Important Insights on Ozempic Use and Unplanned Pregnancies

Babies born to women who are taking weekly injectable medications for weight loss are sometimes referred to as “Ozempic babies.” Weight loss drugs such as semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) are not recommended for pregnant women or women trying to get pregnant. Ozempic babies are typically unplanned pregnancies to women who unexpectedly became pregnant while on these drugs.

Experts say the phenomenon of “Ozempic babies” can be explained by the fact that excess weight is linked to reduced fertility. Therefore, losing weight helps restore ovulation, normal menstrual periods, and fertility, which can lead to pregnancy. Also, it is possible that Ozempic and other similar medications reduce the effectiveness of birth control pills because they interfere with medication absorption.

Please continue reading to learn more about Ozempic babies, including the effects of drugs like Ozempic on fertility, birth control, and the unborn baby. 

What is Ozempic?

Ozempic is a brand name drug that contains semaglutide as the active ingredient. It is used to treat type 2 diabetes. Semaglutide belongs to a group of medications called glucagon-like peptide-1 (GLP-1) receptor agonists. These drugs work by mimicking the action of certain gut hormones that regulate insulin and appetite. Ozempic is taken as a once weekly subcutaneous injection under the skin for blood sugar control. 

Ozempic vs Wegovy: What’s the Difference?

Ozempic has a counterpart that is specifically approved for weight loss. It is sold under the brand name Wegovy and also contains semaglutide as the active ingredient. Wegovy can help you lose weight when used in combination with a reduced-calorie diet and increased physical activity. Clinical trials have shown that people lose weight to the tune of 15% to 20% on average on Wegovy and other similar weight loss drugs. 

Not sure which is right for you? Check out our blog, “Ozempic vs Wegovy for Weight Loss: Key Differences.”

Who Should Use Ozempic?

Adults with type 2 diabetes should use Ozempic along with diet and exercise to improve blood sugar (glucose) control. Taking Ozempic can lower the risk of major cardiovascular events such as heart attack, stroke, and death in adults with type 2 diabetes and cardiovascular disease.

Ozempic is used off-label for weight loss. Its sister drug, Wegovy, is approved for chronic weight management in overweight and obese adults and children aged 12 years and older. Find out, “How Long Does It Take to Lose Weight on Wegovy?”

What Does “Ozempic Babies” Mean?

An Ozempic baby is a baby born to a woman who became unexpectedly pregnant while taking Ozempic. As mentioned, Ozempic is a diabetes medication that many people take off-label as a weight loss medication. 

Maternal-fetal medicine specialists are increasingly reporting surprise “Ozempic babies” and “Ozempic pregnancies.” Women who thought they couldn’t conceive are getting pregnant on Ozempic and other similar medications.

Early indications are that the Ozempic baby boom on GLP-1 receptor agonists like Ozempic can be explained by two things - reduced effectiveness of oral birth control and improved fertility.

Expert Opinion on Ozempic Babies

At present, very little is known about the effects of GLP-1 agonists on fertility and safety during pregnancy. The manufacturers of these drugs, Novo Nordisk (Ozempic and Wegovy) and Eli Lilly (Mounjaro and Zepbound), did not include pregnant women in their clinical trials on these weight loss drugs. 

Nonetheless, with the increasing use of these medications, more women are getting pregnant while on them. Researchers are currently gathering data on the risks of exposure to Ozempic and Wegovy during early pregnancy. 

Does Ozempic Affect Birth Control?

Ozempic and Hormonal Birth Control

The prescribing information for the dual GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1) medication tirzepatide (Mounjaro and Zepbound) includes a warning that its use may reduce the efficacy of oral hormonal contraceptives. These drugs delay gastric emptying (slow the passage of food through the stomach). This makes you feel full longer and regulates appetite, which leads to weight loss. However, delayed gastric emptying can also impact how all oral medications — including oral contraceptives — are absorbed by your body. Learn about 8 Hormone-Free Birth Control Options.

The effect of GLP-1 agonists on birth control pills is especially present when you first start treatment or increase your dose, and it gradually decreases over time. Therefore, patients using oral birth control pills are advised to switch to non-oral contraceptive methods or add a barrier method of contraception for 4 weeks after starting treatment and 4 weeks after each dose increase of tirzepatide. 

Semaglutide (Ozempic and Wegovy) also causes delayed gastric emptying, similar to tirzepatide (Mounjaro and Zepbound). It is, therefore, possible that Ozempic can make oral birth control pills less effective, especially when starting the medication and increasing the dose. However, Ozempic and Wegovy do not affect non-oral methods of hormonal contraception such as intrauterine devices (IUDs), patches, implants, and vaginal rings. Want more information on semaglutide vs tirzepatide? Check out our blog, “Mounjaro vs Ozempic: Weight Loss Drugs Compared.”

Expert Opinions and Medical Guidelines

There are currently no restrictions or guidelines on taking Ozempic and Wegovy with any form of birth control, including the pill.

However, if you are taking Mounjaro or Zepbound (generic tirzepatide) and are on birth control pills, you have two options:

• Switch to a different birth control method, such as an IUD, ring, or implant.

• Use a backup barrier method of birth control, such as condoms, for 4 weeks after starting treatment and every time you increase the dose of tirzepatide.

FAQs About Ozempic and Birth Control

Does Ozempic interact with birth control?

It’s possible Ozempic (semaglutide) interferes with your body’s ability to absorb oral contraceptive pills and makes them less effective. More research is needed to understand this effect. Find out about other Ozempic medication interactions.

Does semaglutide affect birth control?

Small studies have shown that Ozempic (semaglutide) does not affect the absorption and blood concentrations of oral birth control. Larger studies are needed to explore the links between GLP-1 use and birth control failure.

Can you get pregnant while on Ozempic and birth control pills?

There are anecdotal reports of women on GLP-1 agonists like Ozempic and Wegovy experiencing unplanned pregnancies and giving birth to Ozempic babies. We do not know the short- and long-term effects on babies exposed to these drugs during early pregnancy.

Does Ozempic Affect Fertility? 

Ozempic and other GLP-1 medications may affect fertility in two ways. The first is through weight loss, and the second is by making oral birth control less effective. 

Weight Loss and Fertility

Being overweight or obese can interrupt your menstrual cycle and prevent ovulation. In other words, excess body weight is a risk factor for decreased fertility. Weight loss with Ozempic or Wegovy can restore normal ovulation, regularize menstrual cycles, and improve fertility.

Evidence supporting the link between weight and fertility is based on women with a condition called polycystic ovary syndrome (PCOS). PCOS is associated with hormonal imbalances and is linked to insulin resistance, weight gain, irregular menstrual cycles, and reduced fertility. Weight loss improves PCOS symptoms in many women. In addition to lifestyle changes such as eating a reduced-calorie diet and exercising regularly, anti-obesity medications such as semaglutide and liraglutide (GLP-1 receptor agonists) have been recommended for women with PCOS to help normalize menstrual cycles and improve fertility. More research is being done to see if semaglutide can be used as a treatment for PCOS. 

Birth Control and Fertility

On top of increased fertility, drugs such as tirzepatide (Mounjaro and Zepbound), which are similar to semaglutide (Ozempic and Wegovy), have a warning in their prescribing information that they can make birth control pills less effective. Therefore, birth control failure can potentially lead to pregnancy in women taking these medicines. 

Note: Mounjaro and Zepbound have an explicit warning about birth control pills, while Ozempic and Wegovy have a general warning about all drugs taken by mouth.

Does Ozempic Affect Sperm?

There is no evidence of a direct link between semaglutide (Ozempic) and sperm quality. However, obesity and diabetes are linked to low testosterone levels, which in turn can lead to decreased sperm production and reduced fertility in men. By treating diabetes and obesity, Ozempic could potentially improve sperm production. More research is needed on this link. Men should talk to a fertility specialist about the risks and benefits of taking Ozempic if they are planning to become fathers.

Scientific Data on Ozempic and Fertility

The new trend of “Ozempic babies” where women become pregnant after using Ozempic for weight loss, raises interest in the fertility effect of Ozempic and other drugs in its class. 

However, there is no formal data available on Ozempic (semaglutide) and fertility. GLP-1 medicines have not been studied in infertile women as a fertility treatment. There are ethical issues about exposing pregnant women to drugs whose safety during pregnancy is unknown. As a result, pregnant women and women who were trying for a baby were not included in the studies conducted on GLP-1 drugs such as semaglutide and tirzepatide. 

More data needs to be accumulated on whether these medications can affect fertility. This will be possible as more and more women who are on Ozempic become pregnant. In other words, researchers and clinicians will be able to collect indirect information about Ozempic and fertility by studying mothers of Ozempic babies. 

Medical Advice and Precautions: Should You Take Ozempic If You’re Trying to Get Pregnant?   

Taking Ozempic is not recommended if you’re trying to get pregnant. However, a higher weight can negatively impact fertility. Healthcare providers recommend that you should be at a stable and healthy weight before you get pregnant. A healthy eating and exercise plan is the best way to reach your goal weight and improve your chances of getting pregnant and having a healthy baby. 

If weight loss is not achievable with diet and exercise alone, the decision to start, continue, or stop a weight loss medication such as semaglutide (Wegovy or Ozempic) should be made after carefully weighing the benefits and risks.

If you are planning a pregnancy, discuss your medications, weight loss goals, and fertility with your health care team, including your primary care physician, endocrinologist, and obstetrician. 

Can Pregnant Women Take Ozempic?

GLP-1 medications such as Ozempic and Wegovy are not recommended for women who are actively trying to conceive. These medications are used to manage blood sugar levels and excess weight. However, their impact on early pregnancy and the development of the baby is not well understood. The recommendation is to stop taking GLP-1 medications like Ozempic and Wegovy at least 2 months before trying to get pregnant.

If you become pregnant while taking semaglutide (Ozempic), call your doctor immediately. They will ask you to stop taking Ozempic and restart it once you are no longer pregnant or nursing an infant with breast milk. 

Can Semaglutide Cause Birth Defects?

Animal reproduction studies suggest that medications like Ozempic (semaglutide) are associated with a higher risk of miscarriage and birth defects. These medications work by reducing appetite. The restricted energy intake in a pregnant animal does not allow the baby to get enough nutrients and grow properly. As a result, babies born to mice and rats exposed to drugs like Ozempic are small and have malformations.

Small studies in humans have not shown that GLP-1 agonists and other medications for diabetes increase the risk of major birth defects. However, there aren’t enough large studies in humans to confidently say these drugs do not negatively impact pregnancies. 

Because researchers cannot rule out possible risks to the developing baby, you should not take Ozempic while pregnant. However, there may be some exceptions when the risks of stopping Ozempic are more than the potential risks of continuing it. 

In the future, as more women become pregnant while taking Ozempic and give birth to “Ozempic babies”, drug registries will be able to collect information about the effects of these drugs on fertility, pregnancy, and the mother and baby’s health. A Wegovy Pregnancy Registry is collecting data about the safety of Wegovy (semaglutide) in pregnancy. This registry plans to enroll more than 1,100 participants and is due to be completed by mid-2027.

Is Ozempic Safe for Children?

Ozempic (semaglutide injection) is approved for use in adults with type 2 diabetes. The safety and efficacy of this drug have not been established in people younger than 18 years of age.

Can Children Take Wegovy?

Wegovy (semaglutide injection) is approved for use in obese children 12 years of age and older who have an initial body mass index (BMI) at the 95th percentile or higher for age and sex. This medication should be used alongside a reduced-calorie diet and increased physical activity for chronic weight management.