Ozempic Babies: Semaglutide, Fertility and Pregnancy

A woman who had been told for years that she probably would not conceive starts a GLP-1 drug for weight or diabetes. A few months later, she is pregnant.

That story has been repeated enough times that it earned a nickname. “Ozempic babies” is now shorthand for unexpected pregnancies among people taking semaglutide and related drugs, and it shows up constantly in online forums and clinic waiting rooms.

The phenomenon is real. The explanation is less dramatic than the headlines, and the safety picture is more nuanced than either the alarmists or the enthusiasts suggest. Here is what is actually known as of September 2026.

What exactly is an “Ozempic baby”?

It is not a medical term. It is a nickname for a pregnancy that happens, often unexpectedly, in someone taking a GLP-1 receptor agonist [1].

The name is also misleading in one important way: the effect is not specific to Ozempic. Clinicians report the same pattern with Wegovy, Rybelsus, Mounjaro, Zepbound, Trulicity and Saxenda [1][2]. Ozempic simply had the most name recognition when people started talking about it.

None of these drugs is approved for fertility. None has ever been tested as a fertility treatment.

Why does this happen?

The mechanism most clinicians point to is indirect and reasonably well understood.

Excess body weight and insulin resistance disrupt the hormonal signaling that drives ovulation. In polycystic ovary syndrome, that disruption is a defining feature. In obesity-related anovulation, the same pathways are involved. When weight comes down and insulin sensitivity improves, that signaling often normalizes and ovulation resumes.

This is not new. It is the reason weight loss has been standard preconception advice for decades. What changed is that semaglutide and similar drugs produce that weight loss far more reliably than diet and exercise alone.

Sharrón Manuel, a board-certified obstetrician-gynecologist and reproductive endocrinology specialist, attributes the “Ozempic baby boom” to GLP-1 drugs improving metabolic health and supporting weight loss, thereby helping restore ovulation [2].

There is a second, less obvious contributor: surprise. People who have gone years with irregular or absent periods often stop using contraception, reasonably concluding they do not need it. When ovulation returns quietly, there is no signal that anything has changed until a pregnancy test.

How common is it really?

Nobody knows, and that is worth stating clearly.

Cleveland Clinic put it directly: these medications are relatively new, researchers have not quantified their exact effect on fertility, and there is no reliable figure for what percentage of women taking them become pregnant in a given timeframe [1]. Other clinical reviews say the same thing: plenty of anecdotal reports, no formal data [3].

So treat any specific number you see as an estimate at best. What is defensible is the direction: pregnancies are happening in people who did not expect them, and the biological explanation is straightforward.

Does semaglutide interfere with birth control pills?

This is the question with the most confusion attached, so here is the careful answer.

For semaglutide: pharmacokinetic studies found that semaglutide did not reduce oral contraceptive concentrations in the blood or significantly delay their absorption [4]. Reviews summarizing the class reach the same conclusion for semaglutide and for exenatide, liraglutide and dulaglutide: if you are using one of these with a combined birth control pill, contraceptive protection should still work [5].

For tirzepatide, the answer differs. Tirzepatide labeling addresses oral contraceptive absorption and advises an alternative or additional contraceptive method around the time of dose changes. Do not carry the semaglutide conclusion over to tirzepatide.

For everyone: if you are vomiting repeatedly or have severe diarrhea, whatever the cause, pill absorption can be affected. Gastrointestinal side effects are common when starting or increasing a GLP-1 dose. That is a practical reason to talk to a healthcare provider about backup contraception during titration if you are relying on the pill.

The most useful framing: semaglutide probably is not breaking your birth control. It may well be restoring your fertility. Those are different problems with the same outcome.

What does the label say about pregnancy?

Semaglutide is not approved for use during pregnancy. Because the drug clears slowly from the body, the prescribing information directs stopping at least 2 months before a planned pregnancy [6].

That two-month window is a planning conversation, not something to spring on a provider after a positive test. If you are thinking about trying to conceive in the next year and you are on any GLP-1 drug, that is worth raising at your next appointment.

The underlying concern comes from animal studies. In those studies, GLP-1 receptor agonist exposure was associated with embryofetal mortality, structural abnormalities and growth disturbances including delayed bone formation [7]. Animal findings do not translate perfectly to humans, but they are the reason for caution.

What happens if you get pregnant while taking it?

First: contact your healthcare provider promptly. Do not make changes on your own and do not panic based on internet reading.

Second, the human data as of 2026 are more reassuring than the animal studies would suggest, though they remain limited.

Two meta-analyses published in 2026 evaluated tens of thousands of GLP-1-exposed pregnancies and found no significant increase in major congenital malformations or several other adverse birth outcomes [8]. One reported a relative risk of 1.02 for major congenital malformations, which is essentially no difference from comparison pregnancies [9].

A Danish nationwide cohort study using health registry data from October 2009 through December 2023 examined obstetric outcomes after periconceptional GLP-1 exposure [10]. In a set of first-trimester semaglutide exposures, risks of major malformations, preterm birth, large-for-gestational-age babies, neonatal low blood sugar and jaundice were similar to those in insulin-exposed pregnancies, though the estimates were imprecise because the numbers were small [11].

A 2025 systematic review of semaglutide exposure specifically found a spontaneous abortion rate of 23 percent in one included study, comparable to rates in diabetes and obesity comparison groups, and a congenital malformation prevalence of 8.3 percent in another, with no significant increase compared with insulin [12].

The consistent caveat across all of these: exposed pregnancies are still relatively few, rare outcomes cannot be ruled out, and the comparison groups are people with diabetes or obesity, who have elevated baseline risks of their own.

Summary: nothing in the human data so far has raised an alarm, and nothing in it is strong enough to call semaglutide safe in pregnancy.

What about breastfeeding?

The data here are thinner still. General guidance is to avoid GLP-1 drugs while breastfeeding unless the benefits clearly outweigh the risks [3].

That is a judgment call, and it belongs with a healthcare provider who knows your situation, not with a general-audience article.

Do GLP-1 drugs affect male fertility?

This is the part of the story that gets the least attention and has the newest evidence.

The early signal is that GLP-1 drugs do not appear to harm male fertility and may improve some measures in men with obesity.

A 2025 randomized trial enrolled 25 men with obesity, type 2 diabetes and functional hypogonadism. After 24 weeks of once-weekly semaglutide 1 mg, the share of sperm with normal morphology rose from 2 percent to 4 percent (P = .012) [13].

At ENDO 2026, the Endocrine Society’s annual meeting, researchers presented reviews reporting that after 24 weeks of GLP-1 treatment, men aged 18 to 65 with obesity showed improvements in testosterone and sperm measures. A 24-week semaglutide study specifically showed improvements in sperm shape and cholesterol while keeping testosterone and other hormone levels stable [14].

A systematic review across liraglutide, semaglutide, dulaglutide and exenatide found GLP-1 therapy was associated with significant increases in total testosterone, most pronounced in men with obesity and metabolic dysfunction. Liraglutide was linked to changes in luteinizing hormone, follicle-stimulating hormone and sex hormone-binding globulin, while semaglutide showed stability in gonadotropin levels [15].

Read these numbers carefully. Twenty-five men is not a large trial, and a change from 2 percent to 4 percent normal morphology is a small absolute shift even if it is statistically significant. Researchers frame this as evidence of no harm plus a possible benefit, not as a fertility treatment. Some commentators have raised the question of whether these findings should change how testosterone replacement is used in men with obesity, but that is a discussion, not a guideline.

Practical takeaways

If you do not want to become pregnant: do not assume previous irregular cycles still protect you. Talk to a healthcare provider about contraception before or soon after starting a GLP-1 drug, particularly if you have PCOS or have had anovulatory cycles.

If you do want to become pregnant: raise it early. The label’s two-month stopping window needs planning, and your provider may have views about how to manage weight and metabolic health in the interim.

If you are already pregnant on a GLP-1 drug: contact your healthcare provider promptly. The available human data have not shown a clear increase in birth defects, but the drug is not recommended in pregnancy and the decision about what to do next is a clinical one.

If you are a man taking a GLP-1 drug and worried about fertility: the early evidence does not suggest harm. If you are actively trying to conceive and have concerns, a fertility evaluation gives you real information rather than extrapolation from a 25-person trial.

For everyone: nothing in this article is a reason to start or stop a medication. It is a reason to bring the topic up.

Sources

1. ‘Ozempic Babies’: How GLP-1 Agonists Affect Fertility — Cleveland Clinic, March 10, 2025
2. The Ozempic Baby Boom: How Do GLP-1s Affect Fertility? — Endocrinology Advisor
3. Ozempic Babies? What Research Says About Semaglutide and Fertility — GoodRx
4. Is there really an Ozempic baby boom? The unexpected ways GLP-1s could influence fertility — National Geographic, November 4, 2025
5. How GLP-1 Medications Like Ozempic Might Affect Your Birth Control — Clue
6. Wegovy (semaglutide) US prescribing information — Novo Nordisk
7. Pregnancy Outcomes After Semaglutide Exposure — 2025
8. GLP-1 exposure in pregnancy does not clearly raise major birth defect risk — News-Medical, July 10, 2026
9. Periconceptional use of GLP-1 receptor agonists and the risk of major congenital malformations: a systematic review and meta-analysis — Endocrine Connections, 2026
10. Periconceptional GLP-1 receptor agonist exposure and obstetric outcomes: a Danish nationwide cohort study — 2026
11. Unintentional periconceptional exposure to GLP-1 receptor agonists and adverse pregnancy outcomes: a nationwide cohort study in Taiwan — 2026
12. Impact of semaglutide exposure on fetal and neonatal outcomes in pregnant women: a systematic review — 2025
13. Impact of GLP-1 Receptor Agonists on Male Fertility: Emerging Evidence and Future Directions — Urology, September 2025
14. Clinical trials suggest GLP-1s may improve fertility in men with obesity — Endocrine Society, June 13, 2026
15. How GLP-1 drug semaglutide may play a role in reproductive health — Medical News Today, June 18, 2026