“I actually have one patient that’s been on [GLP-1 drugs], actually someone who’s in their late 40s – who… had been trying to get pregnant for years and years – thought it wasn’t possible, and… conceived,” said Dr. Mitchell Kramer, chief of OBGYN at Huntington Hospital.
He joined Audacy station WCBS in New York this week to explain what’s going on with recent reports of medications such as Ozempic and Wegovy leading to unexpected pregnancies.
Both medications are versions of semaglutide, which mimics a hormone that encourages the release of insulin from the pancreas. They are also known as GLP-1 agonists. Dr. Diana Thiara, an internist at UCSF Health and director of the UCSF Medical Weight Management Program, explained to Audacy station KCBS in San Francisco last year that these drugs work on a patient’s pancreas to increase the amount of insulin their body makes.
Thiara also said the medications work on the stomach to decrease gastric emptying. That means that food sits in the stomachs of people taking them longer, which can make them feel fuller and more satiated.
While the drugs were initially developed for people with diabetes, they have become popular for weight loss. According to Healthline, users of the medications have been reporting a new apparent side effect of taking Ozempic and other GLP-1 receptors – pregnancy.
“Some, like TikToker @fxshel1995, are reporting that they became pregnant after years of infertility,” said the outlet.
“I think in general it’s the weight loss that actually is what’s improving fertility,” said Kramer. “You know, obesity, definitely causes metabolic and hormonal disturbances. That increases the risk of infertility. So certainly, the weight loss in and of itself, will increase women’s fertility. Obesity is also a state of inflammation, and reducing the inflammation by weight loss also enhances, fertility.”
He said that with these health improvements, people may start ovulating more regularly and that reduced inflammation of pelvic organs can improve fertility as well.
“Many high BMI patients do not ovulate, some have polycystic ovary syndrome (PCOS), and many just don’t ovulate regularly,” said Dr. Jamie Grifo, program director at NYU Langone Fertility Center in New York City and chief executive physician at Inception Fertility, as quoted by Healthine.
Dr. Neha Lalani, a board-certified endocrinologist with a private practice at Bluebonnet Diabetes & Endocrinology in West Lake Hills, Austin, Texas, also thinks that the improvements to metabolic health associated with weight loss could help improve fertility. Per Healthline, she said the GLP-1 agonist related fertility spike is “definitely real.”
However, she said that weight loss alone isn’t the only possible reason why people on GLP-1 medication are seeing positive pregnancy tests.
Lalani explained that, since these medications slow down stomach emptying, that they also impact how other medications are absorbed by the stomach.
“This causes oral birth control pills to not be absorbed consistently, especially each time the dose of GLP-1/ GIP+ GLP-1 agonists are stepped up,” she explained. “This is resulting in failure of oral birth control pills.”
Kramer said that it is important for health care providers to counsel their patients before the begin taking GLP-1 drugs. Lalani also said people who are taking these medications should use forms of birth control other than the pill if they do not wish to become pregnant.
“And certainly, we know that women who do conceive, accidentally, on these medications should stop the medication right away,” Kramer added. He explained: “We really don’t have enough human data to really say at this point. We don't know a lot about the safety issues with respect to pregnancy and these medications. So obviously the safest thing to do is to discontinue the medication.”
Novo Nordisk, the maker of the Ozempic and Wegovy said in a statement provided to Healthline that it is not clear if the medications are safe for pregnant people. Trials of the medications excluded pregnant people. An ongoing study looking into the safety of Wegovy during human pregnancy is ongoing and not due to be completed until August 2027, said Healthline.
“It would be reasonable to tell the patient: ‘Lose your weight, and when you achieved your weight loss goal, discontinue the medication, and then you can try to get pregnant at the appropriate time,’” said Kramer.
He also said that, at this point, GLP-1 drugs should not be prescribed specifically as a fertility drug. In fact, he recommends that people trying to become pregnant discontinue use of these medications at least two months before they begin trying to conceive.