‘Ozempic Babies’: How GLP-1 Agonists Affect Fertility

Ozempic® is having a moment. It’s become the face of weight loss and diabetes medications that are taking the world by storm.

And for good reason. Obesity and diabetes are some of the most prevalent health conditions in the United States. And Ozempic and other GLP-1 agonists are helping people live healthier lives.

But what you may not expect is that you can be more likely to get pregnant if you or your partner takes these medications. It’s a phenomenon that gave rise to #Ozempicbabies on social media.

“It’s not an overstatement to say we’re seeing an Ozempic baby boom,” says Ob/Gyn Deidre McIntosh, MD. “It’s happening for a lot of people. They’ve tried for years, and now, they’re taking these medications and getting pregnant.”

What are Ozempic babies? And how do GLP-1 agonists increase the potential for pregnancy? Dr. McIntosh explains.

What does ‘Ozempic babies’ mean?

Ozempic can boost fertility and, therefore, raise the odds of getting pregnant. As these medications rise in popularity, so, too, do the number of pregnancies reported by women taking them — and getting pregnant after their partner takes them.

Hence, the moniker “Ozempic babies.”

But that’s simplifying things a bit. Ozempic arguably has the most name recognition, but it isn’t the only GLP-1 agonist. Other GLP-1 agonists appear to have similar effects on fertility. (Though the term “GLP-1 agonist babies” doesn’t quite have the same ring to it.)

That includes medications like:

• Tirzepatide (Mounjaro® or Zepbound®)
• Dulaglutide (Trulicity®)
• Exenatide (Byetta®)
• Semaglutide tablets (Rybelsus®)

These medications are relatively new. Researchers haven’t yet quantified the exact effect of Ozempic and other GLP-1 agonists on fertility. So, we can’t say for sure what percentage of women taking them are likely to become pregnant in a certain timeframe. But we do know that it’s happening — and have some solid theories about why.

But it’s important to note that GLP-1 agonists aren’t fertility treatments. They’re medications that are U.S. Food and Drug Administration (FDA)-approved to help people manage diabetes and, in some cases, obesity and sleep apnea. The potential for increased fertility is a side effect. If you’re experiencing infertility, these are not your magic potions for getting pregnant.

How Ozempic affects fertility

What exactly do medications for diabetes and obesity have to do with fertility? A lot, it would seem.

For starters, living with obesity — a body mass index (BMI) greater than 30 — can be a direct hit to your fertility.

“We know that each BMI point above 29 decreases female fertility by about 5%. That’s pretty significant,” Dr. McIntosh reports. “So, when you take medications like Ozempic that aid in weight loss, it can boost fertility.” Obesity also affects male fertility by suppressing hormones that are responsible for sperm production and sperm health.

But weight loss isn’t the only factor. Things like unmanaged diabetes also affect fertility. And GLP-1 agonists help keep diabetes well-managed.

And there’s more. These medications can affect other factors that can matter when you’re trying to get pregnant. For example, they may:

• Decrease inflammation
• Regulate testosterone levels
• Encourage ovulation

Ozempic’s effects on contraceptives

If you use birth control pills, be aware that GLP-1 agonists can also affect how well those pills work.

“Birth control pills are absorbed by your body similar to how your body absorbs food. They need to be metabolized to work,” Dr. McIntosh points out.

But Ozempic and other GLP-1s work by slowing down absorption. That means your hormonal birth control pill may not be absorbed as well — leaving you vulnerable to an unintended pregnancy.

The risk is highest during titration weeks (when you increase your dosage of GLP-1s). Dr. McIntosh recommends using a backup form of birth control during those weeks, such as condoms or a vaginal diaphragm, to avoid pregnancy.

You might also consider switching to another contraceptive option that won’t be affected by using GLP-1s, like:

• IUDs (including hormonal IUDs and the copper IUD)
• Contraceptive implants (Nexplanon®)
• Vaginal rings (NuvaRing®, EluRyng® or Annovera®)

What happens if you get pregnant on Ozempic?

In the best-case scenario, if you’re trying to get pregnant, you shouldn’t take GLP-1 agonists. And vice versa: If you take GLP-1 agonists, you shouldn’t try to get pregnant.

“We counsel patients who could become pregnant to use appropriate birth control while they’re on these medications,” Dr. McIntosh advises. “The best recommendation is to have a washout period between taking GLP-1 agonists and getting pregnant. Because we just don’t know yet exactly what the long-term outcomes are for people who become pregnant while taking these medications.”

One early study suggested that using GLP-1 agonists during the first trimester didn’t harm fetal development. That’s reassuring to be sure. But it’s also important to note that the study only consisted of 168 pregnant women who took the medications. More research is needed before we can know whether GLP-1 agonists are truly safe during pregnancy.

If you do become pregnant with an Ozempic baby, your healthcare provider will likely recommend stopping GLP-1 agonists to help ensure a healthy pregnancy. They may suggest other pregnancy-safe medications and strategies to replace GLP-1 agonists.

“It’s a conversation that should be held between each patient and their practitioner to weigh the risks of continuing with the medication versus the risks of stopping,” Dr. McIntosh reflects. “Your health is important when it comes to sustaining a healthy pregnancy. So, it’s a decision that needs to be personalized to your needs.”

Bottom line

Ozempic and other GLP-1 agonists are helping people achieve a healthy BMI and manage chronic conditions.

If you’re looking to get pregnant in the near future, they may help with that, too. But they're better used to help prepare your body for pregnancy. With the goal of stopping the medication prior to becoming pregnant.

And if pregnancy isn’t the goal, talk with a healthcare provider about your best options for contraceptives to use while taking GLP-1 agonists.