‘Ozempic babies’: surprise pregnancies while using weight loss drugs

Is there an ‘Ozempic baby boom’ happening? Ozempic, a popular drug prescribed for type 2 diabetes and off-label for weight loss, has been linked to a recent trend of unexpected pregnancies, according to reports on USA Today and CNN.

Ozempic has the potential to interfere with the efficacy of birth control pills by affecting the body’s absorption of hormonal contraceptives and reducing the reliability of oral contraceptives. Losing weight can also help restore normal menstrual periods and ovulation in people with excess weight and low fertility.

This article will discuss the effect of Ozempic as a GLP-1 agonist on the effectiveness of contraceptive pills, why healthcare providers need to educate patients on the importance of backup contraception plans, and how Ozempic may lead to improved fertility among women.

How does Ozempic interfere with oral birth control?

Ozempic (semaglutide) increases insulin release in response to elevated blood sugar. Ozempic also slows down stomach emptying by retaining food for longer periods in the stomach and providing a ‘feeling full’ sensation.’’ This has made Ozempic an effective weight loss medication.

However, this may also interfere with how oral medications work in the body, including birth control pills. Ozempic and other GIP/GLP-1 drugs may lower the absorption of birth control pills and oral contraceptive pills, causing an increase in unplanned pregnancies.

Women who are on birth control pills and taking Ozempic simultaneously are advised to take additional birth control options as ‘backup contraception’ for additional protection. Speak with your healthcare provider about the possibility of unintended pregnancies during Ozempic administration and consider birth control alternatives such as intrauterine devices (IUDs), patches, vaginal rings, and implants.

Why do GLP-1 weight loss drugs like Ozempic improve fertility?

There is no formal evidence available to date that proves that GLP-1 drugs like Ozempic (semaglutide) improve fertility. However, there is anecdotal evidence that some women taking weight loss drugs, such as Novo Nordisk’s Ozempic and Wegovy (there is a Facebook group called “I got pregnant on Ozempic”), as well as Eli Lilly’s Mounjaro and Zepbound (tirzepatide), have experienced surprise pregnancies as a potential side effect.  Some medical experts believe that GLP-1 medications may interfere with the absorption of oral contraceptives, and other medical experts believe that weight loss can boost fertility by restoring normal menstrual cycles and ovulation.

GLP-1 drugs haven’t been studied as fertility treatments and women who were planning on becoming pregnant were not included in any clinical trials on semaglutide because GLP-1 medications are not known to be safe for those who are planning on becoming pregnant.

In the absence of direct clinical trial data that researches the effect these medications have on fertility,  data will need to be gathered in other ways and as more people take GLP-1 drugs and become pregnant, more data will be collected on whether or not GLP-1 drugs improve fertility.

How does Ozempic affect fertility?

Ozempic can impact fertility in two ways: through weight loss and reduced effectiveness of oral birth control.

Weight loss

Weight gain is associated with excess storage of body fat and obesity. Obesity and weight gain are associated with Polycystic Ovary Syndrome (PCOS), which results in problems in ovulation, lowered fertility, and hormonal imbalance. In addition, high blood sugar and high blood pressure are common issues that are linked with PCOS.

Until now, there has been no cure for PCOS. However, weight loss can restore normal ovulation, more regular menstrual periods, and improved fertility.

GLP-1 medications such as Ozempic have proved to be effective weight loss agents. GLP-1 (glucagon-like peptide-1) drugs such as Ozempic and Wegovy (semaglutide) were recommended as a line of therapy in the treatment guidelines of PCOS.

Birth control pills

Zepbound and Mounjaro have warnings in their prescribing information that Zepbound and Mounjaro may reduce the efficacy of oral contraceptives and advise patients to switch to non-oral contraceptives or to add a barrier method of contraception for 4 weeks after starting the medication and for 4 weeks after increasing the dose.

However, there is no such warning in the prescribing information for Ozempic and Wegovy.

GLP-1/GIP drugs are effective at boosting insulin production and slowing down digestion. This provides a feeling of fullness, aiding weight loss. However, this action might interfere with other oral medications by slowing their absorption, including birth control pills.

Reducing the absorption of these pills increases the risk of unintended pregnancy while using GLP-1 drugs such as Ozempic, Wegovy, Mounjaro and Zepbund. If you’re using any of these GLP-1/GIP drugs and birth control pills, it’s important to use an additional contraceptive method like an IUD, patch, ring, or implant. Your healthcare provider should be consulted to discuss your options and prevent unexpected events.

Is Ozempic safe to use during pregnancy?

No, pregnant women or women who are planning to conceive are discouraged from taking Ozempic during pregnancy. Pregnant women were excluded from Ozempic studies. Therefore, there is not enough safety data for using Ozempic during pregnancy.

In some cases, GLP-1 medications can be used as an effective weight management tool for women before they plan to become pregnant as excess weight and low body weight can negatively affect fertility and affect the health of the baby.

As these medications last a long time in the body, it is recommended to be off the medication for at least 2 months before trying to become pregnant. If you are planning on becoming pregnant, speak with a licensed healthcare provider about your medications, health goals and weight goals.

A 2023 observational study with 50,000 pregnant women with type 2 diabetes concluded that there were no statistically significant differences in the number of major congenital malformations among the more than 900 women who were taking GLP-1s when they discovered that they were pregnant. Novo Nordisk, the manufacturer of Ozempic and Wegovy, is managing a registry of women taking Wegovy while nursing or pregnant to track their health data through pregnancy and the first year after delivering a baby. Eli Lilly, the manufacturer of Mounjaro and Zepbound, is also setting up a similar registry.

What to do if you become pregnant while taking Ozempic

Women who get pregnant during Ozempic use are advised to stop taking the medication and contact their healthcare provider immediately. The potential risks of Ozempic use during pregnancy are still unknown, according to the Wegovy (semaglutide) injection 2.4 mg drug registry. According to the National Institutes of Health NIH, it is advised that women who are planning to get pregnant should stop using Ozempic two months before conceiving to allow the body to get rid of the drug. After pregnancy, women can resume Ozempic normally.

Bottom line

Losing weight can help restore normal menstrual cycles and normal ovulation, which helps restore fertility. Many women have reported on social media that they have become pregnant while using weight loss injectable drugs like tirzepatide and semaglutide which is likely a result of the growing popularity of these drugs.

While there isn’t clear evidence available yet that explains this phenomenon, it is believed that birth control pills are not as effective while taking these weight loss drugs because they reduce the absorption of the pills.

While it isn’t entirely clear if GLP-1 drugs are safe to use while pregnant, the manufacturers recommend not taking these medications before trying to get pregnant, immediately stopping to take them if you become pregnant and contacting your healthcare provider.