Are GLP-1s Safe During Pregnancy?

The short answer: No—GLP-1 medications like Ozempic, Wegovy, Mounjaro, and Zepbound aren't recommended during pregnancy. The American College of Obstetricians and Gynecologists (ACOG) advises considering stopping them one to two months before trying to conceive, and the Wegovy label calls for at least two months. If you learn you're pregnant while taking one, contact your healthcare provider right away. Early studies of accidental exposure are reassuring, but there isn't enough data yet to call these medications safe in pregnancy.

GLP-1 medications have gone from niche diabetes treatment to household name in just a few years—and many of the people using them are in their prime baby-making years. So, it's no surprise that today’s OB/GYNs are hearing some version of: "I'm on Ozempic (or Wegovy, or Zepbound)…what happens if I want to get pregnant?"

It's a big enough question that ACOG just released its first practice advisory on GLP-1s in pregnancy and breastfeeding. According to the guideline's lead author, as many as one in 300 women are exposed to a GLP-1 before pregnancy. Here's what the new guidance says, what researchers know (and don't yet know) about these medications and a developing baby, and how GLP-1s may affect your fertility and birth control.

What are GLP-1 medications?

GLP-1 receptor agonists are a class of medications that mimic a natural gut hormone called glucagon-like peptide-1, which helps regulate appetite and blood sugar. Semaglutide—sold as the injections Ozempic and Wegovy and as the tablet Rybelsus—is the best known. Tirzepatide (sold as Mounjaro and Zepbound) is a close cousin that activates both the GLP-1 receptor and a second hormone receptor called GIP, and it's usually grouped with GLP-1s. Depending on the brand, these medications are prescribed for type 2 diabetes, weight management, or both.

One more thing worth knowing: The FDA has flagged concerns about compounded and other unapproved versions of semaglutide and tirzepatide, which don't go through the agency's review for safety, effectiveness, or quality. If you use a compounded GLP-1, the pregnancy guidance below still applies—and it's especially important that your healthcare provider knows exactly what you're taking.

Can you take a GLP-1 while pregnant?

No. ACOG's new guidance advises against using GLP-1s during pregnancy (outside of a clinical trial), and recommends that OB/GYNs counsel patients about the lack of sufficient safety data. The FDA labels for both Wegovy and Zepbound say to stop the medication once pregnancy is recognized.

There are a few reasons for the caution:

• Weight loss isn't a goal during pregnancy: The Wegovy and Zepbound labels both state that weight loss offers no benefit to a pregnant patient and may cause fetal harm. Gaining an appropriate amount of weight—based on your pre-pregnancy weight—is recommended for all pregnant people, including those who started pregnancy with overweight or obesity. (Learn more about pregnancy weight gain.)
• Animal studies raised red flags: In rats, rabbits, and monkeys, semaglutide exposure during pregnancy was linked to early pregnancy loss, structural abnormalities, and growth changes, according to the Wegovy label. The Zepbound label reports reduced fetal growth and fetal abnormalities in animal studies of tirzepatide. In both cases, these effects happened alongside reduced food intake and weight loss in the mother animals, so it's not clear how much is due to the drug itself.
• Human data is still limited: Pregnant people are excluded from drug trials, so most of what we know comes from people who took a GLP-1 before they realized they were pregnant.

One important exception to "just stop": If you take a GLP-1 to manage type 2 diabetes, don't stop or change your medication on your own. High or uncontrolled blood sugar can itself raise the chance of miscarriage, birth defects, and other pregnancy complications, so your healthcare provider will help you switch to a pregnancy-compatible plan.

What does the research say?

According to ACOG's advisory, four systematic reviews and meta-analyses of GLP-1 exposure around conception and in early pregnancy didn't find statistically significant increases in major birth defects, miscarriage, stillbirth, preterm birth, gestational diabetes, or preeclampsia. But ACOG notes that these analyses relied on a limited number of observational studies of varying quality, and one review flagged a possible link with urinary tract malformations based on unadjusted data.

One of the largest individual studies, published in JAMA Internal Medicine, followed pregnancies in people with type 2 diabetes across the Nordic countries, the U.S., and Israel. Compared with insulin, GLP-1 exposure from 90 days before pregnancy through the first trimester wasn't associated with a large increase in risk of major birth defects—though the researchers noted that some of their estimates were imprecise and that confirmation from other studies is needed.

Researchers are also looking at what happens after people stop. ACOG's advisory describes mixed findings: One large study linked GLP-1 exposure around pregnancy with more weight gain during pregnancy and higher rates of preterm birth, gestational diabetes, and high blood pressure disorders, while another found no difference between people exposed during pregnancy and people who'd stopped earlier—suggesting the risks may reflect "rebound" weight gain after stopping rather than the medication itself. A separate study linked a pre-pregnancy GLP-1 prescription with modestly lower rates of gestational diabetes, high blood pressure disorders, preterm delivery, and c-section.

In other words: Accidental early exposure doesn't appear to cause major problems, but that's not the same as proving these medications are safe to use during pregnancy.

Why to Stop a GLP-1 Before Trying to Conceive

GLP-1s like semaglutide, tirzepatide, and dulaglutide stay in your body for a long time, which is why stopping before you start trying is so important.

• ACOG: Recommends that healthcare providers advise patients to consider stopping one to two months before pregnancy.
• Wegovy (semaglutide): The FDA label says to stop at least two months before a planned pregnancy because semaglutide has a half-life of about one week and stays in circulation for about five to seven weeks after the last dose. MotherToBaby notes that the labels for Ozempic and Rybelsus carry the same two-month recommendation.
• Zepbound (tirzepatide): The label doesn't name a specific washout period; it says to stop when pregnancy is recognized. Tirzepatide's half-life is about five days.

Stopping can bring its own challenges. "While patients often experience the positive effects of GLP-1s prior to pregnancy, there are risks associated with both taking the medication and discontinuing," ACOG's Amy Valent, DO, said. Regaining weight is common, so ACOG encourages providers to monitor weight and support patients with nutrition guidance, physical activity, and behavioral support. For people who used GLP-1s before pregnancy, ACOG also recommends checking for nutrient deficiencies (like vitamin D, vitamin B12, and iron stores), a referral to a dietitian when needed, and screening for preeclampsia risk.

What if you got pregnant while taking a GLP-1?

First, take a breath. This happens—especially because GLP-1s can make it easier to get pregnant (more on that below)—and the early research on accidental exposure is reassuring. Here's what to do:

• Call your healthcare provider: Let them know which medication you're taking, your dose, and when you took your last one. The labels for both Wegovy and Zepbound say to stop once pregnancy is recognized.
• If you have diabetes, don't stop without a plan: Your provider will help you transition to a pregnancy-compatible way to manage your blood sugar.
• Consider joining a pregnancy registry: The manufacturers of Wegovy and Zepbound run pregnancy exposure registries that track outcomes, which helps future parents get better answers. Your provider can help you enroll.

Do GLP-1s affect fertility?

There's no evidence that GLP-1s directly harm human fertility—and for some people, they may make getting pregnant easier. That's good news if you're hoping to conceive, but it also means an unplanned pregnancy is a real possibility. Here's what the evidence shows:

• Weight loss may boost fertility: Because GLP-1–related weight loss may improve fertility, ACOG recommends that anyone taking a GLP-1 who could become pregnant be counseled on effective birth control. MotherToBaby notes that obesity and high blood sugar can make it harder to get pregnant in the first place.
• They may help some people with PCOS: Polycystic ovary syndrome is a leading cause of ovulation-related infertility. A meta-analysis of 11 randomized controlled trials in people with PCOS found that GLP-1s were associated with higher natural pregnancy rates and more regular periods compared with control treatments—but no significant difference in IVF pregnancy rates. (Read more about PCOS and pregnancy.)
• Tirzepatide can make the pill less effective: Because tirzepatide slows stomach emptying, it can reduce how much of an oral contraceptive your body absorbs—especially after the first dose. The Zepbound label advises people on birth control pills to switch to a non-oral method (like an IUD, implant, patch, or ring) or add a barrier method like condoms for four weeks after starting and for four weeks after each dose increase. In a clinical pharmacology study cited on the Wegovy label, semaglutide didn't have a clinically relevant effect on oral contraceptive levels—but it's still worth reviewing your birth control with your provider.
• Animal data is limited: In animal studies, female rats given semaglutide or tirzepatide had longer cycles and fewer ovulations, which the Wegovy and Zepbound labels attribute to reduced eating and weight loss rather than a direct drug effect.
• What about partners? Studies haven't been done in men to see whether semaglutide affects fertility, but one animal study found no changes in male fertility, and MotherToBaby notes that a partner's medication exposures are generally unlikely to raise pregnancy risks.

Can you take a GLP-1 while breastfeeding?

Possibly—it's a conversation to have with your provider. ACOG recommends shared decision-making about whether a GLP-1 belongs in your postpartum care plan, but advises against use while breastfeeding a baby who is in the first 28 days of life or was born preterm. For those who do choose a GLP-1 while breastfeeding, ACOG suggests choosing one with a shorter half-life, avoiding oral (tablet) versions, and closely monitoring baby's weight gain.

Early lab studies suggest little medication reaches breast milk: In a small study, semaglutide wasn't detected in breast milk after injections, and in a single-dose study of tirzepatide, the drug was undetectable in most breast milk samples. But there's no data yet on how these medications affect milk supply or a baby's growth over time.

When to Call Your Healthcare Provider

Reach out to your healthcare provider if:

• You're taking a GLP-1 and thinking about getting pregnant in the next year.
• You've had a positive pregnancy test while taking a GLP-1.
• You take a GLP-1 for type 2 diabetes and are pregnant or planning a pregnancy.
• You're on tirzepatide and rely on birth control pills.
• You've stopped a GLP-1 and are struggling with nausea, eating enough, or rapid weight regain.
• You're postpartum and want to restart a GLP-1 while breastfeeding.

FAQ on GLP-1s in Pregnancy

How long before getting pregnant should I stop Ozempic or Wegovy?

The labels for Ozempic, Wegovy, and Rybelsus recommend stopping at least two months before a planned pregnancy because semaglutide stays in the body for weeks. ACOG advises considering stopping any GLP-1 one to two months before trying to conceive. Your provider can help you plan the timing.

I took my GLP-1 before I knew I was pregnant. Should I be worried?

Don’t panic—studies of early, accidental exposure haven't found a clear increase in major birth defects or pregnancy complications. Stop the medication and call your healthcare provider—and if you take it for diabetes, ask how to manage your blood sugar going forward.

Do GLP-1s make birth control less effective?

Tirzepatide (Mounjaro and Zepbound) can reduce the absorption of birth control pills. The Zepbound label recommends switching to a non-oral method or adding a barrier method for four weeks after starting and after each dose increase. Non-oral hormonal methods shouldn't be affected.

Can GLP-1s increase fertility?

They may. Weight loss can improve fertility, and studies in people with PCOS have linked GLP-1s to higher natural pregnancy rates and more regular cycles. That's why ACOG recommends effective birth control for anyone on a GLP-1 who isn't trying to conceive.

Is it okay for my partner to take a GLP-1 while we're trying to conceive?

There are no human studies on GLP-1s and male fertility, but an animal study found no effect, and a partner's medication exposures are generally unlikely to raise pregnancy risks. It's still smart for your partner to mention it to their own healthcare provider.

Can I restart my GLP-1 after giving birth?

Possibly. ACOG supports deciding together with your provider, but recommends avoiding GLP-1s while breastfeeding a newborn in the first 28 days or a baby born preterm. If you're formula-feeding, talk with your provider about when to restart.

The Bottom Line

GLP-1s like Ozempic, Wegovy, Mounjaro, and Zepbound aren't recommended during pregnancy, and ACOG suggests considering stopping them one to two months before you start trying (at least two months for semaglutide, per its label). The early research on accidental exposure is reassuring, but there simply isn't enough data yet to call these medications safe for a developing baby. Because GLP-1s may make it easier to get pregnant—and tirzepatide can make the pill less reliable—the best move is to talk with your healthcare provider about your plans before you're ready to grow your family. This is a fast-moving area of research, so expect guidance to keep evolving.

More on a healthy pregnancy:

• Is Melatonin Safe During Pregnancy?
• Can I Take Tylenol While Pregnant?
• Can I Get a Flu Shot While Pregnant?
• Is Retinol Safe During Pregnancy?

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• American College of Obstetricians and Gynecologists: Use of Glucagon-Like Peptide-1 Receptor Agonists in Pregnancy and Lactation
• American College of Obstetricians and Gynecologists: ACOG Releases New Guidance on the Use of GLP-1s in Pregnancy and Lactation
• Organization of Tetrology Information Specialists MotherToBaby: Semaglutide Fact Sheet
• U.S. Food and Drug Administration: ZEPBOUND (Tirzepatide) Prescribing Information
• U.S. Food and Drug Administration: FDA's Concerns With Unapproved GLP-1 Drugs Used for Weight Loss
• U.S. Food and Drug Administration: WEGOVY (Semaglutide) Prescribing Information
• Safety of GLP-1 Receptor Agonists and Other Second-Line Antidiabetics in Early Pregnancy, JAMA Internal Medicine, Feb 2024
• Effects of GLP1RAs on Pregnancy Rate and Menstrual Cyclicity in Women With Polycystic Ovary Syndrome: A Meta-Analysis and Systematic Review, BMC Endocrine Disorders, Nov 2023

Disclaimer: The information on our site is NOT medical advice for any specific person or condition. It is only meant as general information. If you have any medical questions and concerns about your child or yourself, please contact your health provider.