Obesity and associated metabolic diseases are common, which has led to the increasing usage of weight loss drugs such as Ozempic (semaglutide), a glucagon-like peptide-1 receptor agonist (GLP-1 RA).

Although these medications show promise for improving metabolic regulation and helping people lose weight, worries have been raised about how they can affect reproductive health, specifically fertility and the effectiveness of birth control.

While Ozempic is typically taken for type 2 diabetes, patients may use medication off-label in order to lose weight.

The Relationship Between Fertility and Weight Loss Drugs

Women are posting on social media that they are pregnant after taking GLP-1 medications, such as Ozempic (semaglutide), to lose weight. This new trend has been called "Ozempic babies".

Some Ozempic patients claim that even though they had been on birth control or struggling with infertility for years, they became pregnant while using the injectable medication.

It is advised that women who are using ozempic should cease taking it at least two months before attempting to conceive in order to ensure that the medication has completely left their bodies.

Birth control is typically advised while using Ozempic because a considerable percentage of pregnancies are unexpected.

It can affect fertility to be underweight or overweight, and the relationship between weight and pregnancy is complex.

Weight loss with Ozempic may be beneficial for those who wish to improve their fertility markers and experience more regular menstrual periods.

However, maintaining a healthy balance is necessary because both undernutrition and excessive weight loss can have a detrimental effect on fertility.

Medication for diabetes or weight loss works in several ways, such as by decreasing hunger, boosting fullness, and enhancing glycemic control.

But new research raises concerns about these medications' potential effects on ovarian function and reproductive hormones, which may possibly affect fertility.

Studies on animals have shown that GLP-1 RA administration alters ovarian shape and reproductive hormone levels.

These findings have prompted further research into the possible implications of GLP-1 RA on human fertility.

Dr. Tom Pitts, a board-certified neurologist, shared insights on the effects of Ozempic on fertility during an appearance on NewsNation.

He highlighted that Ozempic has the potential to accelerate the metabolism of birth control, potentially reducing its effectiveness.

Additionally, Pitts noted that Ozempic may address conditions like polycystic ovarian syndrome (PCOS) by correcting insulin resistance, thereby promoting fertility.

However, he emphasized that while Ozempic can facilitate fertility by addressing obstacles such as insulin resistance and obesity, it cannot reverse conditions like ovarian failure.

Dr. Allison Rodgers, an OB-GYN and reproductive endocrinologist, cautioned against using Ozempic to deliberately increase fertility, warning of potential dangers if taken during pregnancy due to lingering drug effects.

Effect on Birth Control Efficacy

One area of worry is the possibility of a weight-loss medication and hormonal contraceptive medicine combination.

Research indicates that GLP-1 RAs, such as Ozempic, could impact the metabolism and absorption of oral contraceptives, hence decreasing their efficacy and raising the chance of an unplanned pregnancy.

One study found that when an oral hormonal contraceptive was co-administered with GLP-1 RA medicines, there was a significant decrease in the area under the plasma drug concentration-time curve, maximum concentration, and time to maximum plasma concentration. 

This implies that GLP-1 RAs might have a noticeable impact on the absorption of oral contraceptives. This result could be caused by the medications' fast dose increase and delayed stomach emptying.

Healthcare professionals who give weight-loss drugs to people of reproductive age need to be aware of this interaction and offer appropriate advice.

Effects on Fertility

Weight reduction medications may have direct impacts on fertility in addition to their influence on the effectiveness of birth control.

Ozempic may be beneficial for women who have certain medical disorders associated with infertility, such as polycystic ovarian syndrome (PCOS). 

GLP1RA prescriptions increase PCOS women's anthropometrics, hormonal indices, menstrual cyclicity, insulin sensitivity, and natural pregnancy rate.

Although it is regarded as an off-label usage, PCOS is strongly associated with both insulin resistance and blood sugar dysregulation, thus using a medicine that can improve both conditions may be beneficial.

Ozempic may help some PCOS-afflicted women conceive, but using medication while pregnant carries potential risks for the mother and the child.

Animal studies after GLP-1 RA treatment have shown changes in reproductive hormone levels and ovarian function, while the precise processes are yet unknown.

One research done on effects of these drugs on male reproductive system shows that GLP-1 receptors are found in the male reproductive system, impacting glucose homeostasis and energy metabolism crucial for spermatogenesis.

Clinical trials indicate GLP-1 RAs promote weight loss and may enhance sperm metabolism and motility. Studies link GLP-1 RA use with improvements in sperm count and motility in obese men.

However, their direct impact on male reproductive hormones requires further research. Despite promising results, longer-term studies are needed to fully understand the effects of GLP-1 RAs on male fertility.

These results underscore the need for more research in this area and raise concerns about the long-term effects of weight reduction drugs on fertility in both men and women.

Clinical Implications and Counseling

Patients of reproductive age who are prescribed weight-loss drugs should get thorough counseling from healthcare practitioners.

This involves talking about other methods of contraception, their possible effects on fertility and birth control effectiveness, and the necessity of closely monitoring menstrual cycles and reproductive status while undergoing treatment.

Together with their healthcare providers, patients should have the authority to make educated decisions regarding their reproductive health.

Dangers of Using Olympic-like Drugs During Pregnancy

The absence of scientific trials involving pregnant subjects means that the dangers of taking semaglutide during pregnancy are not fully understood.

The best predictor of what would occur in a human pregnancy is research on animals, and the findings are regrettably alarming.

The relationship between these pregnancy outcomes and weight loss and potential undernutrition due to taking Ozempic or exposure to the medicine itself is unclear to experts. Studies on animals have identified the following risks:

• Maternal weight growth during pregnancy is minimal

• may cause pregnancy loss

• structural defects in a developing infant

• poor fetal growth in the womb that results in a small birth weight

Conclusion

The necessity of thorough patient counseling and tailored care is highlighted by the growing body of information about weight loss medications like Ozempic and their effects on fertility and the effectiveness of birth control.

Healthcare professionals need to be on the lookout for potential dangers and advantages associated with these medications in order to make sure that patients receive individualized therapy that meets their specific needs in terms of reproductive health.

The long-term effects of birth control and weight loss medications need to be better understood in order to optimize patient outcomes in the treatment of obesity and associated metabolic disorders.