(O-11) Effects of GLP-1 Receptor Agonists on Semen Quality in Men: A Systematic Review

Abstract

Abstract Background Male infertility is a growing concern, particularly in obese men, where metabolic dysfunction may impair spermatogenesis. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are commonly used to manage obesity and type 2 diabetes. While their metabolic benefits are well established, their potential role in improving semen quality is less understood. We aim to evaluate the effects of GLP-1RAs (liraglutide, semaglutide, and dulaglutide) on semen parameters in adult men. Methods We conducted a systematic review following PRISMA guidelines and registered the protocol in PROSPERO. A comprehensive search of PubMed, Embase, Scopus, and Web of Science up to April 2024 was performed. Eligible studies included randomized controlled trials, crossover studies, and cohort studies that assessed semen parameters (volume, concentration, motility, morphology) after GLP-1RA treatment. Comparators included placebo, metformin, or testosterone therapy. Results Four studies involving 215 participants were included. In obese men, liraglutide maintained diet-induced improvements in sperm concentration (1.49-fold) and total sperm count (1.41-fold) over one year and led to a 142.9% increase in sperm motility. Semaglutide improved the proportion of morphologically normal sperm, while testosterone therapy significantly reduced both sperm concentration and total count. Dulaglutide showed no significant effects on semen parameters in healthy men. Overall, improvements were more in obese or metabolically compromised individuals. Conclusions GLP-1 receptor agonists, particularly liraglutide, demonstrate a beneficial effect on semen quality, especially among obese men. These agents may support sperm concentration, motility, and morphology without the adverse reproductive effects observed with testosterone therapy. GLP-1RAs may offer a novel therapeutic avenue in managing male infertility associated with metabolic diso6rders.