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Some social media accounts share stories about women who became pregnant after taking weight-loss medications such as Ozempic. What is the effect of these medications on fertility? What do doctors think about taking weight gain medications to increase the possibility of pregnancy?
Inside Edition, People, Today, USA Today, the New York Post, and others have written about this topic.
Ozambik is the trade name of a drug whose scientific name is semaglutide. Ozambik is used as a treatment for type 2 diabetes. Later it turned out that weight loss was a side effect. Now it appears that improved fertility is another side effect.
For example, Deb Oliveira says that she used to have fertility problems but is now 10 weeks pregnant after taking Ozempic.
“I had no idea what fertility effects this medication had,” Oliveira adds.
For her part, Taler Smith called her 4-month-old child “the Ozambican baby,” stressing, “We were very happy, but we were shocked.”
Smith says she had struggled with fertility problems for years and was taking Ozempic to lose weight when she became pregnant. "We were just trying and we just gave up," she added.
How does Ozempic affect the possibility of pregnancy?
One theory is that the weight loss associated with Ozambic could cause hormonal changes.
"If you have excess fat, you can produce excess hormones and that can cause a hormonal imbalance," said Dr. Lisa Masterson, an obstetrician-gynecologist.
Experts in reproductive medicine and obesity spoke to USA Today and said they had noticed this.
Experts said it was likely to happen for two reasons. First, weight loss corrects hormonal imbalances caused by obesity and metabolic disorders and thus enhances fertility. Second, some medications may reduce the effectiveness of birth control pills, increasing the chances of pregnancy.
Why might weight loss drugs boost fertility?
Decades of research have demonstrated strong links between obesity, metabolic disorders such as polycystic ovary syndrome (PCOS) and fertility problems, so it's not surprising to see that weight-loss medications - which can help some people lose up to 20% of their weight - have an impact. On fertility.
Changing body weight helps many women with these conditions get pregnant, said Dr. Utsavi Shah, an assistant professor of obstetrics and gynecology who specializes in obesity medicine at Baylor College of Medicine in Houston.
“These weight-loss medications change things for women with polycystic ovary syndrome or infertility, but there is nothing specific about them that makes women more fertile, apart from their interaction with birth control pills,” Shah said. “It is the effect of these medications on weight loss that It helps regulate the menstrual cycle, thus increasing the chances of pregnancy.”
Shah said that fat cells release estrogen, so the more weight a person has, the more estrogen they will have. Excess estrogen can prevent regular menstruation and ovulation, which can make pregnancy difficult.
Shah said that obesity also causes insulin resistance, which may lead to high levels of male sex hormones such as testosterone, which does not support pregnancy and affects the quality of eggs.
Contraceptive pills
On a related note, weight loss medications may reduce the effectiveness of birth control pills, as studies have found that tirzepatide - the active ingredient in the medications Mounjaro and Zepbound - reduces the effectiveness of birth control pills.
Monjaro and Zipound delay gastric emptying, which means the stomach takes longer to pass food, which may affect how the body absorbs medications orally.
Shah advises her patients who take these medications and birth control pills to use a backup option, such as condoms.
Dr. Marina Kurian, an obesity surgeon and president of the American Society for Metabolic and Bariatric Surgery, said that these medications affect each person's body differently, so the risks vary.
“Birth control pills are still being digested, and the rate of absorption may be different in people, making their effect on the ovaries different as well,” Kurian said.
For her part, Dr. Tara Narula told NBC that when women become pregnant unexpectedly while taking weight loss medications, there are two possible explanations.
The first reason is that obesity or polycystic ovary syndrome can reduce fertility. “So by taking these medications and stimulating weight loss, you could potentially regulate menstruation and ovulation, and improve fertility,” Narula said.
Second, these medications slow stomach emptying, which may alter the absorption of birth control pills. The same can happen with vomiting or diarrhea, which are common side effects of weight-loss medications.
“Therefore, a woman may not receive effective amounts of birth control pills, which may cause unintended pregnancy,” Narula said.
The prescribing information for Mongaro and Zibond advises that patients taking these medications who are using oral hormonal contraceptives should switch to an oral contraceptive method, or add a barrier method, such as condoms.
Narula warned that weight loss drugs are not fertility drugs, and women should stop taking them immediately if they become pregnant.
Osmpic and insulin resistance
Using medications like Ozempic and Wegovy can improve a woman's chances of getting pregnant if she has insulin resistance or obesity, says Dr. Alex Robles, a reproductive endocrinologist at Columbia University Fertility Center in New York.
He adds that the medications themselves do not enhance fertility, but they can put a woman's body in a more ideal state for pregnancy before she tries to conceive.
“There is a relationship between obesity and infertility,” Robles points out. “Obese women can suffer from hormonal disorders that lead to irregular menstruation, which is a sign that they do not ovulate regularly. But even modest weight loss can restore the normal hormonal processes that allow for ovulation.” ".
In a statement to Today, Novo Nordisk, which makes both Ozempic and Wijovi, said it had no clinical data (from human studies) evaluating the drugs' effect on fertility treatments.
Can you take Ozembek during pregnancy?
The answer is no, and women should stop taking Ozempic and Wijovi at least two months before a planned pregnancy, according to the information attached to the two medicines.
Experts warn that it is not permissible, under any circumstances, for women to use weight-loss medications during pregnancy, as studies conducted on rats, rabbits, and monkeys have shown that these medications, if taken during pregnancy, can lead to miscarriage and birth defects, noting that it has not been proven No studies conducted on humans.
Drug manufacturers recommend that women stop taking weight-loss medications at least two months before a planned pregnancy.
That's how long it can take for the drugs' active ingredient, semaglutide, to exit a woman's body, which is important because doctors don't know how it affects pregnant patients, Robles says.
Wijovi, Mongaro and Zibond may cause harm to the fetus and should not be taken during pregnancy, according to the package information accompanying the medicines.
The information warns against using Ozempic and Monjaro during pregnancy unless the potential benefit justifies the potential risks. She notes that doctors must take into account the risks of poorly controlled diabetes during pregnancy and the potential risks to the fetus from exposure to medications during pregnancy.
Since many women of childbearing age may be interested in taking weight-loss medications, some doctors worry that this group does not know enough about the potential risks if an unplanned pregnancy occurs while they are taking the medications.
Dr. Manijeh Kamyar, a maternal-fetal medicine specialist and obstetrician-gynecologist in Las Vegas, Nevada, says patients often tell her that no one has discussed the risks of Ozempic with them.
"My advice is: While you're undergoing this treatment - if your doctor decides it's best for you - you should definitely use some type of birth control, because if you accidentally get pregnant while taking this medication, I don't know what that will mean for your pregnancy. I can't guarantee," she said. The safety of this medication during pregnancy.
Does Ozempic cause fetal deformities?
Animal data from pregnant rodents, rabbits, and monkeys exposed to semaglutide showed structural abnormalities in the fetuses and early pregnancy loss.
According to the prescribing information for Mongaro and Zibound, animal data from pregnant ferrets and rabbits given terzepatide showed reduced fetal growth and malformations.
Both Kamiar and Robles say safety data does not exist in humans at this time. They add that this may come after years of people using these drugs and accidentally becoming pregnant while taking them.
Besides stopping Ozempic and Wijovi at least two months before the planned pregnancy, Camyar and Robles advise women to avoid using the medications during pregnancy or breastfeeding, as these medications are very likely to be excreted in breast milk. Again, we do not know the effects of this particular medication on the fetus or the baby.
Source: Al Jazeera + agencies + American press + websites