GLP-1 RAs and pregnancy: What women need to know before trying to conceive

After starting GLP-1 receptor agonists (GLP-1 RAs) like Zepbound® and Ozempic®, women reported they got pregnant. This came as a surprise to some, especially those who had been trying to conceive unsuccessfully for a while. But there’s a reason this happens.

Being overweight is linked to fertility problems like implantation issues and miscarriages. Weight loss reduces these risks, and GLP-1 RAs help people between 6–30% of their body weight or more, depending on the medication. 

If you’re trying to lose weight before you conceive, GLP-1 RAs are a safe option. But once you’re pregnant, the official guidance is to stop taking the medication.

So what happens if you get pregnant unexpectedly while on treatment? Are there risks of stopping GLP-1 RAs? We’ll explain the answers to these questions and more to unpack the relationship between GLP-1 RAs and pregnancy.

Understanding GLP-1 RAs

GLP-1 RAs are medications that mimic glucagon-like peptide-1, a hormone your body naturally produces. This hormone has several effects, like regulating blood sugar, reducing appetite, and making you feel more full. 

Though doctors prescribe GLP-1 RAs for many reasons, the two most common are weight management and type 2 diabetes management. According to researchers from Johns Hopkins, women who take GLP-1 RAs lose an average of 11% of their starting weight after 43 weeks of treatment. Up to 63% of type 2 diabetes patients on GLP-1 RAs reach healthy blood sugar levels after at least 12 weeks.

There are multiple GLP-1 RAs on the market, each indicated for different uses. Common GLP-1 RAs include: 

• Tirzepatide (Mounjaro®, Zepbound®)
• Orforglipron (Foundayo®)
• Semaglutide (Ozempic®, Wegovy®)
• Liraglutide (Victoza®, Saxenda®)
• Dulaglutide (Trulicity®)
• Exenatide (Byetta®, Bydureon®)

Are GLP-1 medications safe during pregnancy?

Currently, GLP-1 RAs aren’t recommended for use during pregnancy. This is due to limited research on the topic. Human studies show limited evidence about the medication’s safety and risks, and animal studies suggest potential harm. If you get pregnant unexpectedly or plan to conceive, let your doctor know immediately.

How long should you stop GLP-1 RAs before pregnancy?

Doctors recommend ending treatment around two months before trying to have a baby (varying by medication type). This gives the medication enough time to fully clear out of your body. Talk to your physician—they’ll adjust timing based on what’s right for you. 

What happens if you get pregnant while taking GLP-1 RAs?

Researchers are still studying the effects of GLP-1 RAs during early pregnancy. One small study found no increased risk of major birth defects or miscarriage among women who took GLP-1 RAs during their first trimester. A review of more than 50,000 pregnant women found that use of GLP-1 RAs and other diabetes medications didn’t increase the risk of malformations. 

Though these early studies are promising, clinicians still recommend stopping treatment during pregnancy. GLP-1 RAs aren’t approved for use in pregnancy at this time. As soon as you learn you’re pregnant, stop taking the medication, and talk to your doctor. 

Effects of stopping GLP-1 RAs before pregnancy

Discontinuing treatment can lead to weight regain. Those who stop GLP-1 therapy may also gain more weight during pregnancy compared to those who were never on treatment. 

Researchers also associate ending GLP-1 therapy before pregnancy with a few risks.* Women who stopped taking a GLP-1 RA before or during early pregnancy had roughly 1.3x the risk of preterm birth, gestational diabetes, and high blood pressure conditions during pregnancy, compared to similar women who had not taken a GLP-1 RA.

*These findings show an association between stopping GLP-1 RAs and these outcomes, but not a causation. Many women maintain good health after discontinuing GLP-1 therapy and throughout pregnancy. 

GLP-1 RAs’ possible effects on fertility

Research on how GLP-1 RAs affect fertility is limited but promising. Early studies show these medications minimize pregnancy complications related to gestational diabetes and control blood sugar levels. They may also improve ovulation, menstrual cycle regularity, and pregnancy rates for people experiencing obesity or polycystic ovary syndrome.

Even though this research isn’t conclusive, many people report getting pregnant while taking GLP-1 RAs. That’s where the phrases “Ozempic fertility” and “Ozempic babies” comes from. But GLP-1 RAs aren’t fertility treatments. If you’re trying to start a family, stop taking GLP-1 RAs and talk to your doctor.

How Maven Clinic supports preconception planning

Navigating GLP-1 RA use and pregnancy can feel overwhelming, but you don’t need to handle it alone. At Maven Clinic, we offer integrated care for people navigating all stages of life, including pregnancy. We put a team of specialized clinicians in your corner, from dieticians and pediatricians to OB-GYNs and midwives. This includes GLP-1 RA specialists who guide you through every step.

Compassionate care is at the heart of what we do. To find out more, reach out to our support team, or read about our approach to whole-person care.

FAQ

Do GLP-1 medications affect how well birth control works?

GLP-1 RAs slow gastric emptying (how fast food leaves the stomach), which may reduce how well oral contraceptives are absorbed

Tirzepatide has the most pronounced effect, partially because of its strong gastric emptying delay. Lixisenatide and exenatide may influence outcomes, too. There’s currently no evidence suggesting dulaglutide, liraglutide, or semaglutide affect contraceptive effectiveness. 

Can GLP-1 RAs cause pregnancy? Ozempic®, tirzepatide, and pregnancy

Not directly. These medications may support fertility, mainly by improving metabolic health (like supporting weight loss). They may also support ovulation. But research is limited, and GLP-1 RAs aren’t a fertility treatment. 

When can I restart a GLP-1 medication after pregnancy?

While there’s no set timeline on restarting GLP-1 RAs, currently these medications aren’t recommended if you’re breastfeeding. Because of limited research, it’s unclear whether GLP-1 RAs enter breast milk and how that may affect infant development. 

If you’re not breastfeeding, your physician might discuss restarting treatment earlier. A common timeline is 12–16 weeks post-delivery. Your physician will find the time that makes sense for you. 

Will stopping a GLP-1 RA before pregnancy cause rapid weight regain?

This isn't unique to pregnancy — weight regain after stopping GLP-1 RAs is common. With that said, pregnancy may contribute to additional regain. 

Can semaglutide affect my baby's growth?

Semaglutide may limit fetal growth, but research is limited and primarily from animal studies. Given this uncertainty, GLP-1 therapy isn’t recommended during pregnancy or while breastfeeding.

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