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Recommendation tiers: (i) Strongly Recommended: GLP-1RAs may be used as time-bounded metabolic optimization before OI or ART, aiming to improve metabolic readiness prior to stimulation and pregnancy planning

Most patients describe a GLP-1 shot as a fleeting pinch followed by a faint warmth or small bump that fades within minutes

Reputable pharmacies provide documentation of purity, potency, and sterility testing for each batch

Water-based exercise (hydrotherapy) is often beneficial for many patients, as buoyancy reduces joint stress whilst providing resistance for muscle strengthening, though evidence is supportive but limited

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Natural GLP-1's 1- to 2-minute half-life means its effects dissipate rapidly after secretion, providing only momentary metabolic influence