Ozempic and pregnancy: what you need to know | Goodweigh

Does Ozempic affect pregnancy?

What should you do if you are using Ozempic and are pregnant, planning to become pregnant, or become pregnant unintentionally? This blog explains what using semaglutide means during and around pregnancy, what you should do immediately if you become pregnant, and what measures are needed to prevent an unintended pregnancy while on treatment.

Can Ozempic be used during pregnancy?

No. Ozempic is not recommended for use during pregnancy, whether it is being used to treat type 2 diabetes or for weight loss. No targeted clinical trials have been conducted on pregnant women, as testing the medication in this way is not ethically justifiable. Therefore, data from humans is limited.

What is known is based on observational studies of women who were exposed to the medication unintentionally. A Danish cohort study, which examined 32 pregnancies with exposure to semaglutide during the first trimester, found no increased risk of congenital malformations compared to pregnancies without exposure. An international cohort study, which looked at several GLP-1 agonists, confirmed this picture. However, the studies are small, and the lack of evidence means that caution must still be exercised. Furthermore, weight loss during pregnancy is medically undesirable, which in itself is a reason to stop using Ozempic.

What should you do if you become pregnant while using the medication?

Stop using Ozempic immediately once you know you are pregnant. Do not take another injection and contact your doctor as soon as possible. Treatment is discontinued in all cases once pregnancy is confirmed. Your doctor will assess the situation and guide you through your pregnancy.

If you are unintentionally exposed to the medication in the early stages of pregnancy, do not worry unnecessarily. As described above, available observational studies do not currently show an increased risk of congenital malformations. The medication's instructions for use do, however, recommend that you always seek medical advice in the event of exposure during pregnancy so that the situation can be monitored appropriately.

How far in advance should you stop using it if you want to become pregnant?

At least two months before planned conception. The half-life of semaglutide is about a week, which means the substance remains active in the body for weeks after the last injection. The manufacturer specifies that women must stop using Ozempic at least two months before a planned pregnancy to ensure the substance has completely cleared from the body before conception. In practice, doctors often recommend a slightly longer break. Always discuss the appropriate timing with your doctor.

How can you avoid an unintended pregnancy while using this medication?

If you are using Ozempic and do not wish to become pregnant, it is wise to be diligent about contraception. There are two reasons why the risk of an unintended pregnancy may be higher than expected during treatment.

First, semaglutide can restore ovulation in women who are overweight or have polycystic ovary syndrome (PCOS). Studies suggest that weight loss and improved insulin sensitivity can indirectly increase fertility. Women who previously had irregular or absent ovulation may therefore begin to ovulate while using the medication without being aware of it.

Second, side effects such as vomiting and diarrhea, which can occur especially during the initial phase of Ozempic treatment, may temporarily interfere with the absorption of oral contraceptive pills. While clinical trials have not shown a significant interaction between semaglutide and the concentrations of oral contraceptives, the same rule of thumb applies to persistent vomiting or diarrhea as with any gastrointestinal disturbance: the reliability of the pill may be temporarily compromised.

Non-oral contraceptive methods, such as condoms, hormonal or copper IUDs, implants, or injectable contraceptives, are the most reliable options during treatment because they do not depend on gastrointestinal absorption. It is a good idea to discuss this with your doctor.

Does Ozempic affect fertility?

There is no direct evidence that semaglutide affects human fertility either positively or negatively. However, an indirect effect through weight loss and improved insulin sensitivity has been documented: In women with PCOS or obesity, ovulation may return as weight decreases. This is a desired effect if you are trying to conceive, but it requires effective contraception if pregnancy is not the goal.

Can Ozempic be used while breastfeeding?

The use of Ozempic while breastfeeding is not recommended. There is no data available regarding the presence of semaglutide in human breast milk, its effects on the nursing infant, or its impact on milk production. Due to the lack of research data, the manufacturer recommends avoiding its use as long as you are breastfeeding. Discuss this with your doctor after childbirth.

Summary: the rules are clear

Do not use Ozempic during pregnancy. Stop use immediately if you become pregnant and do not take another injection. Contact your doctor as soon as possible. Stop use at least two months before a planned pregnancy. Use a reliable, preferably non-oral, contraceptive method during treatment. Do not use Ozempic while breastfeeding.

Do you have questions about your own situation? Contact Goodweigh or discuss it with your own doctor.