If you’re not yet aware of Ozempic, you’re probably among the minority of Americans. Between marketing, media coverage, and celebrity shout-outs, it’s been tough to avoid hearing about the Type 2 Diabetes drug that’s become a weight loss sensation throughout the past couple of years.
That being said, not everything you hear about Ozempic (semaglutide) is necessarily accurate. In today’s society, misinformation abounds, and—especially with a pharmaceutical product that’s gained immense momentum so rapidly—it’s crucial to seek out reliable, trustworthy sources and evaluate information about the drug with a critical eye.
While Ozempic has been FDA-approved for the treatment of certain conditions, this doesn’t mean that it’s unequivocally safe and effective for all people at all times. Healthcare providers and patients alike must carefully consider and weigh the benefits of Ozempic against its potential risks based on the specifics of each individual situation.
One pertinent example? Ozempic during pregnancy.
With a large percentage of the patients seeking Ozempic prescriptions being women of childbearing age, taking into account the drug’s impact on fertility, pregnancy, and breastfeeding is vital. In this post, we’ll provide an overview of Ozempic and consider what is known (and unknown) about its potential impacts on pregnancy.
The information below is not intended to constitute or replace medical advice. If you’re considering taking, or are currently taking, Ozempic and are pregnant, breastfeeding, or trying to conceive, it’s important to speak directly with your doctor or healthcare provider.
How Ozempic Works and What It’s Used For
Ozempic is a brand-name prescription drug manufactured by Novo Nordisk. It comes in prefilled, single-patient-use pens and is injected subcutaneously once per week into the thigh, upper arm, or abdomen.
Ozempic was approved by the FDA in 2017 for the treatment of Type 2 Diabetes in adults, as well as associated cardiovascular disease. Its sister drug, Wegovy, was approved in 2021 for chronic weight management in adults who are obese or overweight with at least one weight-related medical condition (such as high blood pressure, high cholesterol, or Type 2 Diabetes). In 2022, Wegovy was also approved for use in severely obese adolescents over the age of 12.
Ozempic and Wegovy share the same active ingredient, semaglutide, and are virtually identical except for the fact that Wegovy comes in a higher dosage. Ozempic is usually taken at a maintenance dosage of 0.5 mg, 1 mg, or 2 mg, while Wegovy is taken at a 2.4 mg dosage. Though associated with healthy weight loss in many patients with Type 2 Diabetes, Ozempic is not technically approved as a weight loss medication. However, it’s sometimes prescribed off-label for this purpose.
Both Ozempic and Wegovy belong to the class of prescription drugs known as GLP-1 receptor agonists. Glucagon-like peptide 1 (GLP-1) is an incretin hormone produced in the human gut in response to food. Semaglutide mimics GLP-1 and binds to its receptors in the body, stimulating insulin release from the pancreas and inhibiting glucose production in the liver. It also slows down gastric emptying and the digestive process.
Used as an adjunct to a healthy diet and regular exercise, semaglutide helps regulate blood sugar control in the body, reduces the risk of major adverse cardiovascular events, and also decreases appetite and cravings. Its common side effects include gastrointestinal issues, injection site reactions, headaches, dizziness, tiredness, as well as sagging skin in the face or body after weight loss. Patients with a personal or family history of thyroid tumors or cancer are not good candidates for Ozempic or Wegovy.
Ozempic and Fertility: The Positive Impacts
For women trying to conceive, obesity and insulin resistance can be substantial barriers. Obesity is associated with hormonal disruptions that can lead to irregular ovulation as well as higher-than-average rates of miscarriage, fetal death, stillbirth, gestational hypertension, macrosomia, and cesarean section. In addition, excess fat can make egg retrieval procedures more challenging due to decreased ovarian visibility and accessibility.
While Ozempic doesn’t actually boost fertility, it does promote weight loss, which can be associated with more regular ovulation and a decrease in various risks associated with pregnancy.
Some women suffering from obesity or PCOS opt to take Ozempic during the period of time before they hope to become pregnant. By reducing their body weight, they increase their odds of natural conception and healthy pregnancy. Overweight or obese women planning to explore IVF may also benefit from weight loss, which can contribute to making the egg retrieval procedure simpler and safer.
Ozempic and Fertility: The Negative Impacts
Weight loss prior to conception can have many benefits, but not all of Ozempic’s impacts on the female body are positive or conducive to increasing fertility.
Some studies have suggested that Ozempic can reduce levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which are essential to regulating ovulation. This can make it more difficult to become pregnant. Such effects may be more pronounced in cases where low body weight is being maintained with the use of Ozempic but should be taken into consideration for all women nonetheless.
Overall, the impact of Ozempic on female fertility is not yet well understood. More research is necessary in order to determine whether or not it’s medically advisable to take Ozempic in the period of time leading up to conception.
Can You Take Ozempic While Pregnant?
Taking Ozempic while pregnant is not advisable. Ozempic’s Indication and Important Safety Information clearly state that you should tell your healthcare provider if you are “pregnant or breastfeeding or plan to become pregnant or breastfeed” while taking Ozempic since “it is not known if Ozempic will harm your unborn baby or passes into your breast milk”. You should only consider taking Ozempic during pregnancy if your doctor believes that the benefits outweigh the serious potential risks of doing so.
The FDA has requested Novo Nordisk to collect further data about the impact of GLP-1 receptor agonists during pregnancy. Currently, a long-term study is underway to analyze pregnancy complications and outcomes in women who took Ozempic during part or all of their pregnancy, but the results aren’t expected to be available for at least another four years.
Nearly half of all pregnancies are unplanned, which means that the potential for unintentional fetal exposure to Ozempic is very real. It’s highly recommended to use birth control while taking Ozempic or Wegovy.
What Animal Studies Have Found
Because pregnant women are regularly excluded from clinical drug trials due to ethical concerns, very few prescription drugs have the opportunity to be fully approved for use during pregnancy. That being said, data from animal studies can often provide some context when deciding whether or not there is cause for concern.
In the case of Ozempic, results from animal studies are not reassuring. In rodents, rabbits, and monkeys, exposure to semaglutide during pregnancy resulted in higher than normal rates of miscarriage and lower birth weight than expected. It was also associated with structural abnormalities in the heart, blood vessels, kidney, liver, cranial bones, vertebra, and ribs.
It’s unclear whether all of these outcomes were directly linked to semaglutide itself or to weight loss caused by caloric deficit during pregnancy (which can also be associated with similar negative outcomes). Either way, it’s clear that more research is needed.
When To Consider Pausing Ozempic
If you’re taking Ozempic and are thinking about getting pregnant or are currently pregnant or breastfeeding, it’s important to speak with your doctor immediately. In most cases, your doctor will recommend that you consider pausing Ozempic since there is reason to believe that the drug may be harmful in such instances.
In addition, your doctor may recommend pausing Ozempic if you’re scheduled for any procedures or surgeries where anesthetization is required—including egg retrieval. Because semaglutide slows gastric emptying, there can be an increased risk of aspiration while sedated.
Pausing (or stopping) Ozempic should be done under the direction and supervision of a doctor. In most cases, it’s entirely possible to stop Ozempic and then start it again after a period of time has elapsed. You may need to return to a lower dosage as your body readjusts to the medication.
Why and When To Stop Ozempic Before Getting Pregnant
Ozempic’s package insert recommends discontinuing the use of Ozempic at least two months before trying to become pregnant, as this is the amount of time it takes for all remaining traces of semaglutide to leave the body. Because there have been no adequate, well-controlled studies to determine semaglutide’s effects on humans during pregnancy, this is the safest option.
In rare cases, it’s possible your doctor may feel that the benefits outweigh the risks of taking Ozempic during pregnancy, based on your personal medical history and circumstances. Most often, alternative drugs and methods are preferred (such as insulin and healthy lifestyle changes), but every situation is unique. In particular, women treating PCOS with Ozempic may warrant careful medical consideration.
Because Ozempic has been associated with increased negative outcomes in animal pregnancies, it is essential to seek medical advice if you’re taking Ozempic and are pregnant, breastfeeding, or trying to become pregnant. Many experts and doctors feel that more public education about the potential risks of taking Ozempic while pregnant is needed.
To conclude, let’s review the key points from this post:
- Ozempic is a prescription Type 2 Diabetes medication that has weight loss as a side effect. Ozempic’s active ingredient, semaglutide, regulates blood sugar levels as well as suppressing appetite and slowing down digestion.
- The impacts of Ozempic during pregnancy in humans are largely unknown; in animal studies, exposure to semaglutide has been correlated with higher rates of miscarriage, lower than normal birth weight, and serious structural abnormalities.
- While weight loss can have a positive impact on fertility, the impacts of taking Ozempic prior to becoming pregnant are still largely unknown; more research is needed in this area.
- It is medically advisable to stop taking Ozempic at least two months before trying to become pregnant and to consult with your doctor immediately if you’re taking Ozempic and discover you are pregnant. Using birth control while on Ozempic is highly recommended.
- Overall, Ozempic is not considered a safe drug to take during pregnancy. Speak directly with your doctor to determine what treatment plan will be the best for your particular needs and circumstances.
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