Few side effects of GLP-1 medication have generated as much media attention as unexpected pregnancies — the so-called "Ozempic babies". Behind the headlines lies a more nuanced story about how these medications interact with reproductive health: sometimes improving it, sometimes requiring careful planning around it.

Whether you are currently taking Wegovy, Ozempic or Mounjaro and want to understand what this means for your fertility, or whether you are planning a future pregnancy and wondering how to time things, here is a thorough and honest overview.

Can GLP-1 medication improve fertility?

Yes — particularly for women whose fertility challenges are linked to excess weight or PCOS (polycystic ovary syndrome). The connection works primarily through weight loss: adipose tissue (body fat) produces oestrogen-like compounds and disrupts insulin signalling, which can suppress ovulation. When significant weight is lost, this hormonal environment often normalises and ovulation can resume — sometimes for the first time in years.

Beyond weight loss, GLP-1 receptors are also present directly in reproductive tissue, including the ovaries, endometrium (uterine lining), and testes. This raises the possibility that semaglutide and tirzepatide may have additional direct effects on reproductive biology, though research in this area is still emerging.

What is well established is that women living with obesity and irregular cycles who begin GLP-1 treatment often experience restored menstrual regularity within months — which can come as a surprise if they had previously believed pregnancy was unlikely.

What are "Ozempic babies"?

"Ozempic babies" is the popular term for the unexpected pregnancies reported by women taking GLP-1 medication. Women who believed themselves to be infertile — or who were simply not focused on contraception — found themselves pregnant after starting Wegovy or Ozempic.

There are at least two mechanisms that help explain this:

If you take oral contraceptives and are starting GLP-1 treatment, it is worth discussing a backup contraceptive method with your doctor — at least for the first few months.

GLP-1 and PCOS — a particularly important connection

PCOS is the most common endocrine disorder in women of reproductive age and one of the leading causes of difficulty conceiving. Insulin resistance — present in the majority of women with PCOS — is a central driver of the hormonal imbalance that leads to irregular or absent ovulation.

GLP-1 receptor agonists, particularly semaglutide, have shown promising results in clinical studies of women with PCOS. A study published in the Journal of Clinical Endocrinology & Metabolism found that semaglutide significantly reduced BMI, testosterone levels, and insulin resistance in women with PCOS, and improved menstrual regularity. Some participants experienced regular menstrual cycles restored for the first time in years.

This does not mean GLP-1 drugs are a dedicated fertility treatment — but the metabolic improvements they produce can create a hormonal environment in which pregnancy becomes possible. For women with PCOS who are trying to conceive, GLP-1 treatment may be one piece of a broader care plan, ideally coordinated between an endocrinologist and a gynaecologist or fertility specialist.

What about male fertility?

Less research exists on GLP-1 and male reproductive health, but there are reasons to pay attention. GLP-1 receptors have been identified in testicular tissue in animal studies, suggesting a potential direct role in sperm production or function. Human clinical data in this area is still limited.

What is well established is that obesity in men is associated with lower testosterone levels, reduced sperm quality, and impaired sperm motility. Weight loss — through GLP-1 medication or other means — has been shown in studies to improve these parameters. A large meta-analysis found that weight reduction in men with obesity led to significant improvements in testosterone levels and semen quality.

If you are a man using GLP-1 medication and fertility is a consideration, it is worth discussing your individual situation with your doctor, as the data are still evolving.

Should you stop GLP-1 before trying to conceive?

Yes — this is a clear and consistent recommendation from both the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA). Semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro) are contraindicated during pregnancy. Animal studies have demonstrated fetal harm at clinically relevant doses, including reduced fetal growth and skeletal malformations at high exposures.

While no large human studies have confirmed these risks, the precautionary principle applies strongly here. Current guidance is:

Practical guidance by situation

Here is a brief summary depending on where you are:

Medical disclaimer

This article is for general informational purposes only and does not constitute medical advice. Always consult your doctor or specialist before making any changes to your treatment. GLP-1 medications should only be used under medical supervision. Guidance on fertility and pregnancy is particularly individual — please work with your healthcare team to make the right decision for your specific situation.

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