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Effects of glucagon-like peptide 1 receptor agonists on testicular dysfunction: A systematic review and meta-analysis

Salvio G, Ciarloni A, Ambo N, Bordoni M, Perrone M, Rossi S, Balercia G

Andrology, 2025

680 participants

Abstract

BACKGROUND: Hypogonadism and infertility are two conditions that are heavily affected by overweight and obesity in the male patient. Glucagon-like peptide 1 agonists (GLP-1RAs) are a recently introduced class of antidiabetic drugs with powerful weight-loss effect; this may induce an indirect positive effect on the testicular function. Nevertheless, recent evidence also suggests a potential direct influence of these molecules on the gonadal function.

OBJECTIVES: Our study aims at evaluating the effects of GLP-1RAs on hormone secretion in male patients and comparing their impact on the testicular function with other antidiabetic agents or weight-lowering drugs.

MATERIALS AND METHODS: A literature search was conducted using PubMed, EMBASE, and Scopus database to assess the effects of GLP-1RAs on hormone levels, sperm parameters, and erectile function in overweight and obese men. Before-after analysis and comparison between therapy with GLP-1RAs and other treatment regimens were performed.

RESULTS: Seven studies (n = 680) were included in the quantitative analysis. Treatment with GLP-1RAs produced a significant increase in total serum testosterone (TT), with a standardized mean difference of 1.39 ng/mL (95% confidence interval: 0.70, 2.09; p < 0.0001). Free serum testosterone (FT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) showed similar increase, while weight, body mass index (BMI), waist circumference (WC), and…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 680 participants or records.

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