Women with fertility issues who have struggled to conceive are finding unexpected success with weight-loss drugs like Ozempic and Mounjaro. These medications are primarily intended to manage blood sugar levels in people with type 2 diabetes and treat obesity, but their potential impact on pregnancy is now raising questions. Torria Leggett, a social worker from North Carolina, is one of the many women who have experienced the fertility-boosting effects of these drugs. After trying unsuccessfully for another child since 2018, she began taking Ozempic in 2022 and later switched to Mounjaro. As she lost weight, she was thrilled to discover she was pregnant. While stories like Leggett’s are encouraging, doctors are emphasizing the need for caution due to the lack of data on the drugs’ safety during pregnancy. They are using these GLP-1 drugs to treat PCOS, a leading cause of infertility, without substantial information on their potential risks. Melanie Cree, director of the PCOS clinic at Children’s Hospital Colorado, notes the increasing number of unintended pregnancies associated with these drugs. “It’s very exciting, but it’s a bit scary because we’re moving forward without all the data,” she says. GLP-1 drugs have been used in diabetes treatment for almost two decades, and their use in obesity is fueling a rapidly growing market. However, companies like Novo Nordisk and Eli Lilly, the manufacturers of Ozempic and Mounjaro, respectively, have not systematically studied their drugs’ use in PCOS and do not plan to do so in the near future. Researchers are conducting independent studies to determine the efficacy and safety of these drugs for PCOS, and US regulators have requested that companies collect information on their use during pregnancy. The studies conducted so far have yielded promising results, but more confirmation is needed, especially in women without diabetes. Researchers from Copenhagen concurred that there is limited information on the long-term safety of GLP-1 drugs, particularly concerning pregnancy outcomes. Concerns arise primarily from animal studies, where semaglutide, the active ingredient in Novo Nordisk’s drugs, has been linked to increased birth defects. Similar studies on Eli Lilly’s drugs have indicated potential risks to the fetus from exposure during pregnancy. It is still unclear how or even if these drugs contribute to pregnancy in women. Weight loss is known to improve fertility in women with PCOS, and studies have shown that Saxenda, an older obesity drug, also raises pregnancy rates in women with this condition who are overweight. GLP-1s may have hormonal effects that promote fertility and may also reduce the effectiveness of oral contraceptives. Some experts believe these drugs may even play a role in male infertility. Rekha Kumar, a reproductive endocrinologist at Weill Cornell Medicine in New York, suggests that GLP-1 drugs “wake up the ovaries,” restoring the reproductive environment to normal function. Kumar, with over 15 years of experience treating infertility and obesity, has observed that these drugs significantly enhance fertility in patients. Pregnant people and those planning to get pregnant were excluded from trials of GLP-1s. Trial participants were required to use contraception, and treatment was discontinued for those who became pregnant during clinical trials of Mounjaro and Zepbound. Experts disagree on the recommended time for patients to stop taking these medications before attempting pregnancy. Some doctors advise a safe period of up to four weeks, while others believe it is acceptable to continue use until the time of pregnancy. Wegovy’s label recommends stopping the drug at least two months before trying to conceive, while Zepbound advises discontinuation upon pregnancy. In Colorado, Cree is leading a study to investigate the effects of Novo Nordisk’s Wegovy on ovulation in women with PCOS. However, ongoing supply issues with the popular drug pose a challenge. Novo Nordisk has declined to provide free supplies because the patients will not be on birth control, a decision Cree finds disappointing. Meanwhile, studies have shown an increasing number of women exposed to GLP-1 drugs during early pregnancy as they are increasingly used for diabetes and other conditions. Private Facebook groups and social media platforms are filled with stories of women who have become pregnant while taking GLP-1 drugs. The US Food and Drug Administration (FDA) has asked Novo Nordisk to establish a registry to collect data on pregnancies while taking Wegovy, but the company has yet to share any results. The FDA has also required an additional pregnancy study using insurance claims or electronic medical records. Eli Lilly plans to set up a similar registry but has not disclosed a timeline. In addition to the FDA’s initiatives, Cree and other researchers are working independently to establish databases to track pregnancy outcomes in GLP-1 patients. PCOS is characterized by excessive production of testosterone, leading to symptoms like excessive hair growth, acne, weight gain, and blocked ovulation. Women with PCOS also exhibit insulin resistance, and the weight-loss effects of GLP-1s may improve insulin sensitivity. Ricardo Azziz, a PCOS expert at the University of Alabama at Birmingham and State University of New York, believes these new drugs have the potential to significantly alleviate symptoms, although he emphasizes the need for more data before recommending them for fertility purposes. Like Leggett, many who have gotten pregnant on weight-loss drugs are left with questions. She wonders about the petite size of her daughter compared to other children her age. “She’s teeny-tiny,” Leggett says. “I’d like to know more about that.” While the potential of these drugs in improving fertility and treating PCOS is promising, further research is crucial to fully understand their safety and long-term effects during pregnancy.
Weight-Loss Drugs Linked to Pregnancy in Women with Fertility Issues
