Ozempic and Pregnancy - What You Need to Know
You can’t turn on the TV without ad after ad for GLP-1 medications such as Ozempic (semaglutide) and others for weight loss and blood sugar control, but there are some concerns for women planning to get pregnant. The term "Ozempic babies" has recently been used to describe ‘surprise’ pregnancies in women who were taking these medications. It’s thought that it be due to hormonal changes due to stabilising blood glucose and potential interference with hormonal contraception. Here's what we know about the FDA's recommendations, disagreement within the RE community, and what you should think about if you're considering stopping GLP-1s.
FDA & European Recommendations
The FDA recommends stopping GLP-1 drugs at least two months before becoming pregnant. This is mostly based on animal research that has identified significant potential developmental issues. These medications have a long half-life, which means it stays in your system for several weeks after you stop taking it. The FDA's two-month guideline is intended to reduce any residual drug levels that may affect early fetal development.
More cautious REs recommend quitting Ozempic three months before attempting to conceive or starting an IVF cycle. They say that more time allows your body to reset hormonally and metabolically, resulting in a more optimal environment for conception and early pregnancy. Other REs are more aggressive in their protocols and only recommend discontinuing the meds one week before egg retrieval (due to the delayed stomach emptying and impact on anesthesia). They assume that the medication's effects will not affect egg quality if discontinued at this time. They do, usually, recommend taking the entire two months off before a Frozen Embryo Transfer (FET) to reduce any potential impacts on early pregnancy.
Given a lack of consensus, it’s important to have a clear discussion with your RE about their specific recommendations and the reasoning behind them. Here are some tips to help you make the most informed decision about your care plan:
Ask About Protocols and Rationale: Each RE and clinic may have unique protocols regarding GLP-1 medications. Understanding why your RE recommends one protocol over another can help you assess your comfort level with the plan.
Discuss Alternatives for Weight and Blood Sugar Management: If your RE recommends stopping, ask about other weight management or glucose-regulating strategies that are safer during pregnancy planning.
Consider a Second Opinion: If you feel uncertain about your RE’s advice or if their recommendation seems out of alignment with FDA guidelines or your health goals, consider consulting a second RE. Different perspectives can provide you with a fuller picture and more peace of mind.
What About Partners Taking GLP-1s?
Currently, there is limited data on how GLP-1 medications impact sperm health. Most research and FDA recommendations have focused on potential risks during pregnancy rather than on male fertility. However, because GLP-1 medications influence blood sugar and metabolic function, there is a theoretical basis to consider possible effects on sperm, although no direct evidence has confirmed this.
There are lots of lifestyle changes you can make to manage blood glucose and weight— such as a ketogenic diet. But exercise, stress, sleep and light all play a role too.
Tracy
