Can You Take Ozempic While Pregnant Or TTC? Experts Caution Against It

Maybe you recognize the name Ozempic, a diabetes management drug, because of its catchy commercial jingle. Or, maybe you’ve seen the medication in headlines about celebrities and influencers taking it for one of its side effects: weight loss. Whether you’re taking the medication for its original purpose or you’re interested in its off-label uses, you might be wondering: Can you take Ozempic while pregnant? What should those who are trying to conceive know about Ozempic and fertility, and is it OK to be taking Ozempic and breastfeeding at the same time? Romper spoke with two experts who explain whether the medication is safe in these scenarios, and who emphasize the importance of not losing weight while pregnant.

What is Ozempic?

Ozempic is one brand of semaglutide, a medication used to manage type 2 diabetes, according to the manufacturer’s website. It is taken as a once-weekly injection administered at home, using an injector similar to an EpiPen. But semaglutides (and a related kind of medication, liraglutides) are also gaining traction in Hollywood as weight loss drugs, The New York Times reports, with celebs like Elon Musk tweeting about using the medication Wegovy himself. Some studies have shown them to be effective at reducing body weight.

“Basically, these medications stimulate glucose-dependent insulin secretion, so they’re used in people who are having issues with insulin, and it can help with diabetes management or obesity,” says Dr. Niamh Condon, DO, an OB-GYN board-certified in obstetrics and gynecology and maternal and fetal medicine, and medical director of labor and delivery at UF Health Jacksonville. “We know poorly controlled diabetes during pregnancy is associated with maternal and fetal risks, so control of diabetes, you would think, is ideal during pregnancy, and it is, but certain medications can be tricky. Not all medications are safe in pregnancy.”

Can you take Ozempic while pregnant?

Whether you’re taking Ozempic to manage diabetes or you’re interested in its off-label uses, OB-GYNs don’t recommend taking it while you’re pregnant.

“Ozempic is not recommended for use during pregnancy for women with diabetes. This is because there are many other, safer alternative diabetes medications to use during pregnancy. Additionally, Ozempic is not recommended to be used during pregnancy for weight loss,” says Dr. Banafsheh Kashani, MD, FACOG, a reproductive endocrinologist and infertility specialist board-certified in obstetrics and gynecology and reproductive endocrinology.

“With this medicine specifically, there are no human studies [about safety during pregnancy], but there have been studies in rats, rabbits, and monkeys, and all have shown adverse fetal effects,” Condon says. “So, it’s difficult to know its safety at this point.”

When asked about what kinds of effects Ozempic had on the animal fetuses, Condon cited growth abnormalities, structural defects, and negative impacts on organ development. “Because there are no human studies yet with respect to pregnancy, maybe we’ll learn more. There might be more to come because diabetes control is really important during pregnancy. But at this point, it’s not recommended.”

Even if Ozempic were to be proven safe during pregnancy, the side effect of weight loss might still prevent it from being used for pregnant patients. “If women remain on Ozempic and have continued weight loss, this can impact fetal growth and development, and lead to a condition called intrauterine growth restriction,” says Kashani. Intrauterine growth restriction, also known as fetal growth restriction, refers to poor growth of a fetus while in the womb, most often because of a lack of nutrition or oxygen from the placenta.

Does Ozempic affect fertility?

When it comes to Ozempic and fertility, both Kashani and Condon say there isn’t good research to explain the effects of semaglutides on human fertility. But animal studies have provided a little insight.

“In male rats, fertility was not affected,” Kashani says. “In female rats, there were some alterations in their menstrual cycles and ovulation, and this suggests some alteration to fertility with the use of Ozempic.”

Kashani adds that dropping below a healthy body weight can suppress ovulation, which may explain what happened in the animal study. If you are on Ozempic and noticing a change in your menstrual cycles, she recommends discussing it with you doctor to make sure you’re still in your ideal body weight range.

On the other hand, Ozempic and similar drugs could theoretically help those with diabetes improve their fertility. “Ozempic can help people with diabetes have an improvement in their blood sugars prior to getting pregnant, and this is beneficial, as better glucose control during pregnancy can lower the rate of miscarriages,” Kashani says.

“Sometimes weight loss and diabetes management can help with fertility, so maybe that’s something we’ll learn about this medication down the road, but right now this is not something we would use to aid in fertility,” adds Condon.

Should you stop taking Ozempic if trying to conceive?

Whether Ozempic might increase fertility for some people is kind of a moot point when you learn you can’t actually be on it when you’re trying to conceive. According to the drug’s website, you should stop using Ozempic two months before you plan to become pregnant. Condon and Kashani second this, saying anyone on the medication should talk to their doctor before trying to conceive.

“This could change as we gather more information about its safety, but for the time being, it is best to stop and wait two months before getting pregnant,” says Kashani.

“Ideally you would see a provider before you got pregnant, and most recommendations say to stop it two months prior to pregnancy just to make sure it’s out of your system,” Condon says. “Physicians should be encouraging contraception use while on this therapy. If a patient becomes pregnant while taking the therapy, the medication should be discontinued and they should be switched to something else so their diabetes is managed.”

Can you take Ozempic while breastfeeding?

It’s still not known if Ozempic passes into your breast milk, according to the safety information on Ozempic’s website. For that reason, doctors say it’s not safe to use as long as you’re breastfeeding.

“What we worry about is, could this accumulate in breast milk and then be passed over to the infant? We just don’t know the possible risks to a breastfed child, so at this point it’s a no until you're done with breastfeeding,” Condon says.

So, if you’re trying to conceive, pregnant, or breastfeeding, it’s best to steer clear of Ozempic and similar medications for now. There isn’t a ton of information available about how semaglutides affect your baby in the womb or via breast milk, and doctors want to know a whole lot more before prescribing these medications to new or expecting parents.

Studies referenced:

Ghusn, W., De la Rosa, A., Sacoto, D., Cifuentes, L., Campos, A., Feris, F., Hurtado, M. D., & Acosta, A. (2022). Weight loss outcomes associated with SEMAGLUTIDE treatment for patients with overweight or obesity. JAMA Network Open, 5(9). https://doi.org/10.1001/jamanetworkopen.2022.31982.

Experts:

Dr. Banafsheh Kashani, MD, FACOG, a reproductive endocrinologist and infertility specialist board-certified in obstetrics and gynecology and reproductive endocrinology

Dr. Niamh Condon, DO, an OB-GYN board-certified in obstetrics and gynecology and maternal and fetal medicine, and medical director of labor and delivery at UF Health Jacksonville