Is Ozempic Safe When Getting Pregnant?

Search Reddit and you’ll find dozens of stories of women getting pregnant while on Ozempic. The type 2 diabetes drug—now known for its off-label use for weight loss—has become so popular that there’s a shortage. The same goes for other similar injectable medications like Wegovy.

In the first five years that Ozempic was available, 68 percent of patients were women, many over 40. But between 2020 and 2023, the number of women between 18 and 25 increased by more than six times.

Talk to your doctor about any medications you’re taking when you learn you’re pregnant or decide to try to get pregnant. GLP-1 class of medications are effective in treating type 2 diabetes and can offer significant weight loss. But are they safe to take when you’re pregnant or trying to conceive? We asked OB-GYNs to weigh in.

Ozempic and Wegovy are in a class of drugs called glucagon-like peptide-1 receptor agonists. Ozempic is approved as a treatment for type 2 diabetes. Wegovy is approved specifically for weight loss in people with obesity.

These drugs, called semaglutides, activate the GLP-1 receptors in the body to signal the pancreas to secrete more insulin and keep glucose levels more balanced. They also block the release of the hormone glucagon, which can make the liver release more sugar into the blood.

In terms of weight loss, semaglutide slows stomach emptying and keeps food in the gastrointestinal tract longer. This makes people feel full for longer, so they eat less. It also works in the brain to regulate the hunger and appetite hormones ghrelin and leptin. The drug can also reduce food cravings and turn off “food noise”—the seemingly constant thoughts about food and hunger.

Diabetes and obesity can definitely impact fertility, but there’s not a ton of data yet to explain Ozempic’s effect on it.

“In diabetes, the insulin metabolism is dysregulated,” says Caitlin Dunne, M.D., a reproductive endocrinologist and fertility specialist at the Pacific Centre for Reproductive Medicine. “Insulin has effects not only on your blood sugar but also on many other places in your body. The ovaries and fertility is one of them.”

Being obese also puts women at risk of conditions that affect fertility, such as polycystic ovary syndrome (PCOS), says Jamie Stanhiser, M.D., M.S.C.R., a reproductive endocrinologist and fertility specialist at Reproductive Partners Fertility Center San Diego. Obesity disrupts insulin, glucose, and hormone balance in the ovaries. Weight loss can help restore ovarian function.

“For women who are able to lose even five to 10 pounds of total weight, but especially if they’re able to lose five to 10 percent of their total weight, they can resume spontaneous ovulation,” Stanhiser says.

As a fertility specialist, Stanhiser works with patients trying to conceive, often via IVF, and in very early pregnancy. “This data is largely from the IVF population, but what we know is that obese women will have lower quality eggs in an IVF cycle,” Stanhiser says. “We also know that egg quality can impact embryo quality. Obesity decreases implantation rate, and we also know obesity increases the risk of miscarriage.”

Obesity and diabetes also increase the risk of other complications during pregnancy. These include preeclampsia, preterm delivery, macrosomia (the baby being excessively big), fetal malformations and delivery via C-section.

By controlling diabetes and helping people lose weight, Ozempic may be able to increase fertility, but more research needs to be conducted to know for certain, the experts say.

All of the experts agree: The recommendation is you should not take weight loss drugs while trying to get pregnant. Stop taking it at least two months before trying to get pregnant.

Why two months? “We know it takes six weeks for semaglutide to be mostly out of your system, so two months is just a safe number for it to be totally gone,” Stanhiser says.

Jillian LoPiano, M.D., M.P.H., FACOG, an OB-GYN and chief health officer at Wisp agrees: “There’s not enough data. We just don’t know, so we’re recommending not using it if you’re trying to conceive and stopping as soon as you find out you get pregnant.”

Women should prioritize getting their weight and diabetes under control before becoming pregnant, as both obesity and diabetes can affect fertility and increase the risk of pregnancy complications. Talk to your healthcare provider about alternative diabetes or weight management options before conception.

Ozempic baby on the way? First, Dunne says, don’t panic. Stop taking weight loss medication immediately and call your doctor.

“If you are pregnant and you’re taking one of these medications, just stop using it, and ask your OB-GYN or family doctor about switching over to something that’s going to control your blood sugar,” she says.

As fertility specialists, Dunne and Stanhiser see patients who are actively trying to get pregnant. But many experience surprise pregnancies, Dunne says. “Using contraception while taking these medications is really, really important.”

But keep in mind that GLP-1 drugs can make oral hormonal contraception less effective, LoPiano cautions. If you’re taking Ozempic and using birth control pills, you may want to use an additional backup method of contraception to prevent an unplanned pregnancy.

Stanhiser says Ozempic is classified as a Category C drug in pregnancy, which means there’s not enough information to be certain about risk. Ozempic hasn’t been widely studied in pregnant humans, only in animal studies. “Because we don’t have the data in humans, we can’t reassure women it’s safe to be on semaglutide,” she says.

Studies in pregnant rodents showed harm to the fetuses. Fetal weight, growth and bone formation were all negatively affected. But, Stanhiser points out, “The dose tested in animals was so high that it was toxic to the mother. It was not a human dose—nothing we would give a human patient—so we can’t really draw too much conclusion from that.”

While the research is still scant, what has emerged appears to be reassuring. A small 2024 observational study found that babies of women who’d inadvertently taken GLP-1 drugs in the first trimester of pregnancy didn’t have an increased risk of major birth defects when compared to pregnant people with diabetes or who were overweight or obese.

Typically, diabetes during pregnancy will be managed with diet, insulin and regular monitoring of blood glucose levels.

Insulin has been widely tested and prescribed to pregnant people and has been found to be safe and effective for managing gestational diabetes. Insulin does not cross the placenta.

Other lifestyle changes, such as exercising regularly, can also help with blood glucose levels. Aim for 30 minutes of moderate exercise five days a week.

While diabetes management during pregnancy is important to reduce the risk of pregnancy complications, women shouldn’t actively try to lose weight while they’re pregnant, LoPiano says. Your physician can guide you on what’s a healthy amount of weight to gain during pregnancy.

Preconception counselling is especially important for women with diabetes or obesity who plan to become pregnant.Your physician will review your medical history, review all of your medications and supplements, and do a benefit/risk assessment to determine the best course of action to manage your diabetes during pregnancy.

A doctor can also share the optimal timeline for conception and review your options for birth control for the period before you start trying to conceive.

“The conventional wisdom is to manage diabetes and obesity and optimize your BMI and weight management prior to becoming pregnant,” LoPiano says.

Women with diabetes or obesity should work with their healthcare provider to develop a plan to optimize and improve fertility, manage their diabetes and weight, and reduce the risk of pregnancy complications well before trying to get pregnant. If Ozempic is part of this plan, it’s recommended you stop taking Ozempic at least two months before trying to conceive.

Ozempic is not recommended while trying to get pregnant, during pregnancy or while breastfeeding, as there’s not enough research yet to confirm its safety.

If you become pregnant while taking Ozempic, stop taking the drug immediately and contact your doctor for next steps and advice for keeping your diabetes under control during your pregnancy.

Experts

• Caitlin Dunne, M.D., a reproductive endocrinologist and fertility specialist at the Pacific Centre for Reproductive Medicine

• Jamie Stanhiser, M.D., M.S.C.R., a reproductive endocrinologist and fertility specialist at Reproductive Partners Fertility Center in San Diego

• Jillian LoPiano, M.D., M.P.H., FACOG, an OB-GYN and chief health officer at Wisp