“I Got Pregnant on Ozempic”: The Science Behind #OzempicBabies

What we know (and don’t know) about GLP-1 drugs, fertility, and birth control

When I first started seeing #OzempicBabies trending on social media, I’ll admit I was confused. Were these people proudly proclaiming they were on these medications? Like a celebratory “Yeah, baby, I’m on Ozempic!”?

No. It turns out it referred to something entirely different… and far more complex.

The hashtag represents a growing phenomenon of unexpected pregnancies among people taking GLP-1 agonists like Ozempic. Facebook groups such as “I Got Pregnant on Ozempic” and countless Reddit threads are filled with women sharing stories of surprise pregnancies while using these medications for diabetes management or weight loss. Some report conceiving despite years of fertility struggles. Others discovered their birth control had failed. And as recent reporting in the BMJ highlights, while these anecdotal reports are capturing widespread attention, the scientific understanding is still catching up.

This raises two important questions: Can GLP-1 agonists like Ozempic (semaglutide) actually increase fertility? And for those trying to avoid pregnancy, do these medications interfere with birth control? Below, we dive into the research to separate social media buzz from scientific evidence. Let’s discuss!

Quick facts: GLP-1 agonists

Here are some quick facts about GLP-1 receptor agonists: how they work, what they’re used for, and why they’ve become a focus in medical research and the public sphere.

• Glucagon-like peptide 1 (GLP-1) is an incretin, a gut hormone that triggers insulin release after you eat, which lowers blood glucose (sugar). GLP-1 also slows down stomach emptying and increases the sense of fullness after eating.

• GLP-1 receptor agonists (often shortened to GLP-1 agonists) mimic and increase the effects of GLP-1 in the body. Because they lower blood glucose and suppress hunger, they’re effective at managing diabetes and causing weight loss.

• Here’s a list of GLP-1 agonists available on the market today:

  • Semaglutide injection (Ozempic, Wegovy)

  • Semaglutide tablets (Rybelsus)

  • Liraglutide (Victoza, Saxenda)

  • Tirzepatide (Mounjaro, Zepbound), which also enhances gastric inhibitory polypeptide (GIP), another incretin

  • Dulaglutide (Trulicity)

  • Exenatide (Byetta)

  • Exenatide extended-release (Bydureon)

  • Lixisenatide (Adlyxin)

• Several GLP-1 agonists are FDA-approved to manage type 2 diabetes and/or obesity, though the exact FDA-approved uses vary among the various products.

• Like all medications, GLP-1 agonists have side effects, including nausea, vomiting, diarrhea, and constipation, especially when first starting the medications or if the dose is increased. More serious risks are also possible, though rare.

Pregnancy: What We Don’t Know Could Matter

Currently, GLP-1 agonists aren’t recommended during pregnancy. In fact, current guidance is to stop taking these medications at least two months before trying to conceive. This recommendation exists because pregnant people (or those trying to become pregnant) were excluded from the initial clinical trials—a common practice in drug development for ethical reasons—leaving us without sufficient human safety data during pregnancy.

While some animal studies show that GLP-1 agonist use during pregnancy results in decreased fetal growth, skeletal anomalies, and embryonic death, it’s important to note that this evidence came from animal studies.

So far, human research on GLP-1 agonist use in the first trimester of pregnancy hasn’t shown clear evidence of harm. Still, these findings should be interpreted with caution. Most available studies only include people exposed to GLP-1 agonists very early in pregnancy (typically no later than the first trimester). And most study participants stopped taking their GLP-1 agonist once they found out they were pregnant. So, we don’t have great data on the effects of longer exposure to GLP-1 agonists during pregnancy. The results of currently ongoing clinical trials may provide more insight, but for now, the widely accepted guidance is to avoid GLP-1 agonists during pregnancy and while trying to conceive.

Can Weight Loss Drugs Affect Fertility?

Now, let’s talk about GLP-1 agonists and fertility. Is there any truth to the #Ozempicbabies hashtag? While these medications are not fertility treatments, they may promote fertility indirectly by aiding weight loss and managing diabetes. Let’s break this down below:

• Being overweight or obese can lower fertility. Losing weight can regulate menstrual cycles and increase the chance of getting pregnant. So this may be one mechanism by which semaglutide and other GLP-1 agonists increase fertility.

• Having diabetes can impact fertility as well, so improving diabetes control with GLP-1 agonists may help improve the chances of becoming pregnant.

There’s also evidence that other mechanisms may contribute to increased fertility rates with GLP-1 agonists, such as their anti-inflammatory properties.

Still, as discussed above, current guidance is to stop taking GLP-1 agonists at least 2 months before attempting to get pregnant, or using contraception to avoid becoming pregnant while taking GLP-1 agonists. Which brings us to our next focus: GLP-1 agonists and their effects on birth control.

When Contraception Meets Delayed Absorption

CDC data tells us that two-thirds of American females between 15 to 49 years old used contraception between 2017 to 2019. Oral birth control pills are a common form of contraception, but they can interact with several medications and supplements. Emerging evidence indicates that some GLP-1 agonists, along with Mounjaro and Zepbound, may make birth control pills less effective. This interaction is only relevant to birth control pills, not other types of contraception such as implants or intrauterine devices (IUDs).

Mounjaro and Zepbound contain tirzepatide, a dual GIP/GLP-1 agonist, which causes slower gastric emptying than GLP-1 agonists. Delayed gastric emptying can reduce how quickly some oral medications get absorbed. Evidence suggests that Mounjaro can decrease oral birth control absorption, especially after you first start it and after a dose increase. This is why the FDA labeling for Mounjaro and Zepbound advises using backup contraception for 4 weeks after you start these medications or increase the dose.

Interestingly, the interaction between Mounjaro and oral birth control doesn’t extend to all GLP-1 agonists. For example, Ozempic and other semaglutide medications aren’t expected to affect oral birth control pills. Of the GLP-1 agonists, only exenatide and lixisenatide are known to potentially interact with oral birth control. For lixisenatide, oral contraceptives should be taken at least one hour before or 11 hours after the injection. For exenatide, it’s recommended to take oral contraceptives at least one hour before an exenatide dose.

Additionally, vomiting and diarrhea—common side effects of GLP-1 agonists—can reduce the effectiveness of oral birth control if it occurs soon after taking a pill. It’s hard to predict exactly the impact that this can have on oral birth control absorption. But if you take a GLP-1 agonist and are experiencing vomiting or diarrhea, talk to your prescriber. You may need to use backup contraception or change your dosing schedule.

Good to know: It’s unclear if GLP-1 agonists affect birth control effectiveness when it is taken for other reasons, such as to treat hormonal acne or menstrual pain. Birth control can also be used to help manage polycystic ovarian syndrome (PCOS), a hormonal condition that often involves high levels of androgens, weight gain, and infertility. Oral contraceptives are often a first-line treatment for PCOS, as they can help restore menstrual cycles and improve hyperandrogenism among people with PCOS. In people who have PCOS and overweight or obesity, losing weight may help establish a regular menstrual cycle and potentially increase fertility. GLP-1 agonists may help achieve this goal. However, this creates a complex situation: while GLP-1 agonists might improve PCOS symptoms through weight loss, certain ones (like exenatide, lixisenatide, and tirzepatide) could potentially interfere with the oral contraceptives being used to manage the condition. This makes it especially important for people with PCOS to discuss both their treatment goals and contraception needs with their healthcare provider when considering GLP-1 agonists.

A Note of Caution

It’s important to note that using GLP-1 agonists without proper medical supervision carries serious risks. The FDA has raised concerns about fraudulent compounded semaglutide and products being sold through unregulated channels, including on social media. These products haven’t undergone FDA review for safety and effectiveness, and taking them without proper medical oversight means missing crucial guidance about reproductive health risks and contraception interactions.

GLP-1s and Reproductive Health: The Bottom Line

After diving deep into the science behind #OzempicBabies, here’s what we know—and what we still need to learn:

• For females considering GLP-1 agonists, it is essential to have a comprehensive conversation with a licensed medical professional about your reproductive goals.

• At this time, GLP-1 agonists aren’t recommended in people who are pregnant or trying to become pregnant. These medications typically aren’t recommended while breastfeeding, either.

• GLP-1 agonists may improve fertility by helping people control their diabetes and lose weight. Other mechanisms may also be at play. But current guidance doesn’t recommend GLP-1 agonists for improving fertility.

• Some GLP-1 agonists (exenatide and lixisenatide) and Mounjaro/Zepbound may affect oral birth control pill absorption, making these medications less effective. There are specific instructions for how to take these medications if you take oral birth control, so make sure you discuss this with your healthcare provider. Non-oral forms of birth control aren’t affected by GLP-1 agonists or Mounjaro/Zepbound.

The #OzempicBabies phenomenon reminds us that medications can have unexpected ripple effects throughout our bodies—effects that social media often discovers before clinical trials fully document them. While these personal stories are valuable, they’re not a substitute for medical guidance. If you’re taking or considering GLP-1 agonists, whether for diabetes management, weight loss, or while navigating fertility concerns, the most important conversation isn’t happening in Facebook groups or Reddit threads—it’s the one you have with your healthcare provider about your individual situation and reproductive goals.

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