Ozempic babies: can prescription weight loss drugs boost fertility?

Ozempic (semaglutide) is a prescription drug in the GLP-1 receptor agonists class. It’s U.S Food and Drug Administration (FDA) approved to improve blood sugar and reduce the risk of serious cardiovascular events, including heart attack, stroke, and death in those with type 2 diabetes. People taking it lose weight, so it’s used off-label (for something it’s not prescribed for) for weight loss too. 

Taking it is also reportedly linked to unplanned pregnancies. Social media posts refer to this phenomenon as “Ozempic babies.” But what’s reality and what’s hype? Do these weight loss drugs boost fertility and lead to pregnancy?

In this article, we dig in and offer some answers.

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Overweight, obesity, and fertility and Ozempic babies

The American Society for Reproductive Medicine (ASRM) reported that obesity contributes to 6% of infertility cases in women who’ve never become pregnant. Women with a body mass index (BMI) between 24 and 31 are 30% more likely to have infertility problems linked with anovulation (when the ovary fails to release an egg during the menstrual cycle) than those at a healthy weight. When a person’s BMI is more than 31, that number increases to 170% more likely. 

Note: BMI measures a person’s body fat based on height and weight. Overweight is defined as a BMI greater than or equal to 25. A BMI greater than or equal to 30 is obesity.

How obesity and weight gain affect fertility

Several studies have shown that overweight and obesity affect reproductive functions in both men and women, resulting in lower fertility rates. Adverse reproductive effects of obesity and overweight can include:

• Irregular menstrual cycles 
• Impaired follicular (tiny fluid-filled sacs that contain one immature egg) development
• Lower number of oocytes (eggs)
• Poor quality of oocytes
• Low sperm count or no sperm 
• Impaired fertilization, embryo development, and implantation

The flip side of this may be that losing weight helps diminish or stop the effects that obesity and overweight have on fertility.

How PCOS may affect fertility

It’s estimated that 8 to 13% of women of reproductive age have polycystic ovary syndrome (PCOS). PCOS is a hormonal imbalance that may be caused by insulin resistance and other factors. It can cause infertility. And obesity can worsen its complications, including infertility. 

What are GLP-1 agonists?

A popular way to lose weight today is using glucagon-like peptide-1 (GLP-1) agonists — such as Ozempic or Wegovy (both semaglutide). Semaglutide lowers blood sugar by mimicking the actions of the GLP-1 hormone. The gut releases the GLP-1 hormone in response to eating, which increases insulin production and lowers blood sugar levels. 

In clinical trials and during post-marketing use, people taking Ozempic for diabetes also lost weight. And studies show that GLP-1 agonist medications lead to sometimes dramatic weight loss. One study found that people taking the 2-milligram Ozempic dose lost between 5% and sometimes more than 10% of their body weight in 40 weeks. People on the 2.4-milligram Wegovy dose lost an average of up to 14.9% of body weight in 68 weeks.

How weight loss and GLP-1s might improve fertility in women

Although researchers aren’t sure how, or if, weight loss and GLP-1 drugs, such as Ozempic and Wegovy, affect fertility, they have ideas, including that they:

• Improve fertility by promoting weight loss as part of a weight loss program in previously infertile women
• Make some types of birth control pills ineffective by interfering with their absorption (GLP-1 drugs slow stomach emptying, which impacts how food and drugs are absorbed)
• Help regulate menstrual cycles and ovulation, which often occurs even with modest weight loss
• Improve metabolic health which could restore healthy ovarian function

And because losing 5 to 10% of your body weight can improve both fertility and PCOS, losing weight with Ozempic might be responsible for Ozempic babies in women with and without PCOS and not Ozempic itself. 

How GLP-1 agonists may Improve fertility in men

While the exact mechanisms of how GLP-1 drugs work for weight loss aren’t well understood, several studies show that their use “appears to be involved in processes vital to spermatogenesis [sperm production].”

 A 2023 study showed an improvement in fertility rates when obese men took GLP-1 weight-loss drugs. The drugs were found to: 

• Improve sperm motility (movement) and metabolism
• Enhance insulin in vitro (in a lab Petry dish)
• Promote positive effects on Sertoli cells ( testicular cells needed for sperm development)

Bottom line: Studies have yet to answer the question of Ozempic babies. But Ozempic itself probably isn’t resulting in Ozempic babies. Losing weight though may be making women and men who take it more fertile and likely to become (or contribute to becoming) pregnant. 

Birth control and Ozempic babies

The buzz over Ozempic babies may have you thinking about birth control. Are Ozempic babies the result of Ozempic affecting birth control? And can you take Ozempic and birth control? 

You can. And one study found that Ozempic did not interfere with the absorption of a certain type of oral contraceptives (birth control pills) that contain levonorgestrel and ethinyl estradiol. This study concluded that there was no evidence that Ozempic lowers the effectiveness of this type of contraceptive. There are many other types of birth control pills, so there’s not enough evidence to show whether Ozempic interferes with other types of contraceptives.

GLP-1 agonists, pregnancy, breastfeeding

Whether Ozempic leads to Ozempic babies or harms pregnant or breastfeeding women isn’t clear. 

People who were pregnant or planned to get pregnant were excluded from Ozempic’s initial clinical trials. And the FDA and Novo Nordisk, who makes Ozempic, couldn’t evaluate its safety during pregnancy. 

Since the drug’s FDA approval, preliminary studies implied that taking Ozempic or other GLP-1 medications during pregnancy may pose serious risks to a developing fetus. It was thought that the risks may include reduced fetal weight and growth or skeletal abnormalities of the developing fetus.

A more recent observational study published in JAMA Internal Medicine in February 2024 though found no apparent link between taking GLP-1 drugs early in pregnancy and major birth defects. 

Still, Novo Nordisk advises those who plan to become pregnant to stop taking Ozempic or Wegovy at least 2 months before trying to conceive. Women who become pregnant or are breastfeeding while taking Ozempic or Wegovy should immediately stop taking the medication.

Key takeaway on Ozempic babies

• It’s possible that GLP-1 drugs like Ozempic affect fertility and are causing pregnancies, but the research hasn’t yet proven this.
• Women are using social media platforms to announce getting pregnant after taking drugs like Ozempic and Wegovy. Many of these women had long-term infertility before taking GLP-1 medications. Others report getting pregnant while taking Ozempic despite being on birth control pills. 
• Studies show that GLP-1 drugs may reduce the effectiveness of some types of birth control pills by interfering with their absorption.
• There’s not enough available study data on whether GLP-1 drugs are safe during pregnancy. There are, though, animal studies that suggest they could harm a fetus during pregnancy. 
• People are advised to stop taking drugs like Ozempic and Wegovy at least 2 months before trying to conceive. If they become pregnant while using these medications, they should stop taking them immediately.

Talk to a provider about Ozempic

If you want to learn more about Ozempic and other alternatives, on Klarity, you can search providers and schedule an appointment to get the answers and information you need. Find a provider on Klarity Health today.