Can Ozempic Affect Fertility? A Guide to GLP-1 Medications and Pregnancy
Can Ozempic Affect Fertility? A Guide to GLP-1 Medications and Pregnancy
For people who are on GLP-1 agonists like Ozempic and thinking about having kids, a lot is still unknown. We asked Marie Couldwell, MD, an endocrinologist at University of Utah Health, for recommendations to keep you and your future kids as healthy as possible.
1. If recommended by a doctor, use GLP-1 agonists to help manage diabetes or attain a healthy weight
For people with type 2 diabetes, GLP-1 agonists lower the risk of serious complications, including heart and kidney problems. They can also be used in combination with lifestyle changes for weight loss, although most people regain most or all of the lost weight after stopping medication use.
Obesity is associated with lower fertility, so attaining a healthy weight before conceiving could improve fertility, Couldwell says. For men, GLP-1 agonist treatment improves fertility, regardless of its effects on weight, she adds. “GLP-1s have a direct effect, independent of weight loss, on reproductive hormones, sperm parameters, and fertility in men. All these parameters improve.”
2. Don’t use GLP-1 agonists while pregnant, breastfeeding, or trying to conceive
While GLP-1 drugs may improve fertility, it’s unknown how they affect fetal development. But rapid weight loss during pregnancy can be dangerous for both mother and baby, so it’s crucial to not use these medications while pregnant.
“We do not recommend using these drugs during pregnancy,” Couldwell explains. “What we recommend for women who want to lose some weight before pregnancy is to use a short-acting GLP-1 that you take orally or inject once a day, rather than a slow-release form that is injected once a week, along with barrier contraception. Once you have reached your ideal body weight, you can discontinue the GLP-1.”
It’s also still unclear if the drugs make it into semen or breast milk, so they shouldn’t be used while trying to conceive or breastfeeding.
3. Use barrier protection while on GLP-1 agonists
People who have previously experienced infertility may have higher chances of getting pregnant, or getting a partner pregnant, while on GLP-1 agonists. This may be related to direct effects of these medications on fertility, or it could be because GLP-1 agonists can make oral birth control less effective.
“There’s a higher risk of pregnancy if someone is on GLP-1s and taking an oral contraceptive,” Couldwell explains. “The oral contraceptive may not get absorbed properly due to the GLP-1 causing slow emptying of the stomach. We therefore recommend using barrier contraception prior to conception.”
Couldwell emphasizes that these recommendations are based on a review of the research thus far, but with so many unknowns, recommendations may change. GLP-1 agonists can be a powerful tool to manage diabetes and control weight, but like any medication, they’re not without risks, so talking with your doctor is always a good choice.