will be performed in the context of a
year-long clinical trial. After a 4-month observation period of either no medication or metformin treatment, we
will treat females aged 12-35 years with obesity and PCOS for 10 months with semaglutide to induce weight
loss and improve ovulation and lower testosterone. We aim to: SA1) Quantitate ovulation frequency before
and after semaglutide in females with PCOS. SA2) Quantitate ovulation frequency following combination
treatment with semaglutide + metformin. SA3) The ovulation response to semaglutide will relate to baseline
characteristics and metabolic response to therapy. This study will define the reproductive impact of currently
available medications on this common, high-risk disease, with the potential to immediately change health
outcomes. We will al...

## Key facts

- **NIH application ID:** 10587181
- **Project number:** 1R01HD108340-01A1
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Melanie G Cree
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $541,072
- **Award type:** 1
- **Project period:** 2023-08-15 → 2028-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10587181

## Citation

> US National Institutes of Health, RePORTER application 10587181, Role of semaglutide in restoring ovulation in youth and adults with polycystic ovary syndrome (1R01HD108340-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10587181. Licensed CC0.

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