Semaglutide and Pregnancy: Precautions and Recommendations

Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1 RA) that was initially developed for the treatment of type 2 diabetes (in the form of Ozempic). Its unique mechanism of action, coupled with impressive clinical results, has also made it a promising option for obese individuals looking to control their weight (in the form of Wegovy).

If you’re pregnant or trying to conceive, you’ll need to thoroughly assess the risks and benefits of any medication you’re taking—semaglutide-based included.

The research on semaglutide and pregnancy is still ongoing, but there are some precautions to take and recommendations to consider.

Both Wegovy and Ozempic contain the active ingredient semaglutide, but they serve different medical purposes. Ozempic is FDA-approved for type 2 diabetes management, while Wegovy is FDA-approved for chronic weight management in adults with obesity or overweight. Throughout this article, any reference to semaglutide for weight loss refers to Wegovy. Mentions of semaglutide for blood sugar control refer to Ozempic.

Is Semaglutide Safe During Pregnancy?

With limited scientific data available, it is difficult to give a definitive answer. But, doctors say no. It is not currently considered safe to take semaglutide during pregnancy.

Does semaglutide affect pregnancy? The FDA says existing research primarily consists of animal studies, and while they are not directly translatable to humans, they raise significant red flags. These include:

Birth defects: Animal studies showed an elevated risk of birth defects when taking semaglutide during pregnancy.
Pregnancy loss: There was also an increased risk of pregnancy loss

It’s not just the semaglutide side effects that you need to worry about, though. It’s the main and intended effect. It’s worth noting that weight loss is generally not recommended during pregnancy. Fetal growth and development is critical, and extreme caloric restrictions can have adverse effects on the developing fetus.

While research on semaglutide and pregnancy in humans doesn’t offer much insight. The FDA and the drug manufacturers have issued recommendations for taking semaglutide during pregnancy.

Due to the long half-life, it is recommended that you discontinue use of semaglutide at least two months before pregnancy. For individuals who are using semaglutide to treat diabetes, continuation is only suggested when “benefits clearly outweigh the risks.”

Before Pregnancy and After Pregnancy

Semaglutide Before Pregnancy

Semaglutide before pregnancy can help prepare the body and positively impact fertility. Obesity is known to decrease fertility. Miscarriage rates and pregnancy complications are also raised. Semaglutide can be a valuable tool for individuals seeking to improve their overall health and increase their chances of successful conception.

Weight loss, hormonal balance, and improved metabolic health may contribute to a more favorable environment for successful pregnancy. But, it’s important to emphasize that semaglutide should be used under the guidance of a healthcare provider, particularly when used in preparation for pregnancy.

It should also be noted that the recommendation is you discontinue use at least two months prior to trying to conceive.

Semaglutide After Pregnancy

Semaglutide is not currently considered safe during pregnancy. But what about semaglutide after pregnancy?

The decision to resume or start taking semaglutide post-pregnancy should be made with your healthcare provider.

For individuals who plan to breastfeed, it’s important to discuss the safety of semaglutide while breastfeeding, as this can affect the choice of treatment and medication regimen.

While it is unlikely to adversely affect the infant, it is not known if semaglutide passes through to the breast milk. Precautions should be taken and your doctor may want you to wait until your baby is fully weaned before beginning treatment.

Before or after pregnancy, ongoing communication with a healthcare provider is crucial. The focus should be on balancing the potential benefits with potential risks while ensuring the safety and well-being of both the mother and the newborn child.

Semaglutide Side Effects and Pregnancy

Semaglutide, like any medication, can be associated with a range of potential side effects. While doctors do not recommend taking semaglutide during pregnancy, if the benefits outweigh the risks for diabetics, they may still continue use.

In that case, understanding these side effects and their relevance to pregnancy is essential. What side effects should you be concerned with?

Birth defects: one of the most critical concerns during pregnancy is the potential risk of birth defects. While the direct causal relationship between semaglutide and birth defects in humans is not firmly established, animal studies have raised concerns.
Gastrointestinal effects: semaglutide may lead to gastrointestinal side effects such as nausea, vomiting, and diarrhea. These symptoms can be especially challenging for pregnant individuals, as they might exacerbate the common pregnancy-related nausea and vomiting (morning sickness).
Hypoglycemia: semaglutide, when used to manage diabetes, can lower blood sugar levels. Hypoglycemia during pregnancy can be a concern, as it may affect both the mother’s health and fetal development.

Small, frequent meals and ginger-containing products may help manage nausea. Careful planning of meals and snacks can also help maintain stable blood sugar levels during pregnancy.

Recommendations and Precautions for Semaglutide During Pregnancy

Consult with a healthcare provider: the most crucial step for individuals considering or currently using semaglutide before, during, or after pregnancy is to consult with a healthcare provider.
Discontinuation before pregnancy: if semaglutide is being used before pregnancy, it’s recommended to discontinue its use at least two months before attempting to conceive. If you find out you’re pregnant while on semaglutide, consult your doctor immediately. They may have you slowly lower your dose as opposed to immediate cessation.
Alternative medication options: if Semaglutide is initially prescribed for diabetes management, discuss alternative treatment options with your healthcare provider that are safer during pregnancy.
Consideration of breastfeeding: if semaglutide is to be continued post-pregnancy, discuss its safety during breastfeeding with your healthcare provider, as it may affect the choice of treatment and medication regimen.

Stay Safe And Talk To Your Healthcare Provider

Doctors do not recommend semaglutide while pregnant or trying to become pregnant. The FDA and drug manufacturers only recommend continuation if the benefits far outweigh the risks.

It is important to stay informed with the latest research and guidelines for semaglutide and pregnancy. You should also be discussing your options with your healthcare provider.

To begin your weight loss journey with semaglutide, or discuss your options, consult with a healthcare provider today!

Sources

Breastfeeding and Medication: Semaglutide and Breastfeeding

National Library of Medicine: Semaglutide

Journal of the Turkish-German Gynecological Association: Impact of obesity on infertility in women

Your Fertility: How does being overweight affect my fertility?

Advisory Board: Weight-loss drugs are booming — but there is more to learn about their side effects

Important Medical Information and Disclaimers

Medical Disclaimer

This information is for educational use only. It does not replace medical advice, diagnosis, or treatment. Semaglutide is the active ingredient in two FDA-approved drugs: Ozempic and Wegovy. Ozempic helps manage blood sugar in adults with type 2 diabetes. Wegovy supports weight loss in adults with obesity or overweight who have at least one weight-related condition. Each medication has a different purpose and dosage schedule. Talk to a licensed healthcare provider before starting, stopping, or changing any treatment.

Do Not Use Compounded Semaglutide

Only use FDA-approved semaglutide medications. Do not use compounded versions. Compounded semaglutide is not FDA-approved and may carry safety and quality risks. The FDA has warned against using these versions due to issues with incorrect ingredients, poor storage, or improper dosage. Always get semaglutide from a licensed pharmacy with a valid prescription.

Individual Results Vary

Your results with semaglutide may differ from others. Clinical trial data may not match real-life outcomes. Your experience depends on how well you follow your treatment plan, your diet and exercise habits, your metabolism, and other medications or conditions. No one can promise specific results.

Important Safety Information

Common side effects include: Nausea, Vomiting, Diarrhea, Constipation, Stomach pain, Decreased appetite, Indigestion or gas, Redness or pain at the injection site

These effects are often mild and may go away over time. Share your full medical history with your provider. Let them know about allergies and current medications. Your provider should check on your progress regularly.