Pregnancy concerns linked to weight loss injections: potential impact on reproductive health

In the realm of weight-loss treatments, GLP-1 agonists like Ozempic, Wegovy, and Mounjaro have gained significant attention. Manufactured by pharmaceutical giants Novo Nordisk and Eli Lilly, these medications have been associated with unexpected pregnancies, raising concerns among healthcare professionals.

Dr Tania Adib, a consultant gynaecologist, and Dr Fionnuala Barton, a specialist menopause doctor, have both expressed concerns about the potential impact of these drugs on oral contraception. Adib suggests that medications like Ozempic may make oral contraception less effective due to delayed stomach emptying and reduced absorption. Barton concurs, advising patients to use barrier contraception in addition to hormonal contraception for four weeks after starting medication and for four weeks after any dose increases.

Moreover, Barton recommends non-oral contraception methods like LARC, IUD, hormonal implant, Depo-Provera injections, or Evra patch for those taking GLP-1 drugs. This advice is based on potential absorption issues that could interfere with oral contraception, potentially reducing its effectiveness.

Reports of increased fertility in women taking weight loss injections have also been raised by Dr Karan Rajan, an NHS general surgeon. Meanwhile, Professor Emily Oster, a parenting data economist, has observed discussions on TikTok about women getting pregnant while taking Ozempic.

The biggest issue, however, is that these medications have not been shown to be safe in pregnancy. A study from the Public Library of Science suggests that GLP-1s may have a negative impact on a healthy pregnancy, although this has only been seen in animal studies. In light of these concerns, both Novo Nordisk and Eli Lilly are building registries of women who took Wegovy and Mounjaro while pregnant or breastfeeding to track health data.

The MHRA has issued an alert regarding contraception and weight-loss medications, including 40 reports of pregnancies while using these drugs, 26 of which were on Mounjaro. The "wash out" period for Mounjaro is one month, while it is two months for Ozempic and Wegovy.

Looking ahead, Dr Adib predicts that in two or three years, more data will be available, potentially leading to different recommendations. A 2024 study by multidisciplinary science journal Nature suggests a plausible connection between weight loss medications like Ozempic and pregnancy.

In the meantime, it's crucial to maintain a healthy body composition for supporting ovarian health and reproduction. Dr Barton emphasizes this point, highlighting the importance of a balanced diet and regular exercise. Moreover, she notes that fertility can improve even without weight loss in individuals with poor metabolic health.

The 'Ozempic baby' hashtag on social media has become popular, but it's essential to remember the potential risks associated with these medications during pregnancy. As more data becomes available, it's crucial to stay informed and consult with healthcare professionals about the best contraceptive options while taking GLP-1 agonists.