{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T02:40:02Z","timestamp":1789094402267,"version":"build-2803163510"},"reference-count":213,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82401967"],"award-info":[{"award-number":["82401967"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>GLP-1 receptor agonists (GLP-1RAs) address key metabolic drivers of Polycystic Ovary Syndrome (PCOS), yet their integration into fertility management remains challenging because reproductive efficacy is variably reported, preconception washout is required, and standardized clinical pathways are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main body<\/jats:title>\n                    <jats:p>We present a structured, fertility-centered, hypothesis-generating narrative synthesis of the metabolic\u2013reproductive\u2013pregnancy continuum in PCOS, integrating evidence from randomized trials, observational studies, reviews, and clinical guidance. Heterogeneous findings are organized by intervention\/comparator, follow-up window, and key effect modifiers, including baseline obesity\/insulin-resistance phenotype, concomitant metformin, and lifestyle co-interventions. The clinical framework is derived from this narrative synthesis rather than from quantitative reproductive meta-analysis. As a methodological proof-of-concept only, we additionally performed a Bayesian network meta-analysis restricted to body-weight change within a prespecified 12\u201316-weeks window in the largest connected treatment network. Because ovulation, clinical pregnancy, time to pregnancy, and live birth were inconsistently defined and sparsely reported across trials, no confirmatory quantitative synthesis or treatment ranking was undertaken for these reproductive outcomes. We therefore distinguish evidence domains explicitly, with relatively robust support for short-term metabolic benefit but substantially greater uncertainty for reproductive translation and periconception safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The narrative evidence supports positioning GLP-1RAs as time-limited, preconception metabolic-optimization tools, not as confirmed fertility-enhancing therapies\n                      <jats:italic>per se<\/jats:italic>\n                      . Their use in PCOS fertility care should be individualized through shared decision-making, with explicit discussion of the difference between established metabolic benefit and hypothesis-generating reproductive benefit, together with drug-specific washout planning and strategies to minimize post-discontinuation rebound. Future trials should standardize reproductive endpoints and systematically capture periconception exposure to enable confirmatory synthesis and individualized benefit\u2013risk estimation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1809416","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T05:43:37Z","timestamp":1780379017000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Balancing metabolic optimization and reproductive safety in Polycystic Ovary Syndrome: a Bayesian-informed framework for GLP-1 receptor agonists"],"prefix":"10.3389","volume":"13","author":[{"given":"Enxue","family":"Song","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Anhui Medical University, Hefei","place":["Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Anhui Medical University, Hefei","place":["Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xilian","family":"Li","sequence":"additional","affiliation":[{"name":"Obstetrics & Gynecology Hospital of Fudan University, Shanghai Key Lab of Reproduction and Development, Shanghai Key Lab of Female Reproductive Endocrine Related Diseases","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenlan","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Third People\u2019s Hospital of Hubei Province","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiwei","family":"He","sequence":"additional","affiliation":[{"name":"Department of Urology, Changhai Hospital, Naval Medical University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyuan","family":"Gao","sequence":"additional","affiliation":[{"name":"Yueyang Integrated Traditional Chinese and Western Medicine Hospital, Shanghai University of TCM","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Cangzhou Central Hospital, Cangzhou","place":["Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biao","family":"Gao","sequence":"additional","affiliation":[{"name":"Teaching and Research Support Center, Naval Medical University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1358755","DOI":"10.3389\/fcell.2024.1358755","article-title":"PCOS stratification for precision diagnostics and treatment.","volume":"12","author":"Joshi","year":"2024","journal-title":"Front Cell Dev Biol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"16596","DOI":"10.1038\/s41598-024-67461-4","article-title":"Transcriptome profiling reveals dysregulation of inflammatory and protein synthesis genes in PCOS.","volume":"14","author":"Li","year":"2024","journal-title":"Sci Rep."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e230342","DOI":"10.1530\/JOE-23-0342","article-title":"Hormonal changes in PCOS.","volume":"261","author":"Yang","year":"2024","journal-title":"J Endocrinol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"2082","DOI":"10.1210\/clinem\/dgae917","article-title":"The influence of study quality, age, and geographic factors on PCOS prevalence-a systematic review and meta-analysis.","volume":"110","author":"Amiri","year":"2025","journal-title":"J Clin Endocrinol Metab."},{"key":"B5","volume-title":"Polycystic Ovary Syndrome.","year":"2025"},{"key":"B6","doi-asserted-by":"publisher","first-page":"26334941251384195","DOI":"10.1177\/26334941251384195","article-title":"Prevalence of polycystic ovary syndrome (PCOS) and its associated hormonal and comorbid risk factors in northeast india: a cross-sectional comparative study.","volume":"19","author":"Yasmin","year":"2025","journal-title":"Ther Adv Reprod Health."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1514250","DOI":"10.3389\/fpubh.2025.1514250","article-title":"Global burden of polycystic ovary syndrome among women of childbearing age, 1990\u20132021: a systematic analysis using the global burden of disease study 2021.","volume":"13","author":"Meng","year":"2025","journal-title":"Front Public Health."},{"key":"B8","doi-asserted-by":"publisher","first-page":"100619","DOI":"10.1016\/j.obmed.2025.100619","article-title":"Exploring female infertility: a comprehensive review of polycystic ovary syndrome (PCOS) and its impact on reproductive health.","volume":"55","author":"Parua","year":"2025","journal-title":"Obesity Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"74","DOI":"10.21037\/apm-20-1893","article-title":"The prevalence of polycystic ovarian syndrome in chinese women: a meta-analysis.","volume":"10","author":"Wu","year":"2021","journal-title":"Ann Palliat Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1177\/1745505717731971","article-title":"Pregnancy-related outcomes for women with polycystic ovary syndrome.","volume":"13","author":"Mcdonnell","year":"2017","journal-title":"Womens Health."},{"key":"B11","doi-asserted-by":"publisher","first-page":"e033572","DOI":"10.1161\/JAHA.123.033572","article-title":"2023 international evidence-based polycystic ovary syndrome guideline update: insights from a systematic review and meta-analysis on elevated clinical cardiovascular disease in polycystic ovary syndrome.","volume":"13","author":"Tay","year":"2024","journal-title":"J Am Heart Assoc."},{"key":"B12","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1016\/j.tem.2024.10.005","article-title":"Is cardiovascular disease in PCOS driven by MASLD?","volume":"36","author":"Chen","year":"2025","journal-title":"Trends Endocrinol Metab."},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1093\/biolre\/ioaf197","article-title":"Insulin resistance in polycystic ovary syndrome: pathophysiological mechanisms of menstrual dysfunction and evidence-based treatment strategies.","author":"Chen","year":"2025","journal-title":"Biol Reprod."},{"key":"B14","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/j.ecl.2020.11.001","article-title":"Cardiometabolic risk in polycystic ovary syndrome: current guidelines.","volume":"50","author":"Cooney","year":"2021","journal-title":"Endocrinol Metab Clin North Am."},{"key":"B15","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1111\/obr.12762","article-title":"Metabolic syndrome in polycystic ovary syndrome: a systematic review, meta-analysis and meta-regression.","volume":"20","author":"Lim","year":"2019","journal-title":"Obes Rev."},{"key":"B16","doi-asserted-by":"publisher","first-page":"108783","DOI":"10.1016\/j.isci.2024.108783","article-title":"Association of metabolic-dysfunction associated steatotic liver disease with polycystic ovary syndrome.","volume":"27","author":"Xu","year":"2024","journal-title":"iScience."},{"key":"B17","doi-asserted-by":"publisher","first-page":"2447","DOI":"10.1210\/clinem\/dgad463","article-title":"Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome.","volume":"108","author":"Teede","year":"2023","journal-title":"J Clin Endocrinol Metab."},{"key":"B18","doi-asserted-by":"publisher","first-page":"5642","DOI":"10.3390\/jcm14165642","article-title":"Obesity as a part of polycystic ovary syndrome (PCOS)-a review of pathophysiology and comprehensive therapeutic strategies.","volume":"14","author":"Bila","year":"2025","journal-title":"J Clin Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"518","DOI":"10.3390\/jpm15110518","article-title":"Impact of reducing obesity in PCOS: methods and treatment outcomes.","volume":"15","author":"Dzienny","year":"2025","journal-title":"J Pers Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1097\/RD9.0000000000000131","article-title":"Research progress on insulin resistance in polycystic ovary syndrome.","volume":"9","author":"Qi","year":"2025","journal-title":"Reprod Dev Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1210\/jcem-50-1-113","article-title":"Correlation of hyperandrogenism with hyperinsulinism in polycystic ovarian disease.","volume":"50","author":"Burghen","year":"1980","journal-title":"J Clin Endocrinol Metab."},{"key":"B22","doi-asserted-by":"publisher","first-page":"741764","DOI":"10.3389\/fendo.2021.741764","article-title":"Resistance to the insulin and elevated level of androgen: a major cause of polycystic ovary syndrome.","volume":"12","author":"Ding","year":"2021","journal-title":"Front Endocrinol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1210\/edrv.18.6.0318","article-title":"Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis.","volume":"18","author":"Dunaif","year":"1997","journal-title":"Endocr Rev."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1876","DOI":"10.1056\/NEJM199806253382603","article-title":"Effects of metformin on spontaneous and clomiphene-induced ovulation in the polycystic ovary syndrome.","volume":"338","author":"Nestler","year":"1998","journal-title":"N Engl J Med."},{"key":"B25","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.ecl.2020.10.002","article-title":"Diagnosis of polycystic ovary syndrome: which criteria to use and when?","volume":"50","author":"Chang","year":"2021","journal-title":"Endocrinol Metab Clin North Am."},{"key":"B26","doi-asserted-by":"publisher","first-page":"100159","DOI":"10.1016\/j.endmts.2024.100159","article-title":"When one size does not fit all: reconsidering PCOS etiology, diagnosis, clinical subgroups, and subgroup-specific treatments.","volume":"14","author":"Unfer","year":"2024","journal-title":"Endocr Metab Sci."},{"key":"B27","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1093\/emph\/eoz011","article-title":"Evolutionary origins of polycystic ovary syndrome: an environmental mismatch disorder.","volume":"2019","author":"Charifson","year":"2019","journal-title":"Evol Med Public Health."},{"key":"B28","doi-asserted-by":"publisher","first-page":"6120","DOI":"10.3390\/jcm12196120","article-title":"An evolutionary model for the ancient origins of polycystic ovary syndrome.","volume":"12","author":"Dumesic","year":"2023","journal-title":"J Clin Med."},{"key":"B29","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1186\/s12916-025-03901-w","article-title":"International evidence-based recommendations for polycystic ovary syndrome in adolescents.","volume":"23","author":"Pe\u00f1a","year":"2025","journal-title":"BMC Med."},{"key":"B30","doi-asserted-by":"publisher","first-page":"100228","DOI":"10.1016\/j.endmts.2025.100228","article-title":"The last update on polycystic ovary syndrome (PCOS), diagnosis criteria, and novel treatment.","volume":"17","author":"Ghafari","year":"2025","journal-title":"Endocr Metab Sci."},{"key":"B31","doi-asserted-by":"publisher","first-page":"16258","DOI":"10.1038\/s41598-025-01287-6","article-title":"Metabolic mediators of the overweight\u2019s effect on infertility in women with polycystic ovary syndrome.","volume":"15","author":"Jafari","year":"2025","journal-title":"Sci Rep."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1326546","DOI":"10.3389\/fendo.2023.1326546","article-title":"Obesity and its impact on female reproductive health: unraveling the connections.","volume":"14","author":"Zheng","year":"2023","journal-title":"Front Endocrinol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1501110","DOI":"10.3389\/fendo.2025.1501110","article-title":"Gestational diabetes mellitus and polycystic ovary syndrome, a position statement from EGOI-PCOS.","volume":"16","author":"Quaresima","year":"2025","journal-title":"Front Endocrinol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"e50725","DOI":"10.7759\/cureus.50725","article-title":"Gestational diabetes mellitus in the setting of polycystic ovarian syndrome: a systematic review.","volume":"15","author":"Slouha","year":"2023","journal-title":"Cureus."},{"key":"B35","doi-asserted-by":"publisher","first-page":"100127","DOI":"10.1016\/j.obpill.2024.100127","article-title":"Glucagon-like receptor-1 agonists for obesity: weight loss outcomes, tolerability, side effects, and risks.","volume":"12","author":"Ghusn","year":"2024","journal-title":"Obes Pillars."},{"key":"B36","doi-asserted-by":"publisher","first-page":"103363","DOI":"10.1016\/j.eclinm.2025.103363","article-title":"The expanding role of GLP-1 receptor agonists: a narrative review of current evidence and future directions.","volume":"86","author":"Moiz","year":"2025","journal-title":"EClinicalMedicine."},{"key":"B37","doi-asserted-by":"publisher","first-page":"e240046","DOI":"10.1530\/JOE-24-0046","article-title":"GLP-1 receptor agonist-based therapies and cardiovascular risk: a review of mechanisms.","volume":"263","author":"Mullur","year":"2024","journal-title":"J Endocrinol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"e40364","DOI":"10.1097\/MD.0000000000040364","article-title":"Effect of GLP-1 receptor agonists on weight and cardiovascular outcomes: a review.","volume":"103","author":"Raza","year":"2024","journal-title":"Medicine."},{"key":"B39","doi-asserted-by":"publisher","first-page":"5921","DOI":"10.3390\/jcm12185921","article-title":"Semaglutide treatment of excessive body weight in obese PCOS patients unresponsive to lifestyle programs.","volume":"12","author":"Carmina","year":"2023","journal-title":"J Clin Med."},{"key":"B40","doi-asserted-by":"publisher","first-page":"2058","DOI":"10.1038\/s41591-024-03015-5","article-title":"Long-term kidney outcomes of semaglutide in obesity and cardiovascular disease in the SELECT trial.","volume":"30","author":"Colhoun","year":"2024","journal-title":"Nat Med."},{"key":"B41","doi-asserted-by":"publisher","first-page":"e2427258","DOI":"10.1001\/jamanetworkopen.2024.27258","article-title":"Clinical outcomes of tirzepatide or GLP-1 receptor agonists in individuals with type 2 diabetes.","volume":"7","author":"Chuang","year":"2024","journal-title":"JAMA Netw Open."},{"key":"B42","doi-asserted-by":"publisher","first-page":"101740","DOI":"10.1016\/j.jacadv.2025.101740","article-title":"An observational study of cardiovascular outcomes of tirzepatide vs glucagon-like peptide-1 receptor agonists.","volume":"4","author":"Dani","year":"2025","journal-title":"JACC Adv."},{"key":"B43","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.1161\/CIRCULATIONAHA.124.070766","article-title":"Treating reproductive-aged women with glucagon-like peptide-1 receptor agonists: what are the clinical considerations?","volume":"150","author":"Sharma","year":"2024","journal-title":"Circulation."},{"key":"B44","doi-asserted-by":"publisher","first-page":"e083550","DOI":"10.1136\/bmjopen-2023-083550","article-title":"Use of GLP1 receptor agonists in early pregnancy and reproductive safety: a multicentre, observational, prospective cohort study based on the databases of six teratology information services.","volume":"14","author":"Dao","year":"2024","journal-title":"BMJ Open."},{"key":"B45","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.ajog.2024.08.024","article-title":"Glucagon-like peptide-1 receptor agonist use in pregnancy: a review.","volume":"232","author":"Drummond","year":"2025","journal-title":"Am J Obstet Gynecol."},{"key":"B46","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1001\/jama.2023.26112","article-title":"First large study of GLP-1 receptor agonists during pregnancy.","volume":"331","author":"Harris","year":"2024","journal-title":"JAMA."},{"key":"B47","doi-asserted-by":"publisher","first-page":"4102","DOI":"10.1111\/dom.16437","article-title":"Glucagon-like peptide 1 (GLP-1) receptor agonists\u2019 use during pregnancy: safety data from regulatory clinical trials.","volume":"27","author":"Parker","year":"2025","journal-title":"Diabetes Obes Metab."},{"key":"B48","doi-asserted-by":"publisher","first-page":"100298","DOI":"10.1016\/j.clinme.2025.100298","article-title":"GLP-1 receptor agonist therapy and pregnancy: evolving and emerging evidence.","volume":"25","author":"Varughese","year":"2025","journal-title":"Clin Med."},{"key":"B49","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1038\/nrendo.2018.24","article-title":"Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment.","volume":"14","author":"Escobar-Morreale","year":"2018","journal-title":"Nat Rev Endocrinol."},{"key":"B50","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1093\/humupd\/dmp008","article-title":"Metabolic features of the reproductive phenotypes of polycystic ovary syndrome.","volume":"15","author":"Moran","year":"2009","journal-title":"Hum Reprod Update."},{"key":"B51","doi-asserted-by":"publisher","first-page":"e1003132","DOI":"10.1371\/journal.pmed.1003132","article-title":"Distinct subtypes of polycystic ovary syndrome with novel genetic associations: an unsupervised, phenotypic clustering analysis.","volume":"17","author":"Dapas","year":"2020","journal-title":"PLoS Med."},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-025-03984-1","article-title":"Data-driven subtypes of polycystic ovary syndrome and their association with clinical outcomes.","author":"Gao","year":"2025","journal-title":"Nat Med."},{"key":"B53","doi-asserted-by":"publisher","first-page":"7030","DOI":"10.1073\/pnas.0602025103","article-title":"Evidence for metabolic and reproductive phenotypes in mothers of women with polycystic ovary syndrome.","volume":"103","author":"Sam","year":"2006","journal-title":"Proc Natl Acad Sci U S A."},{"key":"B54","doi-asserted-by":"publisher","first-page":"108872","DOI":"10.1016\/j.jdiacomp.2024.108872","article-title":"Emerging treatment strategies for polycystic ovary syndrome women with obesity: focus on glucagon-like peptide-1 receptor agonists.","volume":"38","author":"Jensterle","year":"2024","journal-title":"J Diabetes Complications."},{"key":"B55","doi-asserted-by":"publisher","first-page":"359","DOI":"10.2147\/ITT.S499605","article-title":"Interplay between insulin resistance and immune dysregulation in type 2 diabetes mellitus: implications for therapeutic interventions.","volume":"14","author":"Berbudi","year":"2025","journal-title":"Immunotargets Ther."},{"key":"B56","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1097\/00041433-199802000-00008","article-title":"Abdominal obesity.","volume":"9","author":"Carey","year":"1998","journal-title":"Curr Opin Lipidol."},{"key":"B57","doi-asserted-by":"publisher","first-page":"4315413","DOI":"10.1155\/2018\/4315413","article-title":"Role of lipotoxicity and contribution of the renin-angiotensin system in the development of polycystic ovary syndrome.","volume":"2018","author":"Connolly","year":"2018","journal-title":"Int J Endocrinol."},{"key":"B58","doi-asserted-by":"publisher","first-page":"19160","DOI":"10.1038\/s41598-021-98819-7","article-title":"Distinct mechanisms involving diacylglycerol, ceramides, and inflammation underlie insulin resistance in oxidative and glycolytic muscles from high fat-fed rats.","volume":"11","author":"Jani","year":"2021","journal-title":"Sci Rep."},{"key":"B59","doi-asserted-by":"publisher","first-page":"E108","DOI":"10.1152\/ajpendo.00471.2005","article-title":"Influence of TNF-alpha and IL-6 infusions on insulin sensitivity and expression of IL-18 in humans.","volume":"291","author":"Krogh-Madsen","year":"2006","journal-title":"Am J Physiol Endocrinol Metab."},{"key":"B60","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1016\/j.ando.2022.11.004","article-title":"Polycystic ovary syndrome and adipose tissue.","volume":"84","author":"Lemaitre","year":"2023","journal-title":"Ann Endocrinol."},{"key":"B61","doi-asserted-by":"publisher","first-page":"3110","DOI":"10.1210\/jcem.84.9.6010","article-title":"Selective insulin resistance in the polycystic ovary syndrome.","volume":"84","author":"Book","year":"1999","journal-title":"J Clin Endocrinol Metab."},{"key":"B62","doi-asserted-by":"publisher","first-page":"267","DOI":"10.3389\/fendo.2020.00267","article-title":"The immune landscape of visceral adipose tissue during obesity and aging.","volume":"11","author":"Khan","year":"2020","journal-title":"Front Endocrinol."},{"key":"B63","doi-asserted-by":"publisher","first-page":"1153915","DOI":"10.3389\/fimmu.2023.1153915","article-title":"Adipose tissue macrophages as potential targets for obesity and metabolic diseases.","volume":"14","author":"Li","year":"2023","journal-title":"Front Immunol."},{"key":"B64","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1097\/OGX.0000000000000661","article-title":"Polycystic ovary syndrome: impact of lipotoxicity on metabolic and reproductive health.","volume":"74","author":"Brennan","year":"2019","journal-title":"Obstet Gynecol Surv."},{"key":"B65","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1146\/annurev-animal-111523-102249","article-title":"Lipotoxicity and oocyte quality in mammals: pathogenesis, consequences, and reversibility.","volume":"13","author":"Meulders","year":"2025","journal-title":"Annu Rev Anim Biosci."},{"key":"B66","doi-asserted-by":"publisher","first-page":"17455057251376883","DOI":"10.1177\/17455057251376883","article-title":"Relationship between MASLD and women\u2019s health: a review.","volume":"21","author":"Jancova","year":"2025","journal-title":"Womens Health."},{"key":"B67","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1210\/clinem\/dgac567","article-title":"Nonalcoholic fatty liver disease and adverse pregnancy outcomes in women with normal prepregnant weight.","volume":"108","author":"Qian","year":"2023","journal-title":"J Clin Endocrinol Metab."},{"key":"B68","doi-asserted-by":"publisher","first-page":"e186426","DOI":"10.1172\/JCI186426","article-title":"Metabolic dysfunction-associated steatotic liver disease and pregnancy.","volume":"135","author":"Sarkar","year":"2025","journal-title":"J Clin Invest."},{"key":"B69","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1002\/cphy.c190025","article-title":"Glucagon-like peptide-1: actions and influence on pancreatic hormone function.","volume":"10","author":"Davis","year":"2020","journal-title":"Compr Physiol."},{"key":"B70","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1152\/physrev.00013.2014","article-title":"Physiology of proglucagon peptides: role of glucagon and GLP-1 in health and disease.","volume":"95","author":"Sandoval","year":"2015","journal-title":"Physiol Rev."},{"key":"B71","doi-asserted-by":"publisher","first-page":"4223","DOI":"10.1172\/JCI78371","article-title":"Glucagon-like peptide-1 receptors in the brain: controlling food intake and body weight.","volume":"124","author":"Baggio","year":"2014","journal-title":"J Clin Invest."},{"key":"B72","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1016\/j.molmet.2015.07.008","article-title":"Distribution and characterisation of glucagon-like peptide-1 receptor expressing cells in the mouse brain.","volume":"4","author":"Cork","year":"2015","journal-title":"Mol Metab."},{"key":"B73","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1007\/s00429-020-02189-1","article-title":"Distribution and ultrastructural localization of the glucagon-like peptide-1 receptor (GLP-1r) in the rat brain.","volume":"226","author":"Farkas","year":"2021","journal-title":"Brain Struct Funct."},{"key":"B74","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1038\/s41392-024-01931-z","article-title":"Glucagon-like peptide-1 receptor: mechanisms and advances in therapy.","volume":"9","author":"Zheng","year":"2024","journal-title":"Signal Transduct Target Ther."},{"key":"B75","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1016\/j.amjmed.2025.01.021","article-title":"Mechanisms of GLP-1 receptor agonist-induced weight loss: a review of central and peripheral pathways in appetite and energy regulation.","volume":"138","author":"Moiz","year":"2025","journal-title":"Am J Med."},{"key":"B76","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.3390\/pharmaceutics17081036","article-title":"Emerging frontiers in GLP-1 therapeutics: a comprehensive evidence base (2025).","volume":"17","author":"Patel","year":"2025","journal-title":"Pharmaceutics."},{"key":"B77","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1111\/dom.16364","article-title":"Real-world evidence on the utilization, clinical and comparative effectiveness, and adverse effects of newer GLP-1RA-based weight-loss therapies.","volume":"27","author":"Thomsen","year":"2025","journal-title":"Diabetes Obes Metab."},{"key":"B78","doi-asserted-by":"publisher","first-page":"16512","DOI":"10.1038\/s41598-025-99622-4","article-title":"Efficacy and safety of GLP-1 receptor agonists on weight management and metabolic parameters in PCOS women: a meta-analysis of randomized controlled trials.","volume":"15","author":"Lin","year":"2025","journal-title":"Sci Rep."},{"key":"B79","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1111\/dom.13053","article-title":"Effect of liraglutide on ectopic fat in polycystic ovary syndrome: a randomized clinical trial.","volume":"20","author":"Fr\u00f8ssing","year":"2018","journal-title":"Diabetes Obes Metab."},{"key":"B80","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1002\/dmrr.2713","article-title":"Comparative efficacy of anti-diabetic agents on nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized and non-randomized studies.","volume":"32","author":"Tang","year":"2016","journal-title":"Diabetes Metab Res Rev."},{"key":"B81","doi-asserted-by":"publisher","first-page":"S207","DOI":"10.2337\/dc25-S010","article-title":"Cardiovascular disease and risk management: standards of care in diabetes-2025.","volume":"48","year":"2025","journal-title":"Diabetes Care."},{"key":"B82","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1053\/j.ajkd.2024.11.013","article-title":"Kidney and cardiovascular outcomes among patients with CKD receiving GLP-1 receptor agonists: a systematic review and meta-analysis of randomized trials.","volume":"85","author":"Chen","year":"2025","journal-title":"Am J Kidney Dis."},{"key":"B83","doi-asserted-by":"publisher","first-page":"20420188251383064","DOI":"10.1177\/20420188251383064","article-title":"The dual impact of GLP-1 receptor agonists on metabolic and reproductive health in polycystic ovary syndrome: insights from human and animal trials.","volume":"16","author":"Hoteit","year":"2025","journal-title":"Ther Adv Endocrinol Metab."},{"key":"B84","doi-asserted-by":"publisher","first-page":"170481","DOI":"10.1016\/j.peptides.2020.170481","article-title":"The glucagon-like peptide-1 (GLP-1) analog exenatide ameliorates intrauterine adhesions in mice.","volume":"137","author":"Ma","year":"2021","journal-title":"Peptides."},{"key":"B85","doi-asserted-by":"publisher","first-page":"108834","DOI":"10.1016\/j.jdiacomp.2024.108834","article-title":"The efficacy and safety of GLP-1 agonists in PCOS women living with obesity in promoting weight loss and hormonal regulation: a meta-analysis of randomized controlled trials.","volume":"38","author":"Austreg\u00e9silo De Athayde De Hollanda Morais","year":"2024","journal-title":"J Diabetes Complications."},{"key":"B86","doi-asserted-by":"publisher","first-page":"888460","DOI":"10.3389\/fendo.2022.888460","article-title":"The lifestyle modifications and endometrial proteome changes of women with polycystic ovary syndrome and obesity.","volume":"13","author":"Abdulkhalikova","year":"2022","journal-title":"Front Endocrinol."},{"key":"B87","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1002\/rmb2.12034","article-title":"Weight reduction using a formula diet recovers menstruation in obese patients with an ovulatory disorder.","volume":"16","author":"Matsuzaki","year":"2017","journal-title":"Reprod Med Biol."},{"key":"B88","doi-asserted-by":"publisher","first-page":"62","DOI":"10.4103\/0974-1208.69332","article-title":"The impact of female obesity on the outcome of fertility treatment.","volume":"3","author":"Pandey","year":"2010","journal-title":"J Hum Reprod Sci."},{"key":"B89","doi-asserted-by":"publisher","first-page":"1078","DOI":"10.1093\/humrep\/deae058","article-title":"Resumption of ovulation in anovulatory women with PCOS and obesity is associated with reduction of 11\u03b2-hydroxyandrostenedione concentrations.","volume":"39","author":"Wang","year":"2024","journal-title":"Hum Reprod."},{"key":"B90","doi-asserted-by":"publisher","first-page":"214","DOI":"10.3389\/fncel.2016.00214","article-title":"Glucagon-like peptide-1 excites firing and increases GABAergic miniature postsynaptic currents (mPSCs) in gonadotropin-releasing hormone (GnRH) neurons of the male mice via activation of nitric oxide (NO) and suppression of endocannabinoid signaling pathways.","volume":"10","author":"Farkas","year":"2016","journal-title":"Front Cell Neurosci."},{"key":"B91","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1007\/s00429-020-02167-7","article-title":"Networking of glucagon-like peptide-1 axons with GnRH neurons in the basal forebrain of male mice revealed by 3DISCO-based immunocytochemistry and optogenetics.","volume":"226","author":"Vastagh","year":"2021","journal-title":"Brain Struct Funct."},{"key":"B92","doi-asserted-by":"publisher","first-page":"3304","DOI":"10.3390\/nu12113304","article-title":"Glucagon-like peptide-1 (GLP-1) in the integration of neural and endocrine responses to stress.","volume":"12","author":"Diz-Chaves","year":"2020","journal-title":"Nutrients."},{"key":"B93","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1016\/j.fertnstert.2019.06.018","article-title":"Body-image distress is increased in women with polycystic ovary syndrome and mediates depression and anxiety.","volume":"112","author":"Alur-Gupta","year":"2019","journal-title":"Fertil Steril."},{"key":"B94","doi-asserted-by":"publisher","first-page":"R1","DOI":"10.1093\/ejendo\/lvad110","article-title":"Body image concerns in women with polycystic ovary syndrome: a systematic review and meta-analysis.","volume":"189","author":"Davitadze","year":"2023","journal-title":"Eur J Endocrinol."},{"key":"B95","doi-asserted-by":"publisher","first-page":"942","DOI":"10.3390\/medicina58070942","article-title":"Anxiety and depression in women with polycystic ovary syndrome.","volume":"58","author":"Dybciak","year":"2022","journal-title":"Medicina."},{"key":"B96","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/j.rbmo.2017.03.023","article-title":"Effects of liraglutide on ovarian dysfunction in polycystic ovary syndrome: a randomized clinical trial.","volume":"35","author":"Nylander","year":"2017","journal-title":"Reprod Biomed Online."},{"key":"B97","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1530\/EC-16-0113","article-title":"Liraglutide in polycystic ovary syndrome: a randomized trial, investigating effects on thrombogenic potential.","volume":"6","author":"Nylander","year":"2017","journal-title":"Endocr Connect."},{"key":"B98","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1016\/j.fertnstert.2022.04.027","article-title":"Liraglutide 3 mg on weight, body composition, and hormonal and metabolic parameters in women with obesity and polycystic ovary syndrome: a randomized placebo-controlled-phase 3 study.","volume":"118","author":"Elkind-Hirsch","year":"2022","journal-title":"Fertil Steril."},{"key":"B99","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1530\/EJE-13-0797","article-title":"Short-term combined treatment with liraglutide and metformin leads to significant weight loss in obese women with polycystic ovary syndrome and previous poor response to metformin.","volume":"170","author":"Jensterle Sever","year":"2014","journal-title":"Eur J Endocrinol."},{"key":"B100","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/s13048-015-0161-3","article-title":"Short term monotherapy with GLP-1 receptor agonist liraglutide or PDE 4 inhibitor roflumilast is superior to metformin in weight loss in obese PCOS women: a pilot randomized study.","volume":"8","author":"Jensterle","year":"2015","journal-title":"J Ovarian Res."},{"key":"B101","doi-asserted-by":"publisher","first-page":"1194","DOI":"10.3892\/etm.2016.3081","article-title":"Metformin as an initial adjunct to low-dose liraglutide enhances the weight-decreasing potential of liraglutide in obese polycystic ovary syndrome: randomized control study.","volume":"11","author":"Jensterle","year":"2016","journal-title":"Exp Ther Med."},{"key":"B102","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1530\/EJE-18-0175","article-title":"Liraglutide increases IVF pregnancy rates in obese PCOS women with poor response to first-line reproductive treatments: a pilot randomized study.","volume":"179","author":"Salamun","year":"2018","journal-title":"Eur J Endocrinol."},{"key":"B103","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1007\/s12020-023-03487-4","article-title":"Effects and plasma proteomic analysis of GLP-1RA versus CPA\/EE, in combination with metformin, on overweight PCOS women: a randomized controlled trial.","volume":"83","author":"Liao","year":"2024","journal-title":"Endocrine."},{"key":"B104","doi-asserted-by":"publisher","first-page":"945609","DOI":"10.3389\/fendo.2022.945609","article-title":"Effect of metformin versus metformin plus liraglutide on gonadal and metabolic profiles in overweight patients with polycystic ovary syndrome.","volume":"13","author":"Xing","year":"2022","journal-title":"Front Endocrinol."},{"key":"B105","doi-asserted-by":"publisher","first-page":"975","DOI":"10.1111\/dom.14944","article-title":"Semaglutide delays 4-hour gastric emptying in women with polycystic ovary syndrome and obesity.","volume":"25","author":"Jensterle","year":"2023","journal-title":"Diabetes Obes Metab."},{"key":"B106","doi-asserted-by":"publisher","first-page":"108935","DOI":"10.1016\/j.diabres.2021.108935","article-title":"Semaglutide reduces fat accumulation in the tongue: a randomized single-blind, pilot study.","volume":"178","author":"Jensterle","year":"2021","journal-title":"Diabetes Res Clin Pract."},{"key":"B107","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1186\/s12958-025-01447-3","article-title":"Effects of combined metformin and semaglutide therapy on body weight, metabolic parameters, and reproductive outcomes in overweight\/obese women with polycystic ovary syndrome: a prospective, randomized, controlled, open-label clinical trial.","volume":"23","author":"Chen","year":"2025","journal-title":"Reprod Biol Endocrinol."},{"key":"B108","doi-asserted-by":"publisher","first-page":"556","DOI":"10.3390\/nu15030556","article-title":"Effects of a dulaglutide plus calorie-restricted diet versus a calorie-restricted diet on visceral fat and metabolic profiles in women with polycystic ovary syndrome: a randomized controlled trial.","volume":"15","author":"Zhang","year":"2023","journal-title":"Nutrients."},{"key":"B109","doi-asserted-by":"publisher","first-page":"2670","DOI":"10.1210\/jc.2008-0115","article-title":"Comparison of single and combined treatment with exenatide and metformin on menstrual cyclicity in overweight women with polycystic ovary syndrome.","volume":"93","author":"Elkind-Hirsch","year":"2008","journal-title":"J Clin Endocrinol Metab."},{"key":"B110","doi-asserted-by":"publisher","first-page":"e1420","DOI":"10.1210\/clinem\/dgaa692","article-title":"Exenatide, metformin, or both for prediabetes in PCOS: a randomized, open-label, parallel-group controlled study.","volume":"106","author":"Tao","year":"2021","journal-title":"J Clin Endocrinol Metab."},{"key":"B111","doi-asserted-by":"publisher","first-page":"1711","DOI":"10.1007\/s00404-022-06700-3","article-title":"Effect of metformin and exenatide on pregnancy rate and pregnancy outcomes in overweight or obese infertility PCOS women: long-term follow-up of an RCT.","volume":"306","author":"Li","year":"2022","journal-title":"Arch Gynecol Obstet."},{"key":"B112","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1111\/cen.13454","article-title":"Efficacy of exenatide on weight loss, metabolic parameters and pregnancy in overweight\/obese polycystic ovary syndrome.","volume":"87","author":"Liu","year":"2017","journal-title":"Clin Endocrinol."},{"key":"B113","doi-asserted-by":"publisher","first-page":"3019","DOI":"10.1210\/clinem\/dgab408","article-title":"Exenatide, dapagliflozin, or phentermine\/topiramate differentially affect metabolic profiles in polycystic ovary syndrome.","volume":"106","author":"Elkind-Hirsch","year":"2021","journal-title":"J Clin Endocrinol Metab."},{"key":"B114","doi-asserted-by":"publisher","first-page":"4288004","DOI":"10.1155\/2023\/4288004","article-title":"Action mechanisms of metformin combined with exenatide and metformin only in the treatment of PCOS in obese patients.","volume":"2023","author":"Gan","year":"2023","journal-title":"Int J Endocrinol."},{"key":"B115","doi-asserted-by":"publisher","first-page":"2882","DOI":"10.1097\/CM9.0000000000001712","article-title":"Short-term combined treatment with exenatide and metformin for overweight\/obese women with polycystic ovary syndrome.","volume":"134","author":"Ma","year":"2021","journal-title":"Chin Med J."},{"key":"B116","doi-asserted-by":"publisher","first-page":"20420188251355411","DOI":"10.1177\/20420188251355411","article-title":"Combined metformin and exenatide versus only metformin treatments in polycystic ovary syndrome with abdominal obesity and network pharmacology of gene expression: evidence from a randomized clinical trial.","volume":"16","author":"Xuesong","year":"2025","journal-title":"Ther Adv Endocrinol Metab."},{"key":"B117","doi-asserted-by":"publisher","first-page":"17455057241234530","DOI":"10.1177\/17455057241234530","article-title":"A systematic review of GLP-1 on anthropometrics, metabolic and endocrine parameters in patients with PCOS.","volume":"20","author":"Bader","year":"2024","journal-title":"Womens Health."},{"key":"B118","doi-asserted-by":"publisher","first-page":"e13704","DOI":"10.1111\/obr.13704","article-title":"Anti-obesity pharmacological agents for polycystic ovary syndrome: a systematic review and meta-analysis to inform the 2023 international evidence-based guideline.","volume":"25","author":"Goldberg","year":"2024","journal-title":"Obes Rev."},{"key":"B119","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1210\/clinem\/dgae481","article-title":"Risk of type 2 diabetes, MASLD and cardiovascular disease in people living with polycystic ovary syndrome.","volume":"110","author":"Henney","year":"2025","journal-title":"J Clin Endocrinol Metab."},{"key":"B120","doi-asserted-by":"publisher","first-page":"e2432420","DOI":"10.1001\/jamanetworkopen.2024.32420","article-title":"Birth weight, gestational age, and risk of pediatric-onset MASLD.","volume":"7","author":"Ebrahimi","year":"2024","journal-title":"JAMA Netw Open."},{"key":"B121","doi-asserted-by":"publisher","first-page":"103238","DOI":"10.1016\/j.eclinm.2025.103238","article-title":"Adverse pregnancy and birth outcomes in women with biopsy-proven MASLD: a nationwide cohort study.","volume":"83","author":"Marxer","year":"2025","journal-title":"EClinicalMedicine."},{"key":"B122","doi-asserted-by":"publisher","first-page":"33","DOI":"10.20517\/mtod.2025.17","article-title":"Effects of steatotic liver disease and cardiometabolic risk factors in MASLD on adverse pregnancy outcomes.","volume":"5","author":"Yang","year":"2025","journal-title":"Metab Target Organ Damage."},{"key":"B123","doi-asserted-by":"publisher","first-page":"1366940","DOI":"10.3389\/fendo.2024.1366940","article-title":"The maintenance of long-term weight loss after semaglutide withdrawal in obese women with PCOS treated with metformin: a 2-year observational study.","volume":"15","author":"Jensterle","year":"2024","journal-title":"Front Endocrinol."},{"key":"B124","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1186\/s12902-023-01500-5","article-title":"Effects of GLP1RAs on pregnancy rate and menstrual cyclicity in women with polycystic ovary syndrome: a meta-analysis and systematic review.","volume":"23","author":"Zhou","year":"2023","journal-title":"BMC Endocr Disord."},{"key":"B125","doi-asserted-by":"publisher","first-page":"140","DOI":"10.3389\/fendo.2014.00140","article-title":"The effect of liraglutide on weight loss in women with polycystic ovary syndrome: an observational study.","volume":"5","author":"Rasmussen","year":"2014","journal-title":"Front Endocrinol."},{"key":"B126","doi-asserted-by":"publisher","first-page":"979","DOI":"10.12688\/f1000research.167998.1","article-title":"Role of liraglutide in weight management and reproductive health in women with obesity and PCOS- a critical review of the evidence.","volume":"14","author":"Shetty","year":"2025","journal-title":"F1000Research."},{"key":"B127","doi-asserted-by":"publisher","first-page":"2349","DOI":"10.1007\/s43032-023-01222-y","article-title":"The effectiveness and safety of exenatide versus metformin in patients with polycystic ovary syndrome: a meta-analysis of randomized controlled trials.","volume":"30","author":"Ye","year":"2023","journal-title":"Reprod Sci."},{"key":"B128","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1186\/s12902-023-01497-x","article-title":"Comparison of exenatide alone or combined with metformin versus metformin in the treatment of polycystic ovaries: a systematic review and meta-analysis.","volume":"23","author":"Hu","year":"2023","journal-title":"BMC Endocr Disord."},{"key":"B129","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.obmed.2017.06.003","article-title":"Short term monotherapy with exenatide is superior to metformin in weight loss, improving insulin resistance and inflammation in chinese overweight\/obese PCOS women.","volume":"7","author":"Zheng","year":"2017","journal-title":"Obesity Medicine."},{"key":"B130","doi-asserted-by":"publisher","first-page":"1761","DOI":"10.1007\/s40618-023-02084-6","article-title":"Liraglutide and polycystic ovary syndrome: is it only a matter of body weight?","volume":"46","author":"Pugliese","year":"2023","journal-title":"J Endocrinol Invest."},{"key":"B131","doi-asserted-by":"publisher","first-page":"4297","DOI":"10.2147\/DDDT.S522730","article-title":"Semaglutide alleviates ovarian oxidative stress and autophagy via the pi3k\/akt\/mtor pathway in mice with polycystic ovary syndrome.","volume":"19","author":"Guo","year":"2025","journal-title":"Drug Des Devel Ther."},{"key":"B132","doi-asserted-by":"publisher","first-page":"103191","DOI":"10.1016\/j.jogc.2025.103191","article-title":"Pregnancy outcomes of maternal periconceptional exposure to glucagon-like peptide-1 receptor agonists: a scoping review of evidence and reporting trends.","volume":"48","author":"Lee","year":"2025","journal-title":"J Obstet Gynaecol Can."},{"key":"B133","doi-asserted-by":"publisher","first-page":"1241","DOI":"10.1007\/s00404-024-07849-9","article-title":"Considering the use of GLP-1 receptor agonists in women with obesity prior to pregnancy: a narrative review.","volume":"311","author":"Price","year":"2025","journal-title":"Arch Gynecol Obstet."},{"key":"B134","volume-title":"BYETTA (exenatide) Injection, for Subcutaneous Use: Prescribing Information.","year":"2005"},{"key":"B135","volume-title":"Ozempic (semaglutide) Injection, for Subcutaneous Use: Prescribing Information.","year":"2017"},{"key":"B136","volume-title":"Victoza (liraglutide) Injection: Prescribing Information.","year":"2017"},{"key":"B137","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.20951","article-title":"Gestational weight gain and pregnancy outcomes after GLP-1 receptor agonist discontinuation.","author":"Maya","year":"2025","journal-title":"JAMA."},{"key":"B138","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1080\/09513590.2018.1505848","article-title":"The effects of treatment with liraglutide on quality of life and depression in young obese women with PCOS and controls.","volume":"35","author":"Kahal","year":"2019","journal-title":"Gynecol Endocrinol."},{"key":"B139","doi-asserted-by":"publisher","first-page":"2117","DOI":"10.1056\/NEJMoa1916038","article-title":"A randomized, controlled trial of liraglutide for adolescents with obesity.","volume":"382","author":"Kelly","year":"2020","journal-title":"N Engl J Med."},{"key":"B140","doi-asserted-by":"publisher","first-page":"645563","DOI":"10.3389\/fendo.2021.645563","article-title":"Safety of semaglutide.","volume":"12","author":"Smits","year":"2021","journal-title":"Front Endocrinol."},{"key":"B141","doi-asserted-by":"publisher","first-page":"860","DOI":"10.18553\/jmcp.2024.23332","article-title":"Real-world persistence and adherence to glucagon-like peptide-1 receptor agonists among obese commercially insured adults without diabetes.","volume":"30","author":"Gleason","year":"2024","journal-title":"J Manag Care Spec Pharm."},{"key":"B142","doi-asserted-by":"publisher","first-page":"e2457349","DOI":"10.1001\/jamanetworkopen.2024.57349","article-title":"Discontinuation and reinitiation of dual-labeled glp-1 receptor agonists among us adults with overweight or obesity.","volume":"8","author":"Rodriguez","year":"2025","journal-title":"JAMA Netw Open."},{"key":"B143","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1001\/jamainternmed.2022.0338","article-title":"Association of glucagon-like peptide-1 receptor agonist use with risk of gallbladder and biliary diseases: a systematic review and meta-analysis of randomized clinical trials.","volume":"182","author":"He","year":"2022","journal-title":"JAMA Intern Med."},{"key":"B144","doi-asserted-by":"publisher","first-page":"944","DOI":"10.3390\/jcm14030944","article-title":"Pancreatitis risk associated with GLP-1 receptor agonists, considered as a single class, in a comorbidity-free subgroup of type 2 diabetes patients in the United States: a propensity score-matched analysis.","volume":"14","author":"Ayoub","year":"2025","journal-title":"J Clin Med."},{"key":"B145","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1001\/jamaoto.2024.4852","article-title":"GLP-1RA use and thyroid cancer risk.","volume":"151","author":"Brito","year":"2025","journal-title":"JAMA Otolaryngol Head Neck Surg."},{"key":"B146","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1007\/s12020-020-02223-6","article-title":"GLP-1 receptor agonists and pancreatic safety concerns in type 2 diabetic patients: data from cardiovascular outcome trials.","volume":"68","author":"Cao","year":"2020","journal-title":"Endocrine."},{"key":"B147","doi-asserted-by":"publisher","first-page":"e3061","DOI":"10.1002\/dmrr.3061","article-title":"No pancreatic safety concern following glucagon-like peptide-1 receptor agonist therapies: a pooled analysis of cardiovascular outcome trials.","volume":"34","author":"Liu","year":"2018","journal-title":"Diabetes Metab Res Rev."},{"key":"B148","doi-asserted-by":"publisher","first-page":"1538","DOI":"10.1210\/en.2011-1864","article-title":"GLP-1 receptor agonists and the thyroid: c-cell effects in mice are mediated via the GLP-1 receptor and not associated with RET activation.","volume":"153","author":"Madsen","year":"2012","journal-title":"Endocrinology."},{"key":"B149","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1001\/jamaophthalmol.2024.2296","article-title":"Risk of nonarteritic anterior ischemic optic neuropathy in patients prescribed semaglutide.","volume":"142","author":"Hathaway","year":"2024","journal-title":"JAMA Ophthalmol."},{"key":"B150","doi-asserted-by":"publisher","first-page":"208","DOI":"10.37557\/gjphm.v7i1.336","article-title":"Rebound obesity after GLP-1 agonists discontinuation.","volume":"7","author":"Al-Shammaa","year":"2025","journal-title":"Glob J Public Health Med."},{"key":"B151","doi-asserted-by":"publisher","first-page":"e94926","DOI":"10.7759\/cureus.94926","article-title":"Rebound or retention: a meta-analysis of weight regain after the discontinuation of glucagon-like peptide-1 (GLP-1) receptor agonists and other anti-obesity drugs.","volume":"17","author":"Kolli","year":"2025","journal-title":"Cureus."},{"key":"B152","doi-asserted-by":"publisher","first-page":"1553","DOI":"10.1111\/dom.14725","article-title":"Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP1 trial extension.","volume":"24","author":"Wilding","year":"2022","journal-title":"Diabetes Obes Metab."},{"key":"B153","volume-title":"Wegovy (semaglutide): EPAR - Product Information.","year":"2024"},{"key":"B154","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1097\/MED.0000000000000835","article-title":"Glucagon-like peptide-1 receptor agonists and safety in the preconception period.","volume":"30","author":"Minis","year":"2023","journal-title":"Curr Opin Endocrinol Diabetes Obes."},{"key":"B155","doi-asserted-by":"publisher","first-page":"313","DOI":"10.25259\/IJMR_497_2025","article-title":"Efficacy & safety of sodium-glucose cotransporter-2 inhibitors in polycystic ovary syndrome: a meta-analysis with trial sequential analysis.","volume":"162","author":"Ahsan","year":"2025","journal-title":"Indian J Med Res."},{"key":"B156","doi-asserted-by":"publisher","first-page":"20503121241308997","DOI":"10.1177\/20503121241308997","article-title":"Effects of SGLT-2 inhibitors on clinical and biological hyperandrogenism and menstruation irregularities in patients with polycystic ovary syndrome: a systematic review of randomized trials.","volume":"12","author":"Mrabet","year":"2024","journal-title":"SAGE Open Med."},{"key":"B157","unstructured":"Semaglutide Pregnancy and Breastfeeding Warnings.\n          \n          2024"},{"key":"B158","volume-title":"ZEPBOUND (tirzepatide) Injection, for Subcutaneous Use: Prescribing Information.","year":"2023"},{"key":"B159","volume-title":"SAXENDA (liraglutide) Injection: Prescribing Information.","year":"2023"},{"key":"B160","volume-title":"ZEPBOUND (tirzepatide) Injection, for Subcutaneous Use.","year":"2024"},{"key":"B161","doi-asserted-by":"publisher","first-page":"na","DOI":"10.1211\/PJ.2025.1.359584","article-title":"MHRA urges women taking weight loss drugs to use effective contraception.","volume":"314","author":"Robertson","year":"2025","journal-title":"Pharm J."},{"key":"B162","volume-title":"Updated Contraception Advice for Mounjaro (Tirzepatide).","year":"2024"},{"key":"B163","doi-asserted-by":"publisher","first-page":"2886","DOI":"10.3390\/nu16172886","article-title":"Subcutaneous semaglutide during breastfeeding: infant safety regarding drug transfer into human milk.","volume":"16","author":"Diab","year":"2024","journal-title":"Nutrients."},{"key":"B164","unstructured":"Pester\n              P.\n            \n          \n          Study Links GLP-1use to Some Pregnancy Risks \u2014 But the Study Has Key Caveats.\n          \n          2024"},{"key":"B165","doi-asserted-by":"publisher","first-page":"e70021","DOI":"10.1111\/bcpt.70021","article-title":"Pregnancy outcomes after semaglutide exposure.","volume":"136","author":"Kolding","year":"2025","journal-title":"Basic Clin Pharmacol Toxicol."},{"key":"B166","doi-asserted-by":"publisher","first-page":"114836","DOI":"10.1016\/j.ejogrb.2025.114836","article-title":"Impact of semaglutide exposure on fetal and neonatal outcomes in pregnant women: a systematic review.","volume":"317","author":"Mandal","year":"2026","journal-title":"Eur J Obstet Gynecol Reprod Biol."},{"key":"B167","doi-asserted-by":"publisher","first-page":"1597","DOI":"10.1042\/CS20258493","article-title":"Incretin receptor agonism during pregnancy: implications for mother and baby.","volume":"139","author":"Dearden","year":"2025","journal-title":"Clin Sci."},{"key":"B168","doi-asserted-by":"publisher","first-page":"q2440","DOI":"10.1136\/bmj.q2440","article-title":"Ozempic babies: are weight loss drugs leading to unintended pregnancies?","volume":"388","author":"Nadarajah","year":"2025","journal-title":"BMJ."},{"key":"B169","volume-title":"Patient Information: GLP-1 Agonists and Contraception.","year":"2024"},{"key":"B170","doi-asserted-by":"publisher","first-page":"e2695","DOI":"10.1210\/clinem\/dgaa285","article-title":"Obesity, polycystic ovary syndrome, and infertility: a new avenue for GLP-1 receptor agonists.","volume":"105","author":"Cena","year":"2020","journal-title":"J Clin Endocrinol Metab."},{"key":"B171","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1097\/CM9.0000000000002787","article-title":"Cluster analysis reveals a homogeneous subgroup of PCOS women with metabolic disturbance associated with adverse reproductive outcomes.","volume":"137","author":"Chen","year":"2024","journal-title":"Chin Med J."},{"key":"B172","doi-asserted-by":"publisher","first-page":"3096","DOI":"10.1210\/clinem\/dgae298","article-title":"Clustering identifies subtypes with different phenotypic characteristics in women with polycystic ovary syndrome.","volume":"109","author":"van der Ham","year":"2024","journal-title":"J Clin Endocrinol Metab."},{"key":"B173","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1186\/s12911-025-03255-6","article-title":"Artificial intelligence in polycystic ovary syndrome: a systematic review of diagnostic and predictive applications.","volume":"25","author":"Ghaderzadeh","year":"2025","journal-title":"BMC Med Inform Decis Mak."},{"key":"B174","doi-asserted-by":"publisher","first-page":"e58680","DOI":"10.2196\/58680","article-title":"Lightening the load: generative ai to mitigate the burden of the new era of obesity medical therapy.","volume":"9","author":"Stevens","year":"2024","journal-title":"JMIR Diabetes."},{"key":"B175","doi-asserted-by":"publisher","first-page":"e53396","DOI":"10.2196\/53396","article-title":"Harnessing artificial intelligence to predict ovarian stimulation outcomes in in vitro fertilization: scoping review.","volume":"26","author":"Alsaad","year":"2024","journal-title":"J Med Internet Res."},{"key":"B176","doi-asserted-by":"publisher","first-page":"18721","DOI":"10.1038\/s41598-024-69165-1","article-title":"Optimizing oocyte yield utilizing a machine learning model for dose and trigger decisions, a multi-center, prospective study.","volume":"14","author":"Canon","year":"2024","journal-title":"Sci Rep."},{"key":"B177","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/j.fertnstert.2022.04.003","article-title":"An interpretable machine learning model for predicting the optimal day of trigger during ovarian stimulation.","volume":"118","author":"Fanton","year":"2022","journal-title":"Fertil Steril."},{"key":"B178","doi-asserted-by":"publisher","first-page":"1578","DOI":"10.1016\/j.csbj.2025.04.011","article-title":"Intelligent detection for polycystic ovary syndrome (PCOS): taxonomy, datasets and detection tools.","volume":"27","author":"Li","year":"2025","journal-title":"Comput Struct Biotechnol J."},{"key":"B179","doi-asserted-by":"publisher","first-page":"1166","DOI":"10.3390\/s25041166","article-title":"Optimized machine learning for the early detection of polycystic ovary syndrome in women.","volume":"25","author":"Panjwani","year":"2025","journal-title":"Sensors."},{"key":"B180","doi-asserted-by":"publisher","first-page":"1298628","DOI":"10.3389\/fendo.2024.1298628","article-title":"Predicting polycystic ovary syndrome with machine learning algorithms from electronic health records.","volume":"15","author":"Zad","year":"2024","journal-title":"Front Endocrinol."},{"key":"B181","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1186\/s13048-025-01654-x","article-title":"Construction and evaluation of machine learning-based prediction model for live birth following fresh embryo transfer in IVF\/ICSI patients with polycystic ovary syndrome.","volume":"18","author":"Zhu","year":"2025","journal-title":"J Ovarian Res."},{"key":"B182","doi-asserted-by":"publisher","first-page":"e1011020","DOI":"10.1371\/journal.pcbi.1011020","article-title":"Personalized prediction of the secondary oocytes number after ovarian stimulation: a machine learning model based on clinical and genetic data.","volume":"19","author":"Zieli\u00f1ski","year":"2023","journal-title":"PLoS Comput Biol."},{"key":"B183","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1002\/oby.23120","article-title":"Selection of antiobesity medications based on phenotypes enhances weight loss: a pragmatic trial in an obesity clinic.","volume":"29","author":"Acosta","year":"2021","journal-title":"Obesity."},{"key":"B184","doi-asserted-by":"publisher","first-page":"396","DOI":"10.3390\/diagnostics15030396","article-title":"Harnessing artificial intelligence in obesity research and management: a comprehensive review.","volume":"15","author":"Azmi","year":"2025","journal-title":"Diagnostics."},{"key":"B185","doi-asserted-by":"publisher","first-page":"946","DOI":"10.1016\/S0016-5085(25)03109-9","article-title":"Su2057: a genetic risk score associated with nausea resulting from GLP-1 receptor agonist treatment: a post-hoc analysis of a randomized controlled trial of liraglutide.","volume":"169","author":"Fredrick","year":"2025","journal-title":"Gastroenterology."},{"key":"B186","doi-asserted-by":"publisher","first-page":"483","DOI":"10.3390\/metabo14090483","article-title":"Machine learning-based plasma metabolomics in liraglutide-treated type 2 diabetes mellitus patients and diet-induced obese mice.","volume":"14","author":"Park","year":"2024","journal-title":"Metabolites."},{"key":"B187","doi-asserted-by":"publisher","first-page":"1436","DOI":"10.1038\/s41557-024-01532-x","article-title":"Machine learning designs new GCGR\/GLP-1r dual agonists with enhanced biological potency.","volume":"16","author":"Puszkarska","year":"2024","journal-title":"Nat Chem."},{"key":"B188","doi-asserted-by":"publisher","first-page":"1687617","DOI":"10.3389\/fbinf.2025.1687617","article-title":"Machine learning-guided optimization of triple agonist peptide therapeutics for metabolic disease.","volume":"5","author":"Wong","year":"2025","journal-title":"Front Bioinform."},{"key":"B189","doi-asserted-by":"publisher","first-page":"1667","DOI":"10.1111\/jog.16009","article-title":"Predictive model of IVF outcomes for polycystic ovarian morphology and polycystic ovary syndrome in GnRH antagonist protocol using AMH-MoM and ovarian sensitivity index.","volume":"50","author":"Ko","year":"2024","journal-title":"J Obstet Gynaecol Res."},{"key":"B190","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.xfre.2025.02.007","article-title":"Glucagon-like peptide-1 receptor agonists: a magic bullet or a double-edged sword?","volume":"6","author":"Mandelbaum","year":"2025","journal-title":"F S Rep."},{"key":"B191","doi-asserted-by":"publisher","first-page":"e0326210","DOI":"10.1371\/journal.pone.0326210","article-title":"GLP-1 receptor agonist for weight loss and fertility: social media and online perception versus evidence-based medicine.","volume":"20","author":"Merhi","year":"2025","journal-title":"PLoS One."},{"key":"B192","doi-asserted-by":"publisher","first-page":"e70015","DOI":"10.1111\/obr.70015","article-title":"Obesity and female reproductive health; Is there a role for glucagon-like peptide-1 receptor agonists?","volume":"27","author":"Roberts","year":"2025","journal-title":"Obes Rev."},{"key":"B193","doi-asserted-by":"publisher","first-page":"104522","DOI":"10.1016\/j.rbmo.2024.104522","article-title":"Relevance of GLP-1 agonists for infertility practice.","volume":"49","author":"Telek","year":"2024","journal-title":"Reprod Biomed Online."},{"key":"B194","doi-asserted-by":"publisher","first-page":"2930","DOI":"10.3390\/nu17182930","article-title":"Prospective observational case series in infertile women with overweight or obesity treated with a very-low calorie ketogenic diet (VLCKD) prior to an in vitro fertilization (IVF) treatment.","volume":"17","author":"Casalechi","year":"2025","journal-title":"Nutrients."},{"key":"B195","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.fertnstert.2024.05.154","article-title":"Treating obesity and fertility in the era of glucagon-like peptide 1 receptor agonists.","volume":"122","author":"Goldberg","year":"2024","journal-title":"Fertil Steril."},{"key":"B196","doi-asserted-by":"publisher","first-page":"6153","DOI":"10.1038\/s41598-024-56818-4","article-title":"Effect of weight loss before in vitro fertilization in women with obesity or overweight and infertility: a systematic review and meta-analysis.","volume":"14","author":"Jeong","year":"2024","journal-title":"Sci Rep."},{"key":"B197","doi-asserted-by":"publisher","first-page":"1465","DOI":"10.2337\/db18-1465-P","article-title":"GLP-1 receptor agonist liraglutide increased IVF pregnancy rates in obese women with PCOS and previous poor response to first-line reproductive treatments.","volume":"67","author":"Janez","year":"2018","journal-title":"Diabetes."},{"key":"B198","doi-asserted-by":"publisher","first-page":"2658","DOI":"10.1210\/jc.2016-1659","article-title":"Benefit of delayed fertility therapy with preconception weight loss over immediate therapy in obese women with PCOS.","volume":"101","author":"Legro","year":"2016","journal-title":"J Clin Endocrinol Metab."},{"key":"B199","doi-asserted-by":"publisher","first-page":"433","DOI":"10.4103\/jehp.jehp_1946_24","article-title":"Grade II obesity is an independent predictor of poor response to ovulation induction with oral letrozole in infertile women with PCOS: a prospective cohort study from north india.","volume":"14","author":"Tholiya","year":"2025","journal-title":"J Educ Health Promot."},{"key":"B200","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1007\/s13669-023-00350-1","article-title":"Pharmacologic treatment of obesity in reproductive aged women.","volume":"12","author":"Nuako","year":"2023","journal-title":"Curr Obstet Gynecol Rep."},{"key":"B201","doi-asserted-by":"publisher","first-page":"97","DOI":"10.17476\/jmbs.2025.14.2.97","article-title":"Cost-effectiveness of obesity treatments: glucagon-like peptide-1 receptor agonists, endoscopic sleeve gastroplasty, and metabolic\/bariatric surgery.","volume":"14","author":"Huh","year":"2025","journal-title":"J Metab Bariatr Surg."},{"key":"B202","doi-asserted-by":"publisher","first-page":"5280","DOI":"10.1111\/dom.16581","article-title":"Cost-effectiveness analysis of four glucagon-like peptide-1 or glucose-dependent insulinotropic polypeptide\/glucagon-like peptide-1 receptor agonists for the treatment of adult patients with overweight and obesity in china.","volume":"27","author":"Fu","year":"2025","journal-title":"Diabetes Obes Metab."},{"key":"B203","doi-asserted-by":"publisher","first-page":"1690211","DOI":"10.3389\/fpubh.2025.1690211","article-title":"Cost-effectiveness of semaglutide 2.4 mg versus liraglutide 3 mg for the treatment of obesity in greece.","volume":"13","author":"Papantoniou","year":"2025","journal-title":"Front Public Health."},{"key":"B204","volume-title":"Affordable Access to glp-1 Obesity Medications: Strategies to Guide Market Action and Policy Solutions.","author":"Pearson","year":"2025"},{"key":"B205","volume-title":"WHO Issues Global Guideline on the Use of GLP-1 Medicines in Treating Obesity.","year":"2025"},{"key":"B206","doi-asserted-by":"publisher","first-page":"3009","DOI":"10.1210\/clinem\/dgaf401","article-title":"Effect of GLP1 agonists on reproduction.","volume":"110","author":"Couldwell","year":"2025","journal-title":"J Clin Endocrinol Metab."},{"key":"B207","doi-asserted-by":"publisher","first-page":"8597","DOI":"10.1097\/MS9.0000000000004189","article-title":"GLP-1 receptor agonists and preconception planning: bridging the gap between obesity treatment and reproductive safety, a narrative review.","volume":"87","author":"Saad Alfaiz","year":"2025","journal-title":"Ann Med Surg."},{"key":"B208","doi-asserted-by":"publisher","first-page":"1798","DOI":"10.3390\/make6030088","article-title":"Learning optimal dynamic treatment regime from observational clinical data through reinforcement learning.","volume":"6","author":"Abebe","year":"2024","journal-title":"Mach Learn Knowl Extr."},{"key":"B209","doi-asserted-by":"publisher","first-page":"108658","DOI":"10.1016\/j.cmpb.2025.108658","article-title":"Methods in dynamic treatment regimens using observational healthcare data: a systematic review.","volume":"263","author":"Liang","year":"2025","journal-title":"Comput Methods Programs Biomed."},{"key":"B210","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1007\/s40265-020-01435-4","article-title":"Personalized multimorbidity management for patients with type 2 diabetes using reinforcement learning of electronic health records.","volume":"81","author":"Zheng","year":"2021","journal-title":"Drugs."},{"key":"B211","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1186\/s12905-022-01630-3","article-title":"\u201cI felt like she didn\u2019t take me seriously\u201d: a multi-methods study examining patient satisfaction and experiences with polycystic ovary syndrome (PCOS) in canada.","volume":"22","author":"Ismayilova","year":"2022","journal-title":"BMC Womens Health."},{"key":"B212","doi-asserted-by":"publisher","first-page":"299","DOI":"10.2147\/IJWH.S100385","article-title":"The experiences of women with polycystic ovary syndrome on a very low-calorie diet.","volume":"8","author":"Love","year":"2016","journal-title":"Int J Womens Health."},{"key":"B213","doi-asserted-by":"publisher","first-page":"e13612","DOI":"10.5812\/ijem.13612","article-title":"The experience of women affected by polycystic ovary syndrome: a qualitative study from iran.","volume":"12","author":"Nasiri Amiri","year":"2014","journal-title":"Int J Endocrinol Metab."}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1809416\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T05:43:41Z","timestamp":1780379021000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1809416\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,2]]},"references-count":213,"alternative-id":["10.3389\/fnut.2026.1809416"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2026.1809416","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,2]]},"article-number":"1809416"}}