Medically Reviewed
Key Takeaways
- GLP-1 medications are not recommended for weight loss during pregnancy, and most should be stopped if someone becomes pregnant or is trying to conceive.
- Semaglutide drugs such as Ozempic, Wegovy, and Rybelsus require a two-month washout period before attempting pregnancy because the medication remains in the body long after the last dose.
- Human data on GLP-1 use in pregnancy is limited, but available studies suggest no higher fetal risk than insulin, while animal studies show potential developmental concerns.
- Weight loss from GLP-1s can restore ovulation and increase fertility in some people, while certain GLP-1s can also reduce the effectiveness of oral birth control, raising the chance of unplanned pregnancy.
- If someone becomes pregnant while taking a GLP-1, stopping the medication and consulting a healthcare provider allows for safe guidance and appropriate alternatives when needed.
GLP-1 medications offer many potential benefits, such as weight loss, type 2 diabetes management, and lower blood pressure. Clinical trials suggest GLP-1 medications are safe for diverse patient populations.
Which patient populations may want to practice caution when using GLP-1s? People who are pregnant, breastfeeding, or trying to conceive.
Weight loss medications and pregnancy are an underexplored area, but recent research and guidelines from drug manufacturers reveal some important facts about GLP-1 medications and pregnancy.
Continue reading for guidance on when it’s safe to take these medications, why “Ozempic babies” are in the news, and how these medications affect pregnancy and birth control.
Why GLP-1s are Contraindicated in Pregnancy
Glucagon-like peptide-1 receptor agonists (GLP-1RA) are medications that mimic the effects of GLP-1, a naturally occurring hormone that regulates our appetite and helps control blood sugar levels. Due to these potential benefits, various GLP-1 medications are FDA-approved to treat obesity, type 2 diabetes, or both.
When it comes to pregnancy, there are varying guides among the six common classes of GLP-1s. Some should not be used during pregnancy, while others might be used under medical supervision when the benefits outweigh the potential harms.
While the FDA states some GLP-1 medications may be used for type 2 diabetes—when a healthcare provider determines the benefits outweigh potential harms—these medications should not be used for weight loss during pregnancy.
Intentional, significant weight loss may put the baby and/or parent at risk during pregnancy and delivery.
Animal Study Findings vs. Human Data Gap
Most of these drugs are not recommended during pregnancy or are recommended in limited cases where the benefits outweigh potential harms. The reason for this caution is because of findings in animal studies.
Studies on the six drug classes suggest that the use of semaglutide led to fetal harm in pregnant rat populations.
That said, animal studies don’t always directly apply to us. Unfortunately, there isn’t much data with human test subjects. Most of the human studies we have are case studies, meaning they feature results from one patient:
- A 2009 case study on one expecting parent using exenatide suggested there was no fetal harm, though she discontinued exenatide use during the first trimester.
- In a 2003 case study, maternal use of exenatide did not cause harm to the baby.
- A 2015 case study found that a 37-year-old woman had a normal pregnancy after using liraglutide in the first trimester.
Case reports with a small number of patients are not generalizable, though they do suggest that some women may experience a normal pregnancy if they transition off a GLP-1 medication during the first trimester.
The largest study to date is a 2024 study with 50,000 pregnant people with type 2 diabetes. The results suggested GLP-1 medications present no greater fetal risk than taking insulin. While this study offers a larger patient population, it’s still in the “limited evidence” bucket when it comes to GLP-1 medications and pregnancy.
To help address this lack of data, Novo Nordisk is collecting stories from people who took WeGovy when pregnant. Hopefully, their Wegovy Pregnancy database can someday help future mothers and healthcare providers better understand if this medication is safe or not during pregnancy.
Potential Risks to Fetal Development
Animal studies offer potential risks to fetal development, such as:
- Decreased weight at birth
- Harm to fetal development
- Birth defects to internal organs
- Birth defects involving the musculoskeletal structure
- Minor differences in bone structure
- Higher chance of miscarriage
GLP-1s and Breastfeeding: What We Know (And Don't Know)
Similar to pregnancy, few studies explore whether GLP-1 medications are safe when breastfeeding. The FDA states that “the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need.”
Basically, it’s best to consult a healthcare provider if breastfeeding. They can help determine if it makes sense to continue with a GLP-1 medication or not.
The one exception is Rybelsus, which the FDA does not recommend taking when breastfeeding. If the breastfeeding parent requires semaglutide, they should talk to their healthcare provider about switching to another form, ideally an injectable.
Impact on Infant Nutrition and Growth
Most prescription medications are safe to use when breastfeeding. A select few may have an impact on milk production or infant development. To determine if specific drugs are safe, check out the National Library of Medicine’s drug and lactation database.
For semaglutide, the database states that the drug was not found in the milk of mothers who injected the medication. Those who took an oral version of semaglutide did have traces of the medication in their milk supply, which may impact infant development. Still, the chance of adverse impacts is small, since very little of the drug is absorbed into the milk supply.
When it comes to tirzepatide, doses less than 5mg did not usually leave detectable traces in new parents’ milk supplies. Even when traces were present, they didn’t impact the infant’s health. The database recommends that breastfeeding parents use tirzepatide with caution.
The other four types of GLP-1 medications (lixisenatide, exenatide, dulaglutide, and liraglutide) are highly unlikely to be found in the milk supply, and infants cannot effectively absorb traces of these medications. Still, it’s best to use these with caution and under the guidance of a healthcare provider.
Make an Informed Decision
GLP-1 medications interact with pregnancy and family planning in ways that are important to understand before starting treatment. Take our assessment to explore whether tirzepatide or semaglutide might be right for you, and discuss pregnancy planning with our medical team.
The "Ozempic Baby" Phenomenon: Why Fertility Increases
Recently, there have been anecdotal reports on social media of “Ozempic babies,” with some women believing that semaglutide and potentially other GLP-1 medications may increase fertility. There are a few reasons this claim may exist, but GLP-1 medications are not fertility drugs.
Restoring Ovulation through Weight Loss
In limited studies, GLP-1s are associated with a more regulated menstrual cycle. While we often think of the menstrual cycle as monthly periods, it actually has multiple stages, including ovulation, which is when the ovary releases an egg. The time around ovulation is when someone is most fertile, and regular, consistent cycles increase the chance of conceiving.
Still, studies on GLP-1s and fertility are few and far between. Plus, a 2025 meta-review of available research suggested increased fertility is usually experienced among women with polycystic ovary syndrome (PCOS), a hormonal health condition that can lead to irregular periods and makes it more difficult to get pregnant.
The Interaction Between GLP-1s and Oral Contraceptives
Some versions of GLP-1s may impact the efficacy of oral contraceptives. When birth control isn’t as effective, there is a higher chance of getting pregnant.
The GLP-1s that may impact contraceptives include:
The ones that have limited to no evidence suggesting that they affect oral contraceptives are:
- Adlyxin (when oral birth control is taken at least one hour before or eleven hours after)
- WeGovy
- Ozempic
- Trulicity
- Rybelsus
- Byetta (when not administered at the same time as an oral contraceptive)
- Byederon (when not administered at the same time as an oral contraceptive)
If taking a GLP-1 medication that may impact oral birth control, consider switching to a non-oral birth control method, such as an IUD or birth control patch or using another method of birth control alongside oral birth control, such as condoms.
For Zepbound and Mounjaro, the FDA states someone may be able to continue using oral birth control if they also use a barrier method, such as a condom, alongside the oral contraceptive for the four weeks after starting the medication and for the four weeks following each dose increase.
Planning for Conception: The 2-Month Washout Period
All three forms of FDA-approved semaglutide (Wegovy, Rybelsus, and Ozempic) have a recommended two-month “washout period” for women trying to get pregnant. This means the drugs’ manufacturer recommends stopping these medications at least two months before trying to conceive.
Why Timing Matters
A washout period is the set amount of time it takes for the drug and any residual effects to leave the body. For all forms of FDA-approved semaglutide, that period is two months, meaning that some of the drug may still be in someone’s body up to two months after they stop taking the medication.
I often tell patients that GLP-1 medications and pregnancy don’t mix—not because we know they’re dangerous, but because we don’t yet have enough human data to say they’re safe. If someone becomes pregnant while taking a GLP-1, the key is not to panic, but to stop the medication and talk with a clinician about the safest path forward for both parent and baby.
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Dr. Sajad Zalzala, MD, SkinnyRx Medical Director
Alternative Management for Insulin Resistance During Pregnancy
If using semaglutide to help manage insulin resistance, discuss alternative options during pregnancy with your gynecologist. These may include metformin or possibly a different GLP-1 medication.
I Found Out I’m Pregnant While on a GLP-1: What Do I Do?
If you are taking a GLP-1 medication and find out you are pregnant, tell a healthcare provider right away. Pregnant people who are taking these medications for weight loss can safely discontinue the medication under their healthcare provider’s supervision.
A healthcare provider can also help someone determine if they can stay on the medication for type 2 diabetes or if it’s better to transition to a safer alternative medication for type 2 diabetes or prediabetes.
The bottom line: There’s no need to panic. Call a healthcare provider and follow their guidance.
If you’re taking a GLP-1 medication and are pregnant, planning to conceive, or unsure how to proceed, you can take a short SkinnyRx intake assessment that connects you with a licensed clinician who can review your situation and help guide the safest next steps. The assessment allows you to discuss options involving medications like semaglutide or tirzepatide, including whether to pause, stop, or transition treatment based on your needs.
Frequently Asked Questions
By Angela Myers
Contributing Author
Angela Myers is a freelance health writer covering weight management, healthy aging, and nutrition. Her work has appeared in AARP, Well+Good, and Forbes, among others. Before starting her writing career, she conducted award-winning research on how to improve sexual violence prevention courses on college campuses. That research sparked a passion for health communication, and she's been writing about making healthcare accessible and inclusive ever since.
