Miracle or Concern? Unraveling the Mystery of Ozempic Babies

We’ve heard a lot about the effects of Ozempic lately, from rapid weight loss to lowered blood glucose to nausea.

Now, the news is picking up the topic of “Ozempic babies", reporting women who are using Ozempic (semaglutide) are becoming pregnant ...unexpectedly.

But does semaglutide (also sold as Wegovy) really improve fertility? And if so, how? Here’s what we know so far.

What's Ozempic or Wegovy? How does it work?

When you eat or drink something, your brain sends signals to your body, causing salivation and the release of gastric juices and insulin to rise. Next, your GI tract measures the volume of what is coming in, and your body releases the hormone glucagon-like peptide 1 (GLP-1), signaling to the brain that you are full and don't need to eat more.

Ozempic (and Wegovy) mimic GLP-1. They are known as glucagon-like peptide- 1 receptor agonists (GLP-1 RA) and work directly on the brain. They slow down how quickly food or drink passes through the stomach, improve insulin secretion, and reduce appetite, all of which lead to feeling fuller for longer and result in the effect that got them media attention: Weight Loss.

Too much weight and fertility issues

Obesity affects the finely tuned hormonal balance that regulates the menstrual cycle, resulting in fewer ovulations than women of normal weight. This reduces the likelihood of women with a body mass index (BMI) over 27 getting pregnant.

Additionally, women with type 2 diabetes are more likely to be obese than other women and are more likely to suffer from fertility problems and miscarriages.

Similarly, women with polycystic ovary syndrome (PCOS) are more likely than other women to be overweight and have difficulty conceiving due to the hormonal imbalance that leads to irregular menstrual cycles.

How can Ozempic affect fertility?

People who are overweight are advised to lose weight to reduce the risk of health problems. As weight loss can improve menstrual irregularities, it can also increase the chance of pregnancy in overweight women, and improve the sperm quality in men.

Therefore, weight loss and metabolic improvement are the most likely reasons why women taking Ozempic report unexpected pregnancies.

Some women have reported becoming pregnant while taking the birth control pill and Ozempic. This has led some experts to suggest that some GLP-1 RAs may interfere with the absorption of the pill and impair its effectiveness. However, it is uncertain whether there is a link between Ozempic and contraceptive failure.

The Limitation

And while this all sounds great if you're trying to get pregnant- there's only limited scientific data showing the impact of semaglutide on the fetus, with some cases of birth complications, and fetal malfunction.

It’s not yet clear why the birth complications in animals arise; it’s possible they’re driven only by the weight loss the drugs can bring on, not the medications — which both contain the active ingredient semaglutide — themselves. It’s also possible the side effects won’t manifest at all in humans.

But like most drugs, semaglutide’s effects haven’t been studied yet in pregnant people, so the risks to human pregnancy are uncertain.

Given the majority of people accessing Ozempic and Wegovy are women, and a significant portion will be of childbearing age, this needs more attention.

That's why I have summarized the most important steps to support a healthy baby and mother.

The Recommendations

1. Stop using Ozempic/Wegovy at least two months before a planned pregnancy (according to guidelines)
2. Women with diabetes and pregnant or thinking of becoming pregnant should talk to their healthcare provider about switching to older, better-studied drugs to manage their blood sugar, such as insulin, or lifestyle modifications.
3. Women can take additional steps to improve the health of their baby, such as taking folic acid before conception to reduce the risk of neural tube defects, stopping smoking, reducing alcohol consumption, and staying active to manage blood sugar control.
4. Women of childbearing age should consider additional effective contraception, such as condoms while taking semaglutide.

What happens if you get pregnant while taking Ozempic?

For those who become pregnant while taking Ozempic, deciding what to do can be difficult. This decision can become even more complicated when you consider the unknown potential effects of the drug on the fetus.

The Outlook

It may take years to understand the real impact of GLP-1 RAs on pregnancy.
And while these drugs may be necessary to increase their health and likelihood of pregnancy for some, they may not be the healthiest option for others.

I recommend discussing the next steps with their healthcare provider, to ensure the best treatment for the mother and the baby.