Taking a shot: Can a GLP-1 regimen boost fertility?

There’s been a revolving door of viral social media posts recently promoting the idea that you’ll boost your chances of conceiving if you take GLP-1 weight-loss medications.

Unfortunately, the promise of the “Ozempic baby boom” is more myth than reality.

While there is some connection between GLP-1s (semaglutide, like Ozempic or Wegovy, or tirzepatide, like Zepbound or Mounjaro) and pregnancy, this class of medications shouldn’t be thought of as a magical path to conception.

“The GLP-1s aren’t fertility medications,” said Dr. Joshua Stewart, MD, a reproductive endocrinologist at Weill Cornell Medicine. “They don’t cause you to ovulate in the way taking a drug like Clomid [which stimulates ovulation] would.”

However, he does note that “GLP-1s affect other metabolic issues that may improve ovulation in the process.”

In other words, if you have polycystic ovary syndrome, which is one cause of ovulation issues and infertility, or otherwise improve your blood sugar control, lower your insulin levels and lose weight while you’re on a GLP-1, this may, in turn, help regulate ovulation.

Taking a GLP-1 should be considered a preliminary step in preparing your body for pregnancy.

“If a patient isn’t ovulating, and part of the reason is that they have insulin resistance, whether from diabetes, prediabetes or obesity, we may suggest that they go on a GLP-1 for a certain period of time and try to improve their insulin resistance,” Stewart said. “They may start to ovulate on their own or this may help improve their response to fertility medications.”

There are many factors that can contribute to fertility issues, said Dr. Tendai Chiware, MD, a reproductive endocrinologist and director of third party reproduction at Brooklyn’s Genesis Fertility, part of the Pinnacle Fertility network.

“These headlines give the impression that ‘if I use Ozempic I’ll get pregnant,’ but you may need IUI or IVF, you might need to have a fibroid removed or we may need to treat your endometriosis,” she said. “There are multiple factors that contribute to fertility issues.”

One critical factor is that you shouldn’t take these powerhouse weight-loss drugs while you’re actively trying to conceive or are already pregnant.

“We don’t have safety studies about these medications yet” in pregnancy, said Dr. Judi Chervenak, MD, an attending physician at Montefiore Einstein and an associate professor of reproductive endocrinology and infertility at Albert Einstein College of Medicine. “This is something I discuss with my patients routinely when they come in with questions about them.”

Stewart recommends patients stop taking GLP-1s for at least two to three months before trying to conceive, and before beginning infertility treatments.

“Some of the mechanisms by which GLP-1s work and affect our bodies may affect how a fetus develops,” he said.

Experts suggest slowly weaning yourself off a GLP-1, especially since some formulas have extended-release properties, which means they can remain in your body for longer than you may think — and that timeline may vary depending on your body’s response and your metabolism.

And, if you’ve already lost a considerable amount of weight on a GLP-1, you may need some time before you begin infertility treatments.

“If you’ve experienced a dramatic weight loss, you might not be at the point where you should be considering a pregnancy,” said Chiware. “That sort of weight loss can prompt changes in your metabolism and hormones.”

In the end, Stewart says that while GLP-1s have been an incredible advancement in the treatment of diabetes and obesity, as a fertility aide they should be considered a long-term strategy used well before infertility treatments begin.

Additionally, if you’re looking to avoid getting pregnant, these drugs may affect how well your birth control works.

“Oral birth control pills may not be absorbed as quickly, reducing their effectiveness to prevent pregnancy,” said Chiware. “This is more pronounced when the dose of the GLP-1 is being adjusted or produces side effects like vomiting. Alternatives to oral contraception — condoms, intrauterine devices and implants, patches and vaginal rings — are recommended.”

Either way, “the idea of an Ozempic baby boom is an unfair characterization,” said Stewart. “Instead, I’d prefer that patients see these medications as something you would try for two to three months before beginning infertility treatments to see if it helps restore ovulation. It’s not a quick fix.”

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