Ozempic (semaglutide) is a GLP-1 RA (glucagon-like peptide-1 receptor agonist), also known as a “GLP-1” drug. It’s an effective medication for managing type 2 diabetes and for weight loss. Overweight patients with diseases of the heart or blood vessels may take it to lower their chance of a heart attack or stroke.
With little research on how GLP-1 drugs affect pregnancy, experts don’t recommend that you take Ozempic if you’re trying to get pregnant, are pregnant, or are breastfeeding unless otherwise instructed by your doctor.
Ozempic and Pregnancy
If you’re taking Ozempic or any other GLP-1 medication, be sure to talk with your doctor if you’re pregnant, could become pregnant, or are planning to get pregnant. There’s not enough information about the impact of GLP-1 drugs on pregnancy.
Some animal studies have shown that there may be a risk to the developing baby with these medications. For example, research found that drugs like Ozempic may increase the risk of miscarriage or birth defects. Some studies also have reported that offspring were smaller than usual. But in those studies, the parent animal was exposed to higher doses than the dose used in humans.
Studies on humans found no increased risk related to GLP-1s. In one study of 50,000 pregnant people with type 2 diabetes, there was no significant risk of fetal development problems among those who were taking GLP-1s when they learned they were pregnant, compared with those not taking the medications.
Another study found that taking GLP-1s during the first trimester was not linked to a risk of major birth defects, compared with pregnancy outcomes in patients with diabetes or obesity who were not taking the medication.
More studies involving a larger number of people are needed to fully understand what risks these medications have during pregnancy. Since we don’t know for sure about the risks, doctors recommend stopping Ozempic and other GLP-1 medications right away if you get pregnant and you don’t have diabetes.
But if you are on semaglutide to control your diabetes, you should speak with a health care provider before stopping. Uncontrolled blood sugar can increase the chance of birth defects and other pregnancy complications. Your doctor will want to weigh the benefit of using semaglutide against the risks of complications related to diabetes.
If your diabetes isn’t managed well, it can make problems related to diabetes worse. This includes things like heart disease, kidney disease, hypoglycemia, diabetic neuropathy (nerve damage), and problems with your feet, eyes, gums, and teeth.
Uncontrolled diabetes can also raise your risk of serious problems like:
- Miscarriage
- Major birth defects
- Preeclampsia
- Preterm delivery
- Stillbirth
- Low or high birth weight
- Other pregnancy complications
If you have diabetes and become pregnant, your provider may switch you to a different type of drug altogether, such as metformin, which is proven to be safe during pregnancy.
Another reason to stop GLP-1s during pregnancy has to do with nutrition. Eating plenty of healthy foods helps your baby develop the way they’re supposed to. Restrictive dieting is not recommended while pregnant. In fact, you need extra calories.
Ozempic and other GLP-1s can interfere with digestion, making it harder to absorb nutrients. It can even cause side effects like hypoglycemia (low blood sugar) and malnutrition. Other side effects may include:
- Upset stomach
- Stomach pain
- Diarrhea
- Constipation
- Lack of appetite
- Indigestion (heartburn)
- Loss of appetite
- A hard time swallowing
- Vomiting
Lastly, there may be a risk related to anesthesia given during surgery or other medical procedures. Some patients on GLP-1 medication have inhaled food and liquid into their lungs while sedated, known as “pulmonary aspiration.” Pulmonary aspiration can cause dangerous lung damage, infections, and even death. Researchers think this happened because taking GLP-1s, which slows down digestion, kept their stomachs full even though they stopped eating 6 to 8 hours beforehand.
Ozempic and Breastfeeding
Breastfeeding is another area where not enough is known about the impact of Ozempic and other GLP-1s. Based on an animal study, semaglutide is expected to get into breast milk in small amounts.
There are no relevant human studies on the impact of GLP-1s on breast milk, breast milk production, or the breastfeeding child.
It is not recommended to take GLP-1 medications while breastfeeding because the drug can enter the breast milk. That said, it’s unlikely to harm the infant. For one thing, the amount transferred in breast milk is likely to be very low. In addition, only as much as 1% of the medication is absorbed when consumed by mouth.
If you are considering breastfeeding or are currently breastfeeding, be sure to discuss the risks and benefits with your health care professional. Providers generally recommend waiting to restart the medication until after you’re done breastfeeding.
Can You Take Ozempic While Trying to Get Pregnant?
If you take Ozempic for diabetes, your doctor may recommend continuing with the drug. If so, it’s because they think the benefit to you outweighs any risk to the fetus. If your doctor recommends you stop your GLP-1 medication, it is best to wait at least 2 months after taking Ozempic before trying to get pregnant. This is due to the long amount of time the medication remains in your system after stopping. Semaglutide remains in your body for 5 to 7 weeks after the last dose.
If you plan to become pregnant in the near future, your provider may switch you to a different GLP-1 such as liraglutide (Saxenda or Victoza). You take liraglutide daily, vs. weekly for Ozempic, so the medication doesn’t remain in your system as long. That means it can be stopped closer to the time you begin trying to become pregnant.
Those with type 2 diabetes who take GLP-1s before they get pregnant tend to gain more weight during pregnancy than patients who did not take the drugs.
There is no evidence that sperm produced by someone taking GLP-1s like Ozempic would raise the risk of birth defects if a baby is conceived.
Ozempic and fertility
Many people become pregnant unexpectedly while taking Ozempic. This doesn’t happen because of the drugs themselves. It happens because of the changes they cause, including weight loss. In fact, weight loss for any reason can improve your chances of getting pregnant.
If you have irregular periods due to excess weight, drugs like Ozempic may allow you to lose enough weight for regular ovulation (when the ovary releases a fertile egg) to return. This may increase your chance of getting pregnant. Bottom line: Taking any GLP-1 medication can increase a patient’s odds of pregnancy during their reproductive years.
Another reason for improved fertility has to do with blood sugar. The higher insulin levels that come with obesity also disrupt ovulation. Taking GLP-1 medications helps reduce your insulin levels, which can restore fertility.
In some studies, men who take GLP-1s can also have improved fertility. For example, they may produce more sperm or sperm that’s better able to move around. There is no evidence that sperm produced while taking GLP-1s is harmful if a baby is conceived. There is some indication that metformin may have a negative impact on male fertility.
Fertility can decrease when you stop taking GLP-1 medication. If you have diabetes and switch to metformin, while also continuing with lifestyle changes (diet and exercise), that can help you keep from regaining the weight.
Some doctors prescribe GLP-1s to manage PCOS (polycystic ovary syndrome), which is an endocrine disorder that can cause infertility. Here again, semaglutide can restore normal fertility rates by improving insulin sensitivity and promoting weight loss.
Ozempic babies
The term “Ozempic babies” refers to the growing number of those who’ve become pregnant unexpectedly while taking Ozempic or other GLP-1 medications. Experts think this trend likely comes from increased fertility due to changes in weight, insulin sensitivity, and hormones.
Ozempic and Birth Control
Since not enough is known about how GLP-1s affect pregnancy, doctors advise patients on the medication to use birth control. There are concerns about the effectiveness of certain types of birth control – particularly birth control pills – when taking Ozempic or other GLP-1 medications.
Should I change how I take birth control with Ozempic?
More research is needed to understand how GLP-1s affect how well birth control works. One theory is that birth control pills spend less time in the gut because GLP-1s slow down the movement of food. As a result, not as much would be absorbed by the body.
If you’re on birth control pills and taking GLP-1s, you should add a secondary, barrier method of protection, like condoms or spermicide (vaginal contraceptive gel). You could also switch to a method that doesn’t need to be absorbed by the digestive system – such as a vaginal ring, an implant, or IUD (intrauterine device).
Takeaways
With limited research on how Ozempic and other GLP-1 drugs affect pregnancy, experts don’t recommend that you take Ozempic if you’re trying to get pregnant, are pregnant, or are breastfeeding unless otherwise instructed by your doctor. Your doctor will weigh the potential risks of using GLP-1s with the risks of complications due to diabetes. Ozempic and other GLP-1 medications can increase fertility. For that reason, doctors recommend taking extra precautions to prevent pregnancy while on GLP-1s. If you take birth control pills, add a secondary, barrier method (like condoms or spermicide).
Ozempic and Pregnancy FAQs
What happens if you get pregnant while taking Ozempic?
You should stop taking GLP-1 medication right away if you become pregnant, unless you have diabetes. If you’re on medication to control your diabetes, your doctor will want to weigh the benefit of using semaglutide against the risks of complications due to diabetes.
How long does it take for Ozempic to get out of your system?
It takes at least 5 weeks for the medication to leave your system.
What is the “Ozempic baby” phenomenon?
The term refers to the growing number of people who’ve become pregnant unexpectedly while taking Ozempic or other GLP-1 medications. This trend likely comes from increases in fertility due to changes in weight, insulin sensitivity, and hormones that result.
Does Ozempic mess with birth control?
GLP-1s may affect how your body absorbs birth control pills. If you’re on birth control pills and taking GLP-1s, you should add a backup, like condoms or spermicide (vaginal contraceptive gel). You could also switch to a method that doesn’t need to be absorbed by the digestive system, such as a vaginal ring, an implant, or IUD.
