Your friends and favorite celebrities are taking Ozempic and Mounjaro – those weight-loss shots originally for diabetes – and you’re wondering what it all means for starting a family. If you're trying to conceive, you might be asking: Can these GLP-1 medications help my fertility? Are they safe to use if I get pregnant? What about while breastfeeding?
There's talk of surprise "Ozempic babies" on social media – women who struggled with infertility suddenly getting pregnant after losing weight on these drugs. Let's break down what we actually know.
The Quick Facts
What are GLP-1 medications? Originally designed to treat type 2 diabetes, these drugs mimic a gut hormone that helps regulate blood sugar and appetite. The result? People eat less and lose significant weight – clinical trials showed an average loss of 15–20% of body weight.
The big names: Ozempic and Wegovy (both semaglutide), and Mounjaro (tirzepatide). These have become blockbusters for obesity treatment when diet and exercise alone weren't working.
Why "Ozempic Babies" Are Happening
Here's the connection: weight and fertility are closely linked. Carrying extra body fat, especially with conditions like PCOS (Polycystic Ovary Syndrome), can mess with your hormones, disrupt ovulation, and make periods irregular.
Obesity leads to excess estrogen levels (fat tissue produces estrogen), which paradoxically diminishes fertility by throwing off your normal hormonal balance. It can be a frustrating cycle – weight gain impairs fertility, and difficulty conceiving creates stress that can lead to more weight gain.
The hopeful part: Even modest weight loss (5-10% of body weight) can significantly improve fertility. By losing weight, many women see ovulation return and periods become regular again.
Enter GLP-1 medications. By helping patients lose 15% or more of their weight, these drugs can indirectly boost fertility. Doctors are noticing women who struggled with infertility for years are suddenly conceiving after shedding pounds on Ozempic or Mounjaro.
It's not magic fertility dust in the drug itself – it's the weight loss effect. GLP-1 meds aren't fertility treatments, but by treating obesity, they remove obstacles to conception.
The Hidden Risk: Birth Control Failure
It's a well-established fact that GLP-1 agonist medications like Ozempic, Wegovy, and especially Mounjaro can cause oral birth control pills to fail. This happens for two main reasons:
First, common side effects like nausea and vomiting can cause you to throw up the pill before it's fully absorbed. Second, and more importantly, these drugs are designed to slow down your stomach from emptying. This primary function can interfere with and reduce the absorption of oral medications, including the hormones in birth control pills.
Because of this reduced effectiveness, there have been numerous reports of unintended pregnancies. The risk is significant enough that the FDA has issued specific warnings, particularly for tirzepatide (Mounjaro and Zepbound). As a result, many doctors routinely advise patients using these medications to switch to a non-oral form of contraception—such as an IUD, patch, implant, or injection—to ensure they are protected.
Can You Take These Medications While Pregnant?
Short answer: No.
The FDA and manufacturers advise against using GLP-1 medications in pregnancy. The recommendation is to stop taking drugs like semaglutide or tirzepatide at least 2 months before you try to conceive.
Why such a long lead time? These medications stick around. Semaglutide has a long half-life (about a week), and it can take 4-6 weeks for most of it to leave your body. The 8-week buffer ensures the drug is fully cleared.
What about the safety data? Animal studies raised red flags – high doses in pregnant lab animals were linked to pregnancy losses, birth defects, and smaller offspring. We don't have solid human data because these drugs were never tested on pregnant women in clinical trials.
One small observational study of pregnant women with diabetes (who didn't know they were pregnant while on GLP-1s) didn't find higher rates of major birth defects. There are anecdotal reports of women who conceived on these medications and had healthy babies. But these samples are tiny, and we don't have long-term outcomes.
What if you accidentally get pregnant while on these medications? Stop immediately and contact your healthcare provider. Let them know when your last dose was. You'll likely get extra monitoring – early ultrasounds and more frequent check-ups. Many pregnancies with early GLP-1 exposure have turned out fine, so try not to panic.
What About Breastfeeding?
Breastfeeding while on GLP-1 medications is not recommended. The concern is that the drug could pass into breast milk and reach your nursing infant.
One small study of 8 breastfeeding women on semaglutide didn't detect the drug in breast milk. Because GLP-1s are big molecules, some researchers think very little would get into breast milk, and babies' stomachs likely wouldn't absorb much anyway. But due to lack of extensive data, the safe play is to avoid it while nursing.
The plan: If you're breastfeeding, stick to other weight-loss methods. Once you're done nursing, you can discuss with your doctor when it's appropriate to restart a GLP-1 medication.
Your Alternatives When Trying to Conceive
Feeling bummed that these "miracle" shots are off the table? Here are other strategies:
Lifestyle changes: The tried-and-true combo of balanced diet and exercise is first-line. Any amount of weight loss (even 5% of body weight) can improve insulin resistance and hormonal balance. Completely safe for pregnancy, but can be slow and challenging for some women with PCOS or thyroid issues.
Structured support makes a difference: Many women find success with programs specifically designed for the preconception period. At Expect, we've seen women like Emily who started exercising with us at the beginning of her fertility journey, successfully conceived, and then returned to continue training during pregnancy (her son is gorgeous)! Our pre-pregnancy programs focus on sustainable movement that support fertility and long-term health.
Metformin: Not actually a weight-loss drug, but commonly used in women with PCOS or insulin resistance. It improves insulin sensitivity and can promote regular ovulation, with mild weight loss as a side effect. The good news? Metformin is considered safe in pregnancy and often continued to reduce miscarriage risk.
Bariatric surgery: For women with severe obesity, this can be effective before pregnancy. Doctors usually advise waiting 12-18 months after surgery before getting pregnant to allow your body to stabilize.
Fertility treatments: A fertility specialist can provide guidance if weight loss has stalled or time is a factor. Note that most clinics will ask you to stop taking any GLP-1 medications for a minimum of two months prior to starting treatment.
The Bottom Line
GLP-1s can be a powerful tool for weight loss, and losing weight can significantly boost fertility, which is why there have been so many stories about "Ozempic babies." However, until more research is available, it’s advisable to avoid taking these medications if you are pregnant or actively trying to conceive.
The smart approach: Start with lifestyle interventions - nutrition changes, regular movement, stress management, and sleep optimization. These form the foundation of fertility health and can be maintained throughout your entire journey. If lifestyle changes aren't enough and you need additional support, use GLP-1s strategically before pregnancy (with planning) or between pregnancies. Make a game plan with your doctor: use reliable contraception while on the medication, decide when to stop it, and ensure there's a window for it to clear before trying for a baby.
Remember: Fertility and health are about the long game. Reaching a healthier weight - whether through lifestyle changes, medication, or both - sets you up for a safer pregnancy and healthier baby. GLP-1s are one tool to get there, but not the only one, and certainly not the first one to try.
Work with your healthcare team – OB/GYN, fertility specialist, endocrinologist, or dietitian – to create a comprehensive plan tailored to you. Every person's journey is unique, so tune out the social media noise and focus on what works for your situation. The goal is sustainable health changes that support you through conception, pregnancy, and beyond.
Always consult your healthcare provider for personal medical advice. This information is for educational purposes and shouldn't replace professional medical guidance.