Ozempic and Pregnancy: Safety, Risks, and Considerations

Discover the safety risks and considerations about using Ozempic during pregnancy and why experts don't recommend it.

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by
Caitlin Beale, MS, RDN
— Signos
Health & Nutrition Writer
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Updated by

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Science-based and reviewed

Published:
February 29, 2024
February 6, 2024
— Updated:

Table of Contents

The buzz surrounding Ozempic, a medication initially FDA-approved to treat type 2 diabetes, keeps growing. As its use has expanded to weight loss, with more and more people either taking it or interested in it, more questions arise about its use in different populations.

Since there's a close tie between blood sugar, body weight, and fertility, Ozempic seems like a possible tool to support women trying to become pregnant. The problem is that Ozempic is not considered safe for pregnant women and should be stopped when actively trying to conceive (TTC), so it's a delicate balance.

Here's what to know about Ozempic and pregnancy, including safety concerns, potential risks, and important considerations.

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What Is Ozempic (Semaglutide) and How Does It Work?

Ozempic (brand name for Semaglutide, the active ingredient also found in the weight loss drug Wegovy) is an injectable prescription medication known as a glucagon-like-peptide-1 (GLP-1) agonist. 

An agonist is a substance that turns on a particular receptor in the body to produce a specific action. In this case, Ozempic acts like GLP-1, a naturally occurring hormone in the body.

GLP-1 plays a crucial role in regulating appetite, maintaining blood sugar balance, and facilitating digestion. This hormone is secreted in the gut and stimulates the pancreas to release insulin, effectively lowering blood glucose levels.

Ozempic acts like the naturally occurring hormone by binding to the same receptors in the body, so the pancreas responds the same way. It also keeps your body from releasing more stored sugar from the liver. 

This process is why Ozempic is so helpful for those with type 2 diabetes or blood sugar dysregulation, as it can help stabilize blood sugar levels. It also may help improve cardiovascular risk factors like fasting lipid levels and inflammation markers, which is important as people with type 2 diabetes are at an increased risk of heart disease.

Although Ozempic was initially approved for type 2 diabetes and not specifically for weight loss, research suggests that when combined with other healthy lifestyle changes, Semaglutide supports weight loss, possibly by influencing areas of the brain involved in appetite control. It also helps slow down gastric emptying (how quickly food leaves your stomach), so you may feel fuller longer and eat less.

Although Ozempic helps many people with blood sugar and weight management, it does come with a long list of side effects, including constipation, nausea, dizziness, and fatigue.

Ozempic and Its Compatibility With Pregnancy

pregnant-woman

Ozempic is not recommended for use during pregnancy, and those taking it are advised to stop at least two months before trying to become pregnant to make sure the medication is no longer in the body.  Since a significant number of pregnancies are unplanned, it’s usually recommended to use birth control while taking Ozempic. 

The connection between weight and pregnancy is complicated, where being both under or overweight can impact fertility. For some people, weight loss can improve fertility markers and lead to more regular menstrual cycles, so weight loss with Ozempic could help. At the same time, undernutrition and too much weight loss can also negatively impact fertility, so it requires a careful balance.

Women living with certain health conditions linked to infertility, like polycystic ovary syndrome (PCOS), may see a potential benefit from taking Ozempic. While considered an off-label use, PCOS also has a strong tie to insulin resistance and blood sugar dysregulation, so the use of a medication that can positively impact both may be helpful. However, even if Ozempic helps some women with PCOS get pregnant, its use during pregnancy could pose a risk to both mother and baby.

If you are taking Ozempic and become pregnant, make sure to tell your healthcare provider right away.

<p class="pro-tip"><strong>Also Read: </strong><a href="loss-of-appetite-during-pregnancy">Appetite Loss During Pregnancy: Why It Occurs + How to Face It</a>.</p>

Risks of Taking Semaglutide While Pregnant

The risks of taking Semaglutide during pregnancy aren’t completely understood, given the lack of clinical trials examining pregnant people. Animal studies are the best indication of what could happen in human pregnancy, and unfortunately, the results are concerning. 

Experts aren’t clear that these pregnancy outcomes are related to weight loss and possible undernutrition during pregnancy as a result of taking Ozempic or exposure to the medication itself. The following risks have been noted in animal studies: 2 

  • May increase the risk of pregnancy loss
  • Poor fetal growth in utero, leading to low birth weight
  • Structural abnormalities in developing baby
  • Minimal maternal weight gain during pregnancy

Ozempic and Nursing: Is it Compatible?

woman-breastfeeding

When it comes to the compatibility of any substance with breastfeeding─including supplements and medications─experts will always err on the side of caution to protect the health of the newborn. Currently, only animal data exists to show how Ozempic passes through breastmilk, so current recommendations suggest discontinuing the use of Semaglutide while breastfeeding. 

Aside from whether or not Ozempic passes through breastmilk to impact the baby, adequate nutrition is essential for milk supply. If a breastfeeding mother isn’t taking in enough nutrients, it can significantly impact the amount of breast milk she can produce, especially in the early months when establishing a milk supply.

In other words, it makes more sense to focus on developing healthy habits postpartum that will support both weight loss and a healthy milk supply until we have more information about the safety of Ozempic while nursing. 

Frequently Asked Questions

As more and more people turn to Ozempic for their health needs, it's only natural that questions about its use, safety, and potential risks will continue to come up. It's a complex topic, with many medical nuances and individual differences to consider. Here are some of the most common concerns:

Can Ozempic Cause a False Positive Pregnancy Test?

No, Ozempic should not cause a false positive pregnancy test. There have been anecdotal reports of this happening, but it may be due to a faulty test or user error. Pregnancy tests measure the levels of human chorionic gonadotropin (hCG) in urine, which is produced by the placenta during pregnancy. Ozempic does not contain hCG or affect its production. If you are concerned about getting a false positive pregnancy test, discuss it with a healthcare professional and consider taking multiple tests for confirmation.

What if I Took Semaglutide Before I Knew I Was Pregnant?

If you used Ozempic or any other medication containing Semaglutide in early pregnancy before knowing you were pregnant, it's essential to inform your doctor as soon as possible. Your doctor can help you follow the recommended guidelines for discontinuing or adjusting medication during pregnancy.

Does Ozempic Make Birth Control Less Effective?

According to research, there's no indication that Ozempic makes birth control less effective. However, if you experience any changes in your menstrual cycle or suspect a possible pregnancy while on Ozempic, check with your doctor immediately.

Learn How to Improve Your Nutrition and Monitor Blood Sugar with Signos’ Expert Advice.

Signos' app, paired with a Continuous Glucose Monitoring (CGM) system, can play a pivotal role in improving overall health and promoting better dietary habits essential for fertility and a healthy pregnancy. Armed with this knowledge, you can make informed decisions about your health. 

Whether you're pregnant or thinking about becoming pregnant in the near future, understanding the role of diet, blood sugar, and the safety of medications like Ozempic helps you stay in control of your wellness journey. Learn more about how Signos works or find out if it’s a good fit by taking a quick quiz here.

<p class="pro-tip"><strong>Learn More: </strong><a href="ozempic-foods-to-avoid">7 Foods to Avoid to Manage Ozempic Side Effects</a>.</p>

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References

  1. U.S. Food and Drug Administration. (2017). Label for Ozempic. Retrieved from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/209637lbl.pdf
  2. Kapitza, C., Dahl, K., Jacobsen, J. B., Axelsen, M. B., & Flint, A. (2017). Effects of semaglutide on beta cell function and glycaemic control in participants with type 2 diabetes: a randomised, double-blind, placebo-controlled trial. Diabetologia, 60(8), 1390–1399. https://doi.org/10.1007/s00125-017-4289-0
  3. Shah, M., & Vella, A. (2014). Effects of GLP-1 on appetite and weight. Reviews in endocrine & metabolic disorders, 15(3), 181–187. https://doi.org/10.1007/s11154-014-9289-5
  4. Wilding, J. P. H., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., McGowan, B. M., Rosenstock, J., Tran, M. T. D., Wadden, T. A., Wharton, S., Yokote, K., Zeuthen, N., Kushner, R. F., & STEP 1 Study Group (2021). Once-Weekly Semaglutide in Adults with Overweight or Obesity. The New England journal of medicine, 384(11), 989–1002. https://doi.org/10.1056/NEJMoa2032183
  5. Blundell, J., Finlayson, G., Axelsen, M., Flint, A., Gibbons, C., Kvist, T., & Hjerpsted, J. B. (2017). Effects of once-weekly semaglutide on appetite, energy intake, control of eating, food preference and body weight in subjects with obesity. Diabetes, obesity & metabolism, 19(9), 1242–1251. https://doi.org/10.1111/dom.12932
  6. Novo Nordisk. (2017, December). Highlights of Prescribing Information. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/209637lbl.pdf
  7. Silvestris, E., de Pergola, G., Rosania, R., & Loverro, G. (2018). Obesity as disruptor of the female fertility. Reproductive biology and endocrinology : RB&E, 16(1), 22. https://doi.org/10.1186/s12958-018-0336-z
  8. Łakoma, K., Kukharuk, O., & Śliż, D. (2023). The Influence of Metabolic Factors and Diet on Fertility. Nutrients, 15(5), 1180. https://doi.org/10.3390/nu15051180
  9. Jensterle, M., Janez, A., Fliers, E., DeVries, J. H., Vrtacnik-Bokal, E., & Siegelaar, S. E. (2019). The role of glucagon-like peptide-1 in reproduction: from physiology to therapeutic perspective. Human reproduction update, 25(4), 504–517. https://doi.org/10.1093/humupd/dmz019
  10. Kapitza, C., Nosek, L., Jensen, L., Hartvig, H., Jensen, C. B., & Flint, A. (2015). Semaglutide, a once-weekly human GLP-1 analog, does not reduce the bioavailability of the combined oral contraceptive, ethinylestradiol/levonorgestrel. Journal of clinical pharmacology, 55(5), 497–504. https://doi.org/10.1002/jcph.443

About the author

Caitlin Beale is a registered dietitian and nutrition writer with a master’s degree in nutrition. She has a background in acute care, integrative wellness, and clinical nutrition.

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