Can Ozempic Actually Affect Fertility? Here’s What Two Experts Think Is Going On

Weight loss can improve menstrual irregularities, and it may also increase the chance of pregnancy in women with obesity.

by The Conversation, Robert Norman and Karin Hammarberg
MADRID, SPAIN - NOVEMBER 02: A person using Ozempic on November 2, 2023, in Madrid, Spain. Novo Nord...
Europa Press News/Europa Press/Getty Images

We’ve heard a lot about the impacts of Ozempic recently, from rapid weight loss and lowered blood pressure to persistent vomiting and “Ozempic face”.

Now we’re seeing a rise in stories about “Ozempic babies”, where women who use drugs like Ozempic (semaglutide) report unexpected pregnancies.

But does semaglutide (also sold as Wegovy) improve fertility? And if so, how? Here’s what we know so far.

Remind me, what is Ozempic?

Ozempic and related drugs (glucagon-like peptide-1 receptor agonists or GLP-1-RAs) were developed to help control blood glucose levels in people with type 2 diabetes.

But the reason for Ozempic’s huge popularity worldwide is that it promotes weight loss by slowing stomach emptying and reducing appetite.

Ozempic is prescribed in Australia as a diabetes treatment. It’s not currently approved to treat obesity, but some doctors prescribe it “off-label” to help people lose weight. Wegovy (a higher dose of semaglutide) is approved for use in Australia to treat obesity, but it’s not yet available.

How does obesity affect fertility?

Obesity affects the fine-tuned hormonal balance that regulates the menstrual cycle.

Women with a body mass index (BMI) above 27 are three times more likely than women in the normal weight range to be unable to conceive because they are less likely to ovulate.

The metabolic conditions of type 2 diabetes and polycystic ovary syndrome (PCOS) are both linked to obesity and fertility difficulties.

Women with type 2 diabetes are more likely than other women to have obesity and to experience fertility difficulties and miscarriage.

Similarly, women with PCOS are more likely to have obesity and trouble conceiving than other women because of hormonal imbalances that cause irregular menstrual cycles.

In men, obesity, diabetes, and metabolic syndrome (a cluster of conditions that increase the risk of heart disease and stroke) have negative effects on fertility.

Low testosterone levels caused by obesity or type 2 diabetes can affect the quality of sperm.

So how might Ozempic affect fertility?

Weight loss is recommended for people with obesity to reduce the risk of health problems. As weight loss can improve menstrual irregularities, it may also increase the chance of pregnancy in women with obesity.

This is why weight loss and metabolic improvement are the most likely reasons why women who use Ozempic report unexpected pregnancies.

However, unexpected pregnancies have also been reported by women who use Ozempic and the contraceptive pill. This has led some experts to suggest that some GLP-1-RAs might affect the absorption of the pill and make it less effective. However, it’s uncertain whether there is a connection between Ozempic and contraceptive failure.

In men with type 2 diabetes, obesity, and low testosterone, drugs like Ozempic have shown promising results for weight loss and increasing testosterone levels.

Avoid Ozempic if you’re trying to conceive

It’s unclear if semaglutide can be harmful in pregnancy. However, data from animal studies suggest it should not be used in pregnancy due to the potential risks of fetal abnormalities.

That’s why the Therapeutic Goods Administration recommends women of childbearing potential use contraception when taking semaglutide.

Similarly, PCOS guidelines state health professionals should ensure women with PCOS who use Ozempic have effective contraception.

Guidelines recommended stopping semaglutide at least two months before planning pregnancy.

For women who use Ozempic to manage diabetes, it’s important to seek advice on other options to control blood glucose levels when trying for pregnancy.

What if you get pregnant while taking Ozempic?

For those who conceive while using Ozempic, deciding what to do can be difficult. This decision may be even more complicated considering the unknown potential effects of the drug on the fetus.

While there is little scientific data available, the findings of an observational study of pregnant women with type 2 diabetes who were on diabetes medication, including GLP-1-RAs, are reassuring. This study did not indicate a large increased risk of major congenital malformations in the babies born.

Women considering or currently using semaglutide before, during, or after pregnancy should consult with a health provider about how to best manage their condition.

When pregnancies are planned, women can take steps to improve their baby’s health, such as taking folic acid before conception to reduce the risk of neural tube defects and stopping smoking and consuming alcohol.

While unexpected pregnancies and “Ozempic babies” may be welcomed, their mothers have not had the opportunity to take these steps and give them the best start in life.

This article was originally published on The Conversation by Karin Hammarberg at Monash University and Robert Norman at the University of Adelaide. Read the original article here.

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