Ozempic is one of the many glucagon-like peptide 1 (GLP-1) agonist drugs that were originally developed to manage type 2 diabetes. GLP-1 medications, now widely used as effective weight-loss drugs, have an unexpected side effect: boosted fertility. According to UT Southwestern Medical Center, many women who have long struggled with infertility have finally gotten pregnant while taking a GLP-1 agonist. This phenomenon has led to the term “Ozempic babies,” referring to pregnancies that occur while taking one of these weight-loss drugs.

It’s true that a healthy body mass index (BMI) can improve your chances of a healthy pregnancy. However, it’s important to note that GLP-1 medications were not developed to aid in conception, and manufacturers do not claim that these drugs will help people get pregnant. In fact, GLP-1 drugs aren’t considered safe to take during pregnancy. If you are taking a GLP-1 agonist or plan to start taking one, it’s important to discuss family planning with your doctor.

In this article, we’ll discuss the theories behind the fertility-boosting effects of GLP-1s, including key considerations for people on these drugs who are hoping to become pregnant, as well as considerations for those who wish to prevent pregnancy.

How GLP-1 Drugs May Affect Fertility

GLP-1 receptor agonists work by mimicking a hormone called GLP-1, which helps keep blood sugar in check and reduces appetite. Some drugs in this category include:

• Dulaglutide (Trulicity)
• Exenatide
• Semaglutide (Ozempic, Wegovy, and Rybelsus)
• Tirzepatide

Current research is limited and doesn’t tell us exactly how much GLP-1 agonists increase fertility. However, it appears that this association is real — many people on these drugs and their doctors have noted this effect.

How exactly can these weight loss medications impact your ability to get pregnant? They may work indirectly to promote fertility by helping people lose weight and manage chronic conditions.

Effects on Weight

BMI has direct effects on fertility. According to Cleveland Clinic, on average, each BMI point over 29 reduces female fertility by around 5 percent, and a high BMI can also impact male fertility. For these reasons, some people living with obesity struggle with infertility. On the flip side, for some people with high BMIs, losing weight can increase fertility rates. A combination of GLP-1 agonists, healthy diet, and lifestyle changes can cause people to lose weight (and consequently lower their BMI) rapidly, increasing their chances of conception.

Effects on Ovulation

Ovulation is the part of the menstrual cycle in which the ovary releases an egg, allowing for the possibility of fertilization. It’s triggered by hormones, including estrogen. Excess body fat converts estrogen into a weaker hormone and increases testosterone. This hormonal dysregulation can result in people with obesity struggling with irregular ovulation, and this reduces their likelihood of becoming pregnant.

For people with polycystic ovary syndrome (PCOS), one way to promote regular ovulation is through weight loss. People on GLP-1 agonists often experience weight loss in a relatively quick amount of time, improving the chances of restoring ovulation sooner. That’s why some fertility doctors are prescribing GLP-1 agonists to people with PCOS and obesity before they try to get pregnant.

Effects on Sperm

According to the journal Medicina, there is also reason to believe that taking GLP-1 drugs can improve male fertility by making stronger sperm cells. Higher quality sperm can increase the chances of a successful pregnancy. However, more research is needed on the impact of GLP-1 medications on male fertility.

Effects on Birth Control

Even among people using contraceptive (birth control) methods, GLP-1 drugs can raise the risk of an accidental pregnancy. Some GLP-1 medications may interfere with oral birth control pills. Because GLP-1 agonists slow digestion, they may reduce the absorption of oral contraceptives, making them less effective. When you start or increase your dose of GLP-1s, make sure to use a backup form of birth control, such as condoms, for a few weeks.

Also, GLP-1 agonists can cause vomiting. If you vomit within half an hour of taking your oral birth control pill, you may not be protected against pregnancy. Speak to your doctor about preventing surprise pregnancy while on GLP-1s. They can help you find another method that works for you.

GLP-1 Agonists Are Not a Fertility Treatment

Although some note that GLP-1 agents may improve fertility, they are not intended, approved, or recommended as fertility treatments. Unlike medications that are approved to increase fertility, such as clomiphene (Clomid), metformin (Fortamet), and gonadotropins, GLP-1 receptor agonists don’t directly affect reproductive health.

Safety Concerns With Ozempic Pregnancies

There haven’t been many studies on the effects of GLP-1 drugs on people who are pregnant, so it’s not clear if they are safe for the fetus. Some studies haven’t found any major differences in birth defect rates. These studies showed that people taking GLP-1s during pregnancy had similar complication rates to those with diabetes or obesity who weren’t taking these drugs.

Therefore, as of now, there is mixed data about the safety of these drugs during pregnancy. Researchers are currently building a database of pregnancies that have occurred on GLP-1 drugs to better understand how these medications are affecting pregnancies.

Given the lack of safety information, if you’re on a GLP-1 agonist and you’re planning to get pregnant, the U.S. Food and Drug Administration (FDA) recommends stopping your GLP-1 agonist two months before trying to conceive. Researchers also recommend avoiding these medications while breastfeeding, as the drug has been shown to pass through breastmilk in animal studies.

What Happens if You Conceive on a GLP-1?

If you have an unexpected pregnancy while taking a GLP-1 agonist, tell your doctor as soon as possible. They will likely advise you to stop taking your GLP-1, although this will be a personal conversation between you and your healthcare team. People who stop their GLP-1 medication in early pregnancy usually don’t need to do any additional testing or receive a higher level of care during the rest of their pregnancy.

Talk to Your Doctor

GLP-1 drugs offer many health benefits for people living with obesity and other chronic medical conditions. A healthy weight and well-controlled blood sugar can improve the conditions necessary to become pregnant.

However, due to limited data, Ozempic and other GLP-1s are not intended to be fertility-promoting medications. Doctors suggest you stop taking these medications months before getting pregnant to avoid possible complications or harm in your pregnancy. Understanding these risks can help you make the most informed decisions about your reproductive health.

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