Semaglutide is a Glucagon-like Peptide-1 (GLP-1) receptor agonist, primarily approved for managing Type 2 Diabetes and chronic weight management. The drug mimics the naturally occurring GLP-1 hormone, regulating appetite and insulin secretion. As its use has become widespread among individuals of reproductive age, concerns have emerged regarding its potential to negatively affect the ability to conceive. This article examines the current scientific evidence on whether semaglutide directly causes infertility in men or women.
Current Research on Direct Infertility Causation
The most direct answer is that there is currently no human evidence suggesting semaglutide causes infertility. Clinical trials and post-marketing surveillance have not identified a mechanism by which this GLP-1 agonist would inherently prevent conception, nor has it been found to directly cause toxicity to human eggs, sperm, or reproductive organs.
Concerns often originate from early animal studies designed to test the limits of drug exposure. Studies in pregnant animals, such as rats and rabbits, showed fetal harm, but this occurred at very high doses toxic to the mother. The observed effects included reduced fetal growth and structural abnormalities, not a loss of the ability to conceive.
Animal findings do not always translate directly to human physiology. For example, one animal study specifically looking at male reproductive function found no changes in fertility when male rats were exposed to human-equivalent blood levels of the drug. Therefore, the current scientific consensus is that semaglutide does not appear to possess a direct infertility-causing property in either sex.
How Semaglutide Indirectly Affects Reproductive Health
The primary impact of semaglutide on reproductive health is indirect and often beneficial, mediated through metabolic improvements. Excess body weight is a significant barrier to conception for many individuals, as it disrupts the hormonal balance required for normal reproductive function. Semaglutide facilitates substantial weight loss, which subsequently improves fertility parameters.
This effect is pronounced in women with Polycystic Ovary Syndrome (PCOS), a common endocrine disorder causing anovulatory infertility. PCOS is associated with insulin resistance and elevated androgen levels, which interfere with normal ovulation. Weight loss achieved with semaglutide can reduce insulin resistance and lower androgen levels, helping to normalize the menstrual cycle.
The return of regular menstrual cycles and spontaneous ovulation following weight loss has led to anecdotal reports of “Ozempic babies”—unexpected pregnancies in individuals who previously struggled to conceive. Semaglutide’s effect on reproductive function is largely a downstream consequence of improved metabolic health, making it a tool that can increase the likelihood of conception for those whose infertility is related to weight or metabolic dysfunction.
Safety Protocols for Planned and Unplanned Pregnancy
Although semaglutide does not cause infertility, its use is strongly discouraged during pregnancy due to potential risks to the developing fetus. Animal studies demonstrated that exposure during gestation can be associated with fetal growth restriction and specific structural abnormalities. This preclinical evidence mandates a conservative approach to protect the health of the unborn child, despite limited human data.
Women planning to conceive must discontinue semaglutide well in advance of attempting pregnancy. Manufacturers recommend a washout period of at least two months (eight weeks) before conception. This timeframe accounts for the drug’s long half-life, ensuring the medication is fully cleared from the body before the earliest stages of fetal development.
Women of childbearing potential should use effective contraception throughout treatment. Semaglutide slows gastric emptying, which can reduce the absorption and effectiveness of oral contraceptive pills. If an unplanned pregnancy occurs while taking the medication, the drug must be stopped immediately, and the patient should contact their healthcare provider to report the exposure and receive appropriate monitoring.