Writen by Megan Cote, NP – Women’s Health, Hormone & Metabolic Medicine Specialist
If you’ve been on social media at all this year, you’ve probably come across the term “Ozempic babies.” These are the stories of women who became pregnant while taking GLP-1 medications like Ozempic®, Wegovy® (semaglutide), or Zepbound™ (tirzepatide). GLP-1s are widely used today for weight loss, metabolic health, PCOS management, and hormone support, and this has led both clinicians and patients to wonder what these medications actually do to fertility.
Here’s the truth: GLP-1s are not fertility drugs, and they should not be used during pregnancy or while actively trying to conceive. However, they can indirectly improve ovulation for some women, especially those with PCOS, insulin resistance, irregular cycles, or metabolic dysfunction.
How GLP-1s Improve Cycle & Hormone Health
Many women with irregular periods or long cycles also struggle with insulin resistance. High insulin causes the ovaries to make extra androgens (like testosterone), which disrupts follicle development and can stop ovulation altogether, a key driver of PCOS. GLP-1s lower insulin levels. When insulin improves, androgen levels typically fall, allowing follicles to mature again and cycles to become more predictable.
They also reduce inflammation and oxidative stress, which most women don’t realize directly affects egg quality. Chronic inflammation stresses the follicles and weakens the cells that support egg development. Lowering inflammation creates a healthier environment for ovarian function.
They help stabilize blood sugar and cortisol levels. GLP-1s slow digestion and reduce glucose spikes, helping to prevent cortisol surges. High cortisol can interfere with ovulation, so steadier levels support cycle regularity.
They support weight loss when needed. Research shows that even a modest 5–10% weight reduction can restore ovulation for many women with PCOS or insulin resistance. By lowering appetite, cravings, and visceral fat, GLP-1s improve metabolic health and support hormonal balance, especially when combined with a protein-rich diet and strength training.
So do GLP-1s help fertility?
Indirectly, yes, especially for women whose cycle issues stem from metabolic dysfunction or PCOS. But long-term data in women without these conditions is still limited. These medications are best used to help prepare your body for pregnancy, with the goal of stopping the medication prior to trying to become pregnant.
What about the “Ozempic baby” phenomenon?
Two main causes explain unexpected pregnancies:
- Ovulation resumes once insulin resistance, inflammation, and androgen excess improve.
- Tirzepatide may reduce the absorption of oral contraceptives due to delayed gastric emptying.
While reported pregnancies have generally been reassuring, research remains limited.
Manufacturer guidance:
- Semaglutide: stop ≥ 2 months before conception
- Tirzepatide: stop ≥ 1 month before conception
Final thoughts
GLP-1 medications are not fertility drugs, but they are powerful tools for improving metabolic and hormonal health. When insulin stabilizes, inflammation decreases, cortisol steadies, and overall metabolic health improve, ovulation often becomes far more predictable. With the right timing and clinical guidance, GLP-1s can help prepare the body for a healthier pregnancy in the future. Because pregnancy safety data is still limited, shared decision-making and appropriate timing remain essential.
