Unexpected Pregnancies on GLP-1s: What’s Really Happening?
The term "Ozempic babies" has been gaining attention on social media, referring to unexpected pregnancies that occur while individuals are using GLP-1 medications. While the term specifically refers to Ozempic, it broadly encompasses all GLP-1 medications. This trend has sparked widespread conversation about the impact of these drugs on fertility, with many women sharing stories of conceiving despite past fertility challenges or while on birth control.
Why Might GLP-1 Medications Boost Fertility?
Current consensus is that two primary mechanisms may explain the "Ozempic babies" phenomenon:
Improved Fertility Through Weight Loss
The most significant factor appears to be the relationship between weight loss and fertility improvement. For individuals with obesity, this significant weight loss can lead to:
Restored ovulation and more regular menstrual cycles
Rebalanced hormone levels, particularly estrogen, which rises with obesity and can diminish fertility
Improved symptoms of conditions like PCOS that often coincide with obesity and fertility issues
Medical experts note that each BMI point above 29 decreases female fertility by approximately 5%, making the weight loss effects of these medications potentially significant for fertility.
Potential Interference with Oral Contraceptives
The second mechanism involves how GLP-1 medications might affect the efficacy of hormonal birth control, particularly oral contraceptives:
The slowing down of gastrointestinal transit time, could affect the absorption of oral medications, including birth control pills
Side effects like vomiting and diarrhea, could further reduce the effectiveness of oral contraceptives if pills are not properly absorbed
Anecdotally, the risk appears to be highest during titration weeks when patients increase their dosage. However, it's worth noting that while this mechanism is frequently discussed on social media, there is limited published research specifically exploring the relationship between semaglutide and the effectiveness of oral birth control.
Clinical guidance
Regulatory bodies have issued warnings about using GLP-1 medications before and during pregnancy:
The FDA recommends discontinuing these medications at least two months before a planned pregnancy
The UK's Medicines and Healthcare Products Regulatory Agency (MHRA) has issued alerts regarding contraception and weight loss injections, stating these drugs must not be taken during pregnancy, while trying to get pregnant, or during breastfeeding
If unexpected pregnancy occurs, immediate discontinuation of the medication is advised, and patients should seek prompt medical evaluation and regular antenatal care.
Encourage a conversation with prescriber about non-oral contraceptive methods, especially during titration periods.
Your Conversations Matter
The "Ozempic babies" phenomenon underscores the important role you play in guiding patient decisions about contraception, fertility, and GLP-1 medication use. By fostering open, informed discussions, you can help patients make safe, personalised choices.
As these medications continue to grow in popularity, understanding their full range of effects, including their potential impact on fertility, will remain an important area for ongoing research and public health communication.
References
Cleveland Clinic. (2025). Ozempic Babies. Available at: https://health.clevelandclinic.org/ozempic-babies [Accessed 22 June 2025].
Frank, A. (2024). Ozempic babies: are weight loss drugs leading to unintended pregnancies? BMJ, 388, q2440. doi: https://doi.org/10.1136/bmj.q2440
GOV.UK. (2023). Women on “skinny jabs” must use effective contraception, MHRA urges in latest guidance. Available at: https://www.gov.uk/government/news/women-on-skinny-jabs-must-use-effective-contraception-mhra-urges-in-latest-guidance#:~:text=Women on “skinny jabs” must,in latest guidance - GOV.UK [Accessed 22 June 2025].
University of Texas Southwestern Medical Center. (2025). Surprise Ozempic babies underscore links between obesity and fertility. Available at: https://utswmed.org/medblog/surprise-ozempic-babies-underscore-links-between-obesity-and-fertility/#:~:text=The FDA recommends that people,before becoming pregnant if possible. [Accessed 22 June 2025].
Women's Health. (2025.). Why Are So Many People Getting Pregnant On Ozempic?. Available at: https://www.womenshealthmag.com/weight-loss/a62932157/ozempic-birth-control-fertility-pregnancy/ [Accessed 22 June 2025].
Thanks for reading!
Leif
Got feedback? Email leif@glp1dietitianhub.com, I'd love to hear from you.
Note: This newsletter is for educational purposes only and should not be considered medical advice. Always consult a qualified healthcare professional for personalised guidance.
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