Semaglutide and Pregnancy: What You Need to Know

Semaglutide should NOT be used during pregnancy. Here's why: Animal studies: Studies in rats and rabbits showed increased risk of birth defects, pregnancy loss, and growth problems at clinically relevant doses. Insufficient human data: We don't have enough data from human pregnancies to confirm safety, and the animal findings make it unethical to conduct such studies. No benefit during pregnancy: Weight loss isn't recommended during pregnancy, and blood sugar can be managed with pregnancy-safe alternatives like insulin. FDA classification: The FDA recommends discontinuing semaglutide at least 2 months before planned pregnancy.

If you're considering pregnancy: The 2-month rule: Stop semaglutide at least 2 months before trying to conceive. This allows the medication to clear your system. Why 2 months? Semaglutide has a long half-life (approximately 1 week). It takes several weeks to be fully eliminated from your body after your last dose. What to expect: • Some weight regain after stopping is normal • Appetite and hunger typically return • Blood sugar may be harder to control (if diabetic) Work with your provider: Plan the transition with your healthcare team, especially if you have diabetes and need alternative blood sugar management.

If you're taking semaglutide and don't want to become pregnant: Consider your contraception carefully: Semaglutide may reduce the effectiveness of oral contraceptives by slowing their absorption. FDA recommendation: Use a non-oral contraceptive method or add a barrier method for 4 weeks after starting semaglutide and 4 weeks after each dose increase. More reliable options: • IUD (hormonal or copper) • Implant (Nexplanon) • Injectable (Depo-Provera) • Barrier methods (condoms, diaphragm) Don't assume infertility: Weight loss improves fertility. Even if you've had difficulty conceiving before, semaglutide-induced weight loss may restore fertility.

If you discover you're pregnant while on semaglutide: Immediate steps: 1. Stop taking semaglutide right away 2. Contact your healthcare provider 3. Don't panic—many exposed pregnancies have good outcomes What your provider will do: • Confirm pregnancy and estimate timing • Assess how much medication exposure occurred • Recommend appropriate monitoring • May refer to a maternal-fetal medicine specialist What we know about exposure: Limited data suggests that early pregnancy exposure, while not ideal, doesn't guarantee problems. Many women who discovered pregnancy while on semaglutide have had healthy babies. Additional monitoring: Your provider may recommend extra ultrasounds or other tests to monitor fetal development.

After pregnancy, can you breastfeed while taking semaglutide? Current recommendation: No. Why not: We don't know if semaglutide passes into breast milk, and we don't know its effects on nursing infants. If you want to breastfeed: Wait until after weaning to restart semaglutide. Discuss alternative weight management strategies with your provider during breastfeeding. If breastfeeding isn't planned: You can discuss restarting semaglutide with your provider after delivery. There's no required waiting period if you're not nursing.

If you were taking Ozempic for type 2 diabetes: Transition to pregnancy-safe options: Insulin is the gold standard for managing diabetes during pregnancy. Your provider will help you transition. Timing: Start planning the transition at least 2 months before trying to conceive. Close monitoring: Diabetes management during pregnancy requires frequent blood sugar monitoring and regular prenatal visits. Gestational diabetes: Even women without pre-existing diabetes may develop gestational diabetes. This is managed separately from pre-existing diabetes.

Restarting semaglutide after pregnancy depends on your breastfeeding plans: If not breastfeeding: You can discuss restarting with your provider soon after delivery. Your body has been through significant changes, so the timing should be individualized. If breastfeeding: Wait until you've finished breastfeeding to restart semaglutide. What to expect: • You'll likely restart at a lower dose and titrate up • Weight management goals may need to be reassessed post-pregnancy • Give your body time to recover from pregnancy before focusing heavily on weight loss

Important fertility considerations: Weight loss improves fertility: Many women taking semaglutide for weight loss experience improved fertility, especially those with PCOS. Surprise pregnancies: "Ozempic babies" have become a phenomenon—unexpected pregnancies in women who didn't realize their fertility had improved. Plan accordingly: • If you don't want to get pregnant, use reliable contraception • If you do want to get pregnant, work with your provider on timing • Don't assume past infertility means current infertility