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The Checkup: Ozempic babies? Explaining unexpected pregnancies on GLP-1 drugs


Recently, the term “Ozempic baby” has been cropping up on social media from TikTok to Facebook to Reddit. Some women are saying they're getting unexpected pregnancies while on the medication.

If your parents gave you the birds and bees conversations but you feel like they totally left out the chapter about Ozempic babies, you’re not alone. That’s why The Checkup’s question today is: Just what are Ozempic babies?

Lizzy McGrevy, Side Effects Public Media’s community engagement specialist, spoke with Managing Editor Farah Yousry about that.

This transcript has been edited for length, style and clarity.

Lizzy McGrevy: Can you please shed some light and tell us what exactly is happening here? 

Farah Yousry: The way Ozempic –– and other “Glucagon-like peptide 1” or GLP-1 drugs that spur weight loss –– works is through a process called delayed gastric emptying. So, it takes longer for the food to be absorbed by our body. And that helps people feel fuller for longer, and so they won't reach out to food as often, which results in weight loss.

Now, obesity, diabetes, and insulin resistance are all issues that impact women's fertility and ability to carry a healthy pregnancy, because there are hormones that are stored in the fatty tissue that work against the natural, typical process that helps people get pregnant. So, when someone takes Ozempic, and addresses these issues, they may find that their fertility struggles have also been resolved. And they find themselves carrying a baby when they did not expect it.

McGrevy: That makes a lot of sense. But I have also seen posts from women who are taking Ozempic. And they say they got pregnant, even though they're on birth control pills. How is that happening?

Yousry: Birth control pills work in different ways, depending on what kind of hormones are in them. Some pills suppress ovulation altogether. Others may make it harder for the sperm to fertilize an egg. And this all depends on if the person takes the bill as directed, so that the hormones can do their jobs. Now, Ozempic, and the whole delayed gastric emptying process, can also interfere with the way medications –– including the birth control pill –– are absorbed by the body.

“The levels of the hormone aren't going to be consistent. And those conditions that we're trying to set up to prevent pregnancy might actually occur,” said Linda Cassar, an associate professor at George Washington University's School of Nursing who’s worked OBGYN patients for over three decades. “You know, maybe an egg does get released, maybe the cervical mucus doesn't thicken the way we expect it to. And maybe the wall, the uterus does get a little thicker. So when the hormones from the pills aren't absorbed in those even concentrations, and the way we hope sets up conditions where pregnancy could happen.”

McGrevy: So it sounds like some of these pregnancies are happening unexpectedly, which, I'm guessing, means women may be taking the medication for weeks into the pregnancy. What do we know about the safety of these drugs for the pregnant person and for the fetus?

Yousry: According to Ozempic’s prescribing information, lab studies on animals have shown that the drug during pregnancy sometimes resulted in pregnancy loss or fetus abnormalities. But it's very hard to ethically design a study where researchers can test the impact of these drugs on the pregnant person and the development of the fetus. So, as of now, there really isn't enough safety information available.

We also do not know after the pregnancy if, for example, the GLP-1 medications get passed on through breastfeeding and what kind of impact this has on the newborn. So, medical experts advise that if someone is planning to get pregnant, and they are on Ozempic or the other semaglutide medications, they should be off of it for at least two months before trying to conceive. Kassar said it has to be planned.

“It’s not just, ‘Oh, I've lost 35 pounds while I've been taking this medication for my diabetes. I feel healthier. Now I'm going to try to get pregnant’,” Cassar said. “There has to be a discussion about what other medication that's doing the job that Ozempic is doing, that's been studied a little bit better in human patients. What other things can we substitute there?”

Kassar said there are some other alternatives out there that doctors can talk to you about that could be safer for a pregnant person.

McGrevy: Thank you Farah. I can now check off Ozempic babies is something I've truly learned about because you can't trust everything here on TikTok.

Yousry: That's why we have The Checkup.

McGrevy: Yes. So, if you have questions, and you don't want to just trust random people on the internet, you can always write into us and we will try to find experts to answer your questions next time on The Checkup.

The Checkup by Side Effects Public Media is a regular audio segment on WFYI's daily podcast, WFYI News Now.

Side Effects Public Media is a health reporting collaboration based at WFYI in Indianapolis. We partner with NPR stations across the Midwest and surrounding areas — including KBIA and KCUR in Missouri, Iowa Public Radio, Ideastream in Ohio and WFPL in Kentucky.

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