Can Ozempic Help You Get Pregnant?
We get this one a lot, and Ozempic seems to be everywhere right now. Our experts from Harvard & Emory break down the evidence — or lack of it.
TL:DR: If you have been using Ozempic (or any other semaglutide or GLP-1 receptor antagonists) and are planning to conceive, it’s a good idea to talk to your doctor since it is currently not recommended during pregnancy (and by extension, while trying to conceive) given limited safety evidence.
Beyond safety concerns, and perhaps more importantly, there is currently very limited data on what impact these type of drugs may have on fertility.
The science shows that for individuals experiencing obesity, type-2 diabetes, or some PCOS typologies, Ozempic and other medications like it may help support metabolic and hormonal health and may therefore improve fertility in some people.
However when misused to maintain a very low body weight, the opposite is true: it causes a disruption to both metabolic and hormonal health that can negatively impact fertility.
Ozempic is a type of medication called a semaglutide, which is used to treat type 2 diabetes by controlling blood sugar levels. While Ozempic is not approved by the FDA for weight loss, some healthcare providers may prescribe it for this purpose.
If you have been using Ozempic (semaglutide) and are planning to conceive, it is important to discuss your plans with your doctor, since Ozempic is currently not recommended for use during pregnancy (in fact, given limited safety data available, the American Diabetes Association recommends that women who are pregnant or planning to become pregnant should avoid using Ozempic and other GLP-1 receptor agonists).
When it comes to the research on the effects of Ozempic (and other semaglutides) on fertility specifically, the evidence is also extremely limited, mostly done on animal models, lacks long-term study and follow up, and is “early” in our evidence grading system.
Plus, the results are mixed: some studies suggest that Ozempic may have a positive impact on fertility while others point to more negative impacts. We’ll try to break this down.
When it comes to female fertility, the topic of weight loss is mostly studied in obese and PCOS populations.* Studies show sustained weight loss (even when modest) can help improve fertility by reducing insulin resistance, regulating menstrual cycles, and improving hormone levels.
*PCOS presents differently in different people, and the "type" of PCOS these studies observe tends to be one correlated with higher body weight. Not all PCOS patients present this way, and we don't have good evidence on whether Ozempic and other similar medications help or hurt for those groups.
When it comes to male fertility, supporting metabolic issues which can be tied to sustained weight loss can help improve testosterone levels in men with type 2 diabetes and obesity, and can therefore lead to better sperm quality and sexual function.
However, even though weight loss in general is well studied, weight loss with Ozempic and other medications in this class has not been studied much in humans. In one of the best studies in humans on this topic to date, men treated with a GLP-1 agonist for weight maintenance after losing weight through caloric restriction did not have any benefit in terms of semen quality compared to men treated with diet and exercise; the men who did best in in terms of better semen quality were those who lost weight and were able to maintain weight loss regardless of how they were treated.
Especially when Ozempic is being used inappropriately to maintain a very low body weight, your body may not be getting the “metabolic health” benefits of the drug. Instead, your body experiences extreme caloric deprivation and goes into survival mode, which can alter hormone levels, specifically by rewiring your pituitary gland.
In female fertility, your pituitary gland is responsible for secreting luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Since Ozempic can impact pituitary gland function, this may explain why Ozempic has been seen to reduce levels of LH and FSH hormones, which are essential signals for coordinating regular ovulation.
In male fertility, Ozempic use has also been associated with reduced testosterone levels, which can affect sperm production and male fertility. Though the data is somewhat limited here, there is some suggestion that there might be lower testosterone levels immediately after an ozempic infusion, but that these levels return to normal. There is also evidence that GLP-1 receptors may exist in the testicular tissue – which is evidence that Ozempic may have direct impacts on testicular function.
There is also unclear evidence about the use of Ozempic and similar medications by either parent and fetal/child health.
For these reasons, in some cases your doctor may ask you to stop Ozempic use before trying to conceive, and perhaps even waiting 2-3 months before trying to allow the medication to be cleared from your system and for your body to readjust to its natural hormonal balance.