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Alternatives to GLP-1 RAs in preconception management When GLP-1 RAs are discontinued, metformin remains the most established alternative, improving insulin sensitivity and ovulatory function with a strong safety record [30,31]

Tan CCS, Owen CJ, Tham C, Bertoletti A, van Dorp L, Balloux F

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Interestingly, the dual agonist tirzepatide has shown efficacy in neuroprotection, by counteracting hyperglycemia and insulin resistance-related effects at the neuronal level (Fontanella et al., 2024)

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However, symptoms may temporarily worsen following dose increases