Ozempic's baby boom: Docs discuss GLP-1 impacts on fertility and sexual health

Women who have struggled with fertility are going viral online for sharing stories about becoming pregnant while using Ozempic, sparking discussions patients about the potential of GLP-1s as fertility treatments. 

Although patients with fertility issues may see weight-loss drugs as the answer to their prayers, Ozempic’s prescribing information advises that the drug be discontinued at least 2 months before a planned pregnancy, given the long washout period and limited data on potential risks to the fetus.

Welcome or not, there is also the issue of patients unfamiliar with the anecdotal evidence linking Ozempic with unexpected pregnancies.

What to know: Women's health

Experts note that GLP-1s likely contribute to fertility as a byproduct of weight loss.^[] ‘‘Because GLP-1 receptor agonist medications like Ozempic can reduce body weight and improve insulin sensitivity, they can also help restore ovulation and increase overall fertility. Patients who have struggled to conceive previously or assume they are infertile may also be less stringent about taking birth control pills as directed, which decreases their effectiveness,’’ says Ilana Ressler, MD, an OB/GYN and reproductive endocrinologist at Illume Fertility.

However, using GLP-1s before pregnancy comes with the risk of birth defects. Animal studies have shown that Ozempic can cause abnormalities in offspring, but there are not currently sufficient human studies to help you inform patients on the risks to fetal development.^[]

A 2024 study examined 478 women who were pregnant: 168 patients had been exposed to GLP-1s during their first trimester, 156 patients had diabetes and no GLP-1 exposure, and 163 patients were overweight or obese and had no GLP-1 exposure.

To date, only a handful of studies have evaluated the health of mothers and babies when Ozempic is used during any stage of pregnancy. Dr. Ressler also highlights the lack of research on the drug's safety during pregnancy. ‘‘Semaglutide is not recommended for women who are pregnant or breastfeeding,” she notes. “Additional research is needed to confirm the drug’s safety profile. Regular monitoring of women on Ozempic who do become pregnant while on the drug will also provide more precise information as data accumulates.’’

Impacts on men's libido and fertility

Ozempic's effects on men's sexual health can vary. While some research suggests that Ozempic can cause low libido and erectile dysfunction, many men also report an increase in libido and improvements in erectile function.

A randomized study compared the effect of semaglutide with that of testosterone replacement therapy (TRT) on sperm quality in men with obesity and type 2 diabetes–related functional hypogonadism.^[] Those given semaglutide had a significantly higher number of morphologically normal sperm, total sperm count, and concentration, compared with those on TRT. Semaglutide also significantly increased testosterone levels, but not as much as TRT. Both treatments increased sexual desire.  

Serena H. Chen, MD, an OB/GYN, reproductive endocrinologist, and director of advocacy at CCRM Fertility, tells MDLinx, ‘‘Obesity has significant adverse effects on fertility, sexual function, and overall health, and if GLP-1 agonists can reduce obesity, it makes sense that we would see a positive effect. However, clear data on direct impacts is still pending. There is no evidence for a direct impact on male fertility, but again, obesity has a significant negative impact on male fertility, and if Ozempic resolves that, male fertility is likely to improve.’’