What To Know About Going On Ozempic If You Plan To Get Pregnant, According To Doctors
It just takes a bit of planning with your health care provider.
December 6, 2024
Written By: Amy Wilkinson
When it comes to family planning decisions, they can often feel black and white. To try or not to try? What’s more, the decision to try to conceive often trumps whatever else is happening in your life at the moment—including whether or not to go on, or stay on, a weight loss drug like Ozempic.
The topic of weight loss drugs and pregnancy is a layered one. You may be asking yourself questions such as, is it worth going on a GLP-1 if you’re planning on trying for a kid in the next, say, six months? A year? Is it even safe? When would I have to wean off? Could I go back on a medication postpartum, or while breastfeeding?
For various reasons—including the health of the mother and baby—many experts say that the simple answer is yes, it is safe to go on a weight loss drug ahead of conception. “I always say [that] mom comes first before the baby, and her health is most important. So achieving an ideal weight is good for her health and for the baby’s health,” says Salli Tazuke, MD, a board-certified ob-gyn and reproductive endocrinologist and co-founder and co-medical director of CCRM Fertility in San Francisco.
But before going on a weight-loss drug like semaglutide (a.k.a. Ozempic when prescribed for diabetes, and Wegovy when prescribed for weight loss), it’s important to discuss your fertility plans with your doctor. Precise and individualized planning will be essential, doctors agree. WH spoke with experts to find out what you need to know about going on Ozempic when you want to have a baby—here’s what they shared.
No, you can’t go on a weight loss drug if you’re already pregnant.
For a drug to be approved for the pregnant population, it must go through rigorous testing with that population, and that has not yet happened for semaglutide or other GLP-1 (glucagon-like peptide 1) agonists, says Carrie Burns, MD, a board-certified endocrinologist and director of diabetes in pregnancy at Penn Medicine in Philadelphia. However, in animal testing, semaglutide has been linked with negative side effects. Researchers studying the impact on pregnant mice, for instance, noted decreases in both fetal body weight and in the activity of various nutrient transporters in the placenta (meaning the fetus wasn’t getting the proper amount of vital nutrients). Animal studies have also shown a link to higher rates of miscarriage.
Of course, “Humans are different from rats, mice, and monkeys—but in animal studies it did not look safe,” Dr. Burns says, adding that the levels of semaglutide administered in these animal studies were at “toxic levels,” and not what a person prescribed a weight loss drug would be taking. Nonetheless, “until there’s better human study, it is not approved,” Dr. Burns says.
Large-scale human studies could be a long time coming given the risks associated with exposing a pregnant woman (and her fetus) to a potentially harmful drug. (One small prospective study of early pregnancy GLP-1 users in a handful of European countries and Israel, published recently in BMJ Open, found no increase in major birth defects or pregnancy loss, when compared with control groups of pregnant women with diabetes and pregnant women who are obese. But larger studies would be needed to validate these results.) At this point, researchers are working to study the drug’s effects retrospectively by establishing a pregnancy registry that collects data on women who were exposed while unknowingly pregnant. (Wegovy, a semaglutide that is approved for weight loss, has already established such a registry.)
In the scientific literature, there’s at least one such retrospective case of a woman who didn’t know she was pregnant taking semaglutide up until about the fourth week of her pregnancy. According to the paper published in the International Journal of Gynecology & Obstetrics, the woman delivered a baby girl who was otherwise healthy except for hypoglycemia (low blood sugar). The delivery itself was also complicated by shoulder dystocia (when one or both shoulders don’t easily clear the birth canal), but neither of those issues could directly be linked to semaglutide use.
Bottom line? Until there’s more exhaustive data on the side effects of semaglutide on pregnant women and their fetuses, it’s simply not worth the risk.
