Does Ozempic Affect Fertility or Birth Control?
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Some women taking drugs like Ozempic are getting a big surprise: unintended pregnancies that happen even though they’re on birth control or have a history of infertility.
While the exact number of these pregnancies are hard to come by, a small but growing number of women are taking to social media to talk about their #ozempicbabies. They say they got pregnant while taking Ozempic, a type 2 diabetes drug, or the weight loss medicine Wegovy. Both drugs are in a family of medicines known as GLP-1 receptor agonists that can help control blood sugar levels, reduce hunger, and promote weight loss.
“I was taking Ozempic and I got pregnant,” one of these women says on TikTok. “Here’s your PSA to everyone: There are studies that show that a GLP-1 drug lessens the effectiveness of your birth control, and then it also heightens your fertility.”
“Do not take it if you’re pregnant,” this woman also warns. “I did stop taking it immediately when I found out, and the baby is actually healthy. The baby was checked this morning and the baby was doing good.”
Why Would Ozempic Babies Happen?
Because people with obesity often struggle to conceive, it’s hard to say at this point how much these pregnancies might occur due to weight loss as opposed to the specific effects of GLP-1 medicines, experts say.
“Obesity is a common risk factor for subfertility, so weight loss is likely to increase fertility,” says Beverly Tchang, MD, an obesity specialist and assistant professor at Weill Cornell Medicine in New York City.
Certain gynecologic conditions, like polycystic ovarian syndrome (PCOS), often coincide with obesity and difficulty conceiving, Dr. Tchang says. Weight loss can improve conditions like PCOS as well as fertility.
In people with type 2 diabetes — another chronic health condition associated with obesity and fertility issues — weight loss can also make it easier to conceive, says Sonia Hernandez Diaz, MD, DrPH, an epidemiology professor at the Harvard T.H. Chan School of Public Health in Boston.
“It is plausible that these medications might improve fertility in certain patients, whether it is through weight loss or through other cardiometabolic effects,” Dr. Hernandez Diaz says.
However, there is also some evidence to suggest that GLP-1 drugs might interfere with the effectiveness of hormonal contraceptives — birth control pills many women take to prevent pregnancy, Tchang says. Ozempic and two similar medicines with a different active ingredient, Mounjaro and Zepbound, carry warnings about this potential side effect in their prescribing information.
But this evidence is based on studies of Mounjaro and Zepbound, two drugs with a different active ingredient than Ozempic. Both of these medicines contain tirzepatide, which targets both the GLP-1 hormone and the GIP hormone.
“Tirzepatide is a GLP-1 and GIP receptor agonist, so we don’t know if this applies to medications with GLP-1 alone” like Ozempic, Tchang says.
How to Avoid Getting Pregnant When Taking Ozempic
Still, people of reproductive age who take Ozempic and rely on hormonal contraceptives to prevent pregnancy may want to consider taking precautions, experts say.
Alternative birth control is a good idea for people on both hormonal contraceptives and a GLP-1, says Michael Kane, PharmD, a professor at the Albany College of Pharmacy and Health Sciences in New York.
“Patients who currently use oral hormonal contraceptives are advised to switch to a non-oral contraceptive method or to add a barrier method of contraception,” Dr. Kane says.
Ideally, patients should switch contraceptives or start using condoms to back up their birth control for four weeks after starting treatment and for four weeks after each dose increase.
When patients on these medicines want to conceive, they should halt treatment at least one to two months before trying for a baby, Kane advises. That’s because animal studies point to a potential for these medicines to harm growing babies.
People taking GLP-1 drugs specifically to lose weight so they can more easily conceive should focus on each of things separately instead of taking Ozempic while trying to conceive, says Frank Greenway, MD, a professor and medical director at the Pennington Biomedical Research Center in Baton Rouge, Louisiana.
“A safer strategy would be to lose the weight on the GLP-1 agonist and continue the contraception until the drug is out of the body before attempting to initiate a pregnancy,” Dr. Greenway says. “It is known that weight loss improves fertility, so losing the weight first and getting pregnant after the weight loss is a safer way to determine if the reason for the infertility was due to obesity.”
What to Do if You’re Pregnant With an Ozempic Baby
The first thing to do if you get pregnant while you’re on Ozempic is talk to your doctor about the safest way to stop using it, especially if you have type 2 diabetes.
“If women get pregnant while taking GLP-1, they should stop the medication and inform their prescribing doctor and their ob-gyn,” Tchang says. “We do not know the effects of GLP-1 agonists in human pregnancies, but their ob-gyn may want to do more frequent monitoring.”
While people taking GLP-1 drugs for weight loss may be able to simply stop and reconsider using these medicines after their pregnancy, people who need these drugs for type 2 diabetes can’t just stop without a plan for managing their blood sugar, Tchang adds. “Stopping the GLP-1 means they will likely need a different agent to control their diabetes, and this needs to be an individualized discussion with their doctor.”
After delivery, patients may also want to consider waiting to resume treatment with GLP-1 drugs if they plan to breastfeed.
“It is unknown if GLP-1 medications are excreted into breast milk,” Kane says. Lactating people “should consider the potential risk of infant exposure to the drug, the benefits of breastfeeding to the infant, and the benefits of treatment to the mother.”
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