Ozempic and Pregnancy: Does the Drug Affect Fertility?

Fertility is a complicated thing, and there are several factors that dictate when and how a person conceives. So when we hear about “hacks” to getting pregnant — like the idea that Mucinex can help people conceive — we tend to be wary. Right now there’s a lot of chatter online about people getting pregnant after going on Ozempic. But can Ozempic and drugs like it really impact fertility?

TikTok is filled with testimonials from people who say they started taking a medication for weight loss like semaglutide (brand name: Ozempic or Wegovy) or tirzepatide (Zepbound, Mounjaro) and became pregnant not long after. “I was taking semaglutide and . . . I got pregnant,” shared TikToker @dkalsolive in one viral video.

The comments of her post were flooded with similar messages. “My little Mounjaro baby is almost 6 months old after trying for over 10 years with PCOS,” wrote one person. “My surprise Ozempic baby is almost 4 months old and thankfully very healthy,” said another.

So, we asked doctors for the truth: does Ozempic actually improve your fertility, or are these random coincidences?

How Do These Medications Work?

Ozempic is a type 2 diabetes drug with a main active ingredient called semaglutide. It belongs in a class of medications called glucagon-like peptide 1 (GLP-1) agonists and, while it’s technically FDA-approved to treat type 2 diabetes, it’s used off-label for weight loss. (Fellow semaglutide medication Wegovy is FDA-approved for weight loss, though.)

These medications work by mimicking a protein in your body called glucagon-like peptide 1 (GLP-1), explains Mir Ali, MD, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA. This helps increase the production of insulin in your body, which helps with blood sugar management.

But these medications also slow down the movement of food through your gut and signal to your brain to eat less and store less in your body, Ali explains. As a result, you’re not as hungry as you would usually be if you weren’t on the medication.

Tirzepatide medications like Zepbound and Mounjaro work in a similar way, but target an additional receptor called glucose-dependent insulinotropic polypeptide (GIP) receptors. While semaglutide and tirzepatide can both lead to weight loss, research in the journal Nature Medicine has shown that tirzepatide usually helps people drop a greater percentage of their body weight.

Does Ozempic Affect Fertility?

Doctors say there are a few reasons why someone might get pregnant on Ozempic or similar injectable medications. One factor may be weight loss, says Christine Greves, MD, an ob/gyn at the Winnie Palmer Hospital For Women & Babies.

Dr. Greves says that excess weight can cause hormone imbalances that affect ovulation. So it stands to reason that losing excess weight might help restore hormone balance and regular ovulation, improving fertility.

The key words here is “excess” — being underweight also affects fertility, reports the Mayo Clinic, and research on whether weight loss helps everyone is mixed. For example, a 2022 study in the journal PLOS Medicine found that a preconception weight loss program had no impact on fertility, compared to one that included exercise but not targeted weight loss.

Another possible reason someone might experience a “surprise” baby: semaglutide and tirzepatide also slow gastric emptying, which is the rate that food moves through the gut, Dr. Greves says. “That can affect the absorption ability of birth control pills,” she says. As a result, someone may not be getting as large of a dose of oral contraceptives that they thought they were, raising the risk of getting pregnant.

For that reason, if you’re thinking of going on one of these medications and you’re also taking an oral contraceptive, make sure to talk to your doctor. If you don’t want to conceive, Dr. Greves recommends using a backup contraception method, like condoms. She also suggests considering an intrauterine device (IUD), which doesn’t rely on your stomach or digestive system to work properly.

So the bottom line is yes, it’s possible that these medications can impact fertility, albeit not directly. Whether they’ll do so for the entire time you’re on them or temporarily isn’t clear, Dr. Ali says. “It’s something patients should be aware of, regardless,” he says. And while there are anecdotal reports of people taking these medications in the hopes that they’ll help them conceive, that isn’t a recommended use — both because it’s unclear how helpful they are, and also because the meds may not be safe to take during pregnancy (more on that below).

What to Do If You Get Pregnant While On Ozempic

Semaglutide and tirzepatide are not approved for use in patients who are pregnant, and Wegovy states that the medication can cause harm to the fetus. So, if you become pregnant while on these meds, Dr. Ali says you should stop taking the drugs “immediately,” and talk to your doctor about next steps.

Research has not been done on semaglutide in pregnant humans, but animal studies have found a higher risk for miscarriage. Animal studies with tirzepatide also found an increased risk of birth defects.

That’s just one of the reasons why, as of now, doctors aren’t recommending people take these medications in order to help them become pregnant. In fact, Dr. Ali says, “If you’re planning to get pregnant, it’s better to be off the medication for two months beforehand.” (The prescribing information for Ozempic and Wegovy say the same thing.)

Ultimately, anyone considering taking one of these medications or currently on them should be working closely with a doctor. And if you’re also considering trying to conceive or think you may be pregnant, that’s something you definitely want to bring up with your medical provider.

The information in this article is not medical advice. You should always consult your doctor regarding matters pertaining to your health and before starting any course of medical treatment.

Korin Miller is a writer specializing in general wellness, health, and lifestyle trends. Her work has appeared in Women’s Health, Self, Health, Forbes, and more.