Ozempic 'oops' babies spark debate about weight-loss shot use as fertility drugs

Reasons for concern come mostly from animal experiments. The active ingredient in Novo’s drugs, semaglutide, has been linked to increased birth defects in animals. Similar studies of Lilly’s drugs have shown there “may be risks to the fetus” from exposure during pregnancy, the company said.

No one is exactly sure how — or even whether — the drugs contribute to women becoming pregnant. Weight loss is known to boost fertility in women with PCOS, and studies have shown that Saxenda, an older obesity drug, also raised pregnancy rates in women with the disorder who were overweight. GLP-1s may also have hormonal effects that promote fertility, and may blunt the impact of oral contraceptives. Some experts think the drugs might even have a role in male infertility.

Rekha Kumar, a reproductive endocrinologist at Weill Cornell Medicine, says GLP-1 drugs “wake up the ovaries,” resetting the reproductive environment for normal function. After treating patients with infertility and obesity for more than 15 years, one thing is clear, Kumar said: “These patients are becoming very fertile.”

Pregnant people and those planning to get pregnant were excluded from trials of GLP-1s. Trial participants have been required to use contraception, and treatment was discontinued for those who became pregnant during clinical trials of Mounjaro and Zepbound, Lilly said.

Experts Split

Experts are split on how soon patients should stop taking the medications before a planned pregnancy. Some doctors are telling patients that up to four weeks is safe; others say it’s fine to keep using them up until the time of pregnancy. Wegovy’s label says people should stop taking the drug at least two months before trying to get pregnant, while Zepbound’s recommends that people who become pregnant stop the drug.

In Colorado, Cree is running a study to find out how Novo’s Wegovy affects ovulation in women with PCOS, but ongoing supply problems with the popular drug present a challenge. Novo won’t provide free supplies because the patients won’t be on birth control, she said, a decision she called “very disappointing.”

Meanwhile, a study found that the number of women exposed to GLP-1 drugs during early pregnancy appears to be increasing, as more turn to them for diabetes and other conditions. The Facebook group “I got Pregnant on Ozempic” has 597 members; on TikTok, dozens have said they’ve become pregnant while taking a GLP-1 drug.

The U.S. Food and Drug Administration asked Novo to set up a registry to collect data on those who got pregnant while taking Wegovy, but the company has yet to share any results. It’s also required to do an additional pregnancy study using insurance claims or electronic medical records, the FDA said. Lilly is planning to set up a similar registry, but declined to say when. Meanwhile, Cree and a handful of researchers are scrambling to set up their own databases to track pregnancy outcomes in GLP-1 patients.

Not A Cure

PCOS is a somewhat mysterious condition that typically involves irregular ovulation and high levels of male hormones called androgens. It’s the most common hormonal disorder in women, putting them at increased risk of diabetes, heart disease and mental health issues.

Those with the condition frequently make too much testosterone, leading to effects like extra hair growth, acne and weight gain, and blocking ovulation. They also don’t respond properly to insulin, and the weight-loss effects of GLP-1s may improve sensitivity to the hormone.

The new drugs “are not going to cure you, but it’s going to improve the symptoms significantly,” said Ricardo Azziz, a PCOS expert and professor at the University of Alabama at Birmingham and SUNY Albany in New York. Still, he thinks more data is needed before doctors recommend the drugs for fertility.

People like Leggett, who got pregnant on a weight-loss drug, also have some questions. She sometimes wonders why her daughter is smaller than other kids the same age.

“She’s teeny-tiny,” Leggett said. “I’d like to know more about that.”

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—With assistance from Jessica Nix and Naomi Kresge.