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9 Research gaps and future priorities 9.1 Reproductive-oriented RCTs: shifting from metabolic surrogates to hard endpoints To date, most GLP-1RA trials in PCOS have been designed around metabolic efficacy (weight change and insulin-resistance/glycaemic indices) as the primary outcomes, with reproductive outcomesovulation, clinical pregnancy, and live birthreported inconsistently and often as secondary or exploratory measures
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For example, the UK Summary of Product Characteristics (SmPC) for Wegovy (semaglutide 2.4 mg) includes a precautionary note in Section 4.4 advising healthcare professionals to monitor patients for suicidal ideation and behaviour, particularly those with a history of psychiatric disorders
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