What You Need to Know About Ozempic and Pregnancy

Pregnant woman on scale.

Ozempic is a brand name for an active pharmaceutical ingredient called semaglutide.

Not only has this drug been designed to treat type 2 diabetes by regulating blood sugar levels, Ozempic has also been proven to aid weight loss in certain individuals.

A few years after the release of Ozempic, the manufacturer received FDA approval to market a separate drug called Wegovy. Wegovy also contains semaglutide and is specifically designed for weight loss.

Since then, Ozempic and Wegovy have received much attention in the media for their weight loss benefits. However, despite the popularity of these drugs, not many people know how they affect pregnant patients.

In this article, we will outline how Ozempic may impact fertility, pregnancy, and breastfeeding mothers.

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What is Ozempic?

Typically, Ozempic may be prescribed by healthcare providers to those who have been diagnosed with type 2 diabetes — a long-term chronic medical condition that results in unregulated blood sugar levels.

The drug works to regulate blood sugar by mimicking a naturally occurring hormone called glucagon-like peptide-1 (GLP-1). Semaglutide increases insulin secretion and suppresses glucagon release. It also slows gastric emptying. These three functions help to manage blood sugar levels.

In some people, Ozempic may help to suppress appetite, helping people feel fuller for longer. This can result in reduced food intake and subsequent weight loss.

Additionally, maintaining controlled blood sugar levels can contribute to weight management.

Although numerous studies have examined the benefits of Ozempic for blood sugar control and weight management, limited research is available regarding its effects on pregnant women and their unborn babies.

So if you are pregnant and considering Ozempic for weight loss, be sure to consult with your healthcare provider. They can give you information about potential risks associated with the drug and work with you to develop a comprehensive treatment plan to reach your weight loss goals.

Are Weight Loss Drugs Safe to Take While Trying to Get Pregnant?

Overall health plays a significant role in conceiving a baby, so it’s no surprise that a person’s weight can impact their ability to get pregnant. Nutrition, physical activity, and weight are three factors that may increase the chances of conception and a healthier pregnancy.

Women wanting to conceive may turn to weight loss drugs to achieve an optimal weight for fertility, but many health experts advise against this. This is primarily because the effects of these drugs are largely unknown.

If you are trying to get pregnant and want to lose weight, consider speaking to your healthcare provider. They can help you develop a healthy lifestyle plan to lose weight and better prepare for pregnancy.

Key Point: When to Stop Using Ozempic or Wegovy Before Conception

Novo Nordisk recommends that women trying to conceive should stop using the medication at least two months before becoming pregnant. This allows enough time for the semaglutide to leave the body completely. It also provides time for the body to readjust and regain its natural hormonal balance.

Does Ozempic Affect Fertility Potential?

Currently, there is no evidence suggesting that Ozempic directly affects women's fertility.

However, according to the Centers for Disease Control and Prevention (CDC), women who aim to conceive have a higher likelihood of getting pregnant when their blood sugar is well-managed, which is the main purpose of Ozempic.

Well-controlled blood sugar levels in women are associated with a reduced risk of miscarriages and improved fertility.

Being obese or overweight can also interfere with becoming pregnant. Increased body fat can cause a hormonal imbalance and prevent women from ovulating.

In men, weight loss can result in better sperm quality and improved sexual function, which may enhance fertility.

Even modest weight loss in women with obesity or polycystic ovary syndrome (PCOS) can improve hormone balance and increase the chances of regular and proper ovulation.

Key Point: What is PCOS?

Polycystic ovary syndrome is a hormonal disorder in women of reproductive age. PCOS can interfere with a woman’s ability to conceive due to irregular or absent ovulation and hormonal imbalances.

Although the direct impact of Ozempic on fertility remains unclear, the weight loss benefits of the drug could potentially enhance fertility.

At present, there is limited research available on how semaglutide affects fertility treatments. However, many patients wanting to receive fertility treatments are often required to lose weight first.

Animal Studies Find Ozempic Unsafe for Pregnant Animals

Semaglutide has never been tested on pregnant humans, but there are several studies on how it affects expectant animals.

Semaglutide found to cause harm in pregnant rats

In a study involving pregnant rats, it was found that semaglutide caused fetal harm, resulting in early pregnancy losses or major birth defects in their babies.

These rats were given less than the maximum recommended human dose (MRHD) of Ozempic.

Key Point: What is MRHD?

A maximum recommended human dose refers to the highest dose of a medication or substance that is considered safe for humans to take based on scientific studies and regulatory guidelines.

The study lasted eight weeks and found that the rat offspring had a low birth weight and various defects.

Some of the rats in the study were given the oral form of Ozempic, which contains salcaprozate sodium (SNAC) to help with the absorption of the drug.

It was found that this absorption enhancer could bypass the female rat’s placenta and reach fetal tissue in the offspring.

It was also found that SNAC increased stillbirths and decreased the viability of the rat babies.

Fetal complications in rabbits and monkeys

Another study on rabbits given an Ozempic MRHD discovered miscarriages and structural abnormalities that resulted in birth defects.

A trial on cynomolgus monkeys found that semaglutide also led to structural abnormalities and birth complications.

The monkeys and rabbits in these studies experienced weight loss while being given the drug.

Despite this research, it is still currently unknown whether these fetal outcomes and birth complications could occur in humans.

The Risks for Pregnant Women with Poorly Controlled Diabetes

It’s worth noting that pregnant women with diabetes have an increased risk of pregnancy complications.

Unmanaged blood sugar in the first two months of pregnancy can affect your unborn baby’s organ development. This can lead to infants with birth defects in the brain, spine, and heart.

Babies born from diabetic mothers can experience high blood pressure while in the womb, resulting in them growing larger than the average infant. This can cause discomfort in pregnant women, and they may need a C-Section to deliver the baby.

Also, uncontrolled blood glucose levels can lead to early birth, which means the infant could be born with breathing, heart, vision, and intestinal problems. Women with unmanaged diabetes could also have a higher potential risk of miscarriage or stillbirth.

According to the manufacturer, Ozempic should only be used for blood sugar management in pregnant women if the potential benefit justifies the risk to the unborn child.

Can You Take Ozempic for Weight Loss During Pregnancy?

Pregnant mothers may want to take steps to prevent weight gain while carrying their baby, including taking Ozempic. However, weight gain during pregnancy is not only normal; it is a necessity.

During pregnancy, something called obligatory weight gain occurs. This means that pregnant women will naturally gain weight due to changes in maternal tissues, the growth of the baby, the placenta, and the fluid surrounding the developing fetus.

According to the CDC, not gaining enough weight during pregnancy could result in babies being born prematurely or too small for their age.

Even if you are overweight or obese, it is still recommended that you gain some weight during pregnancy. The CDC says your pre-pregnancy weight and body mass index (BMI) will determine how much weight you need to gain.

This index is a universal metric used to determine an individual's weight category, such as being underweight or overweight.

These are the healthy weight gain recommendations for women pregnant with one baby, according to the CDC:

BMI Category Amount to Gain During Pregnancy
Underweight: BMI less than 18.5 28 to 40 pounds
Normal Weight: BMI 18.5-24.9 25 to 35 pounds
Overweight: BMI 25.0-29.9 15 to 25 pounds
Obese: BMI greater than or equal to 30.0 11 to 20 pounds

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What to Do if You Get Pregnant While Taking Ozempic

If you are currently taking Ozempic or Wegovy and discover that you are pregnant, it’s crucial that you consult with a healthcare provider right away.

You shouldn’t try to stop taking these medications on your own.

Your doctor can help you safely discontinue using the drug and ensure you’re receiving the right care for your pregnancy.

Can Ozempic Be Taken While Breastfeeding?

There is currently no evidence that proves that Ozempic is safe to use while breastfeeding. Similarly, the data regarding whether semaglutide can be passed to an infant via breast milk is still limited.

While new mothers may be tempted to use Ozempic to lose weight quickly after their pregnancy, this is not advised as it may impact your infant if you are breastfeeding.

If you are breastfeeding and want to lose weight, speak to a physician about your options to help keep you and your baby safe.

FDA Monitoring and Further Studies

The FDA is currently monitoring cases where women are taking Ozempic or Wegovy during pregnancy.

It has also requested that Novo Nordisk start researching the potential risks and complications related to Ozempic and Wegovy in pregnancies that have already occurred.

The manufacturer has now created a registry to follow the health outcomes of women exposed to semaglutide during pregnancy compared to those who were not. These studies are expected to be completed between 2027 and 2033.

Where Can I Learn More About Other Options for Weight Loss While Pregnant or Breastfeeding?

At LifeMD, we understand that weight loss is not just about changing the number on the scale but also identifying the root causes of weight gain and addressing any related health issues. That’s why we developed the LifeMD Comprehensive Weight Loss Program, a 360°, primary care-oriented approach to weight loss.

While GLP-1s are powerful tools for weight loss, they’re not an option for everyone, including women who are pregnant or breastfeeding. Come learn about your other weight-loss options.

Dr. Danielle Weiss

Dr. Weiss earned her MD from NYU School of Medicine, completed her residency at Scripps Mercy San Diego, and an endocrinology fellowship at Stanford University. She’s Board Certified in both Internal Medicine and Endocrinology, Diabetes, and Metabolism.

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This article is intended for informational purposes only and should not be considered medical advice. Consult a healthcare professional or call a doctor in the case of a medical emergency.

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