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1.4 Rationalizing fertility-centered review of GLP-1RAs in PCOS: bridging metabolic-reproductive divide 1.4.1 Clinical paradox: tension between metabolic optimization and reproductive urgency While GLP-1RAs have been established as a first-line intervention for managing metabolic comorbidities in PCOS, their potential teratogenic risks and the requirement for strict preconception washout periods present a formidable clinical dilemma for reproductive specialists