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4.3.1 Available evidence for natural pregnancy rates and TTP Published meta-analytic summaries and follow-up data from individual trials suggest that GLP-1RA-based metabolic optimization may be associated with higher natural conception rates and shorter time to pregnancy in selected overweight or obese women with PCOS ( 4.3.2 Methodological limitations and clinical strategies Existing studies generally treat pregnancy-related outcomes as secondary or exploratory endpoints and seldom report analyses stratified by weight-loss achievement, insulin-resistance improvement, or washout structure ( 4.4 ART-related outcomes: limited signals, fragmented evidence, and target population boundary In the context of ART, PCOS is often associated with excessive but poor-quality follicles, OHSS risk, and impaired endometrial receptivity

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