Phenomenon "Ozempic-Babies" - Finally a wish baby with the injection pump: justified hope or risk?
Social media trends: The "I got pregnant with Ozempic" Facebook group already has over 900 members shortly after its start, and the number is growing every week. Women share experiences of getting pregnant unexpectedly while undergoing treatment with the weight loss injection.
Affected women and experts have been observing for some time that women using the medication to reduce their weight are disproportionately getting pregnant. Is it due to weight loss? The medication itself? And how should women handle this unexpected effect of the weight loss injection?
In reminder: Ozempic and its sister drug Wegovy contain the active ingredient Semaglutid and are better known as weight loss or anti-obesity injections. In Germany, these medications have been available for about a year. Doctors prescribe them to people with diabetes (Ozempic) or obesity (Wegovy). Among the patients are many young women. And not a few of them desperately want children but cannot become pregnant due to their obesity.
Weight loss injection and pregnancy: Women with PCOS seem to benefit the most
One reason: In women with obesity, there is often a certain hormonal imbalance. Excessive fat tissue produces additional estrogen and testosterone. However, an excessively high level of these messenger substances can prevent ovulation. The quality of the eggs may also be reduced. Semaglutid appears to correct these unfavorable mechanisms.
Preliminary observations show: Women with Polycystic Ovarian Syndrome (PCOS) seem to benefit the most from the shedding pounds.
Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder in women of reproductive age. They have
- irregular menstrual cycles,
- elevated blood levels of male hormones,
- ovaries with many small cysts (polycystic), which do not ripen normally.
Affected women often have trouble getting pregnant. The hormonal imbalance prevents a normal ovulation and is triggered by obesity. They are advised to lose weight, for example, through a healthier lifestyle. Metformin, a diabetes medication, also helps. For women with unfulfilled child desire, there is the possibility of fertility treatment. Recently, the weight loss injection has also been used: It reduces weight, hormonal imbalance improves, ovulation becomes regular, and the likelihood of pregnancy increases.
"Weight loss is the most effective way for overweight women to become pregnant," summarizes Friederike Weschenfelder, senior doctor at the Women's Clinic of the University Hospital Jena, who is familiar with the study situation. Every kilogram lost brings the hormonal balance back into balance and with it ovulation and menstrual cycle.
However, women do not have to become thin to improve their chances of pregnancy. "It's enough if women lose five to ten percent of their weight for the normal ovulation to resume," explains Weschenfelder. However, this moderate weight loss is the least likely to be achieved through a diet change alone. The pounds cling stubbornly.
Not all women are happy about increasing fertility. In online forums, women report getting pregnant despite using the pill due to GLP-1-medicines like Semaglutid, which slow down gastric emptying – an effect desired for weight loss. However, medicines like the pill are absorbed more slowly into the bloodstream due to this effect, and they work based on blood levels. If there is not enough of it in the body, they cannot effectively prevent pregnancy. The manufacturer already warned about this side effect earlier, but vaguely, by adding a note that reliable contraception should be used during treatment.
"We must advise women taking Semaglutid carefully regarding contraception," says gynecologist Weschenfelder. Only then can we prevent unwanted pregnancies. "On the one hand, it can happen that the pill does not work as usual. On the other hand, women should be aware that their menstrual cycle normalizes relatively quickly if they lose some weight, and they can get pregnant."
For those who wish to have a child, they can first take the medication in combination with a reliable contraceptive and then stop the medication. According to the manufacturer's recommendation, there should be a two-month gap between the end of therapy and conception to allow the body to fully metabolize the medication.
Missing Data
However, there is still insufficient data on how the medication affects the fetus in the womb. Gynecologist Wolfgang Paulus at the University of Ulm advises women and experts on medications during pregnancy. He warns: "Medications can have fatal effects in the first trimester of pregnancy." [Here you can read the full interview with the gynecologist.]
Studies on whether Semaglutid could harm the fetus are currently insufficient, and they are also difficult to conduct. Medications should not be tested on pregnant women in general. Therefore, experts like Weschenfelder and Paulus rely on reports from women who have taken the medication unknowingly while pregnant. Experimental data can complement these case studies. "We know from animal studies that Semaglutid in the dosage we use in humans has no effects on the embryo," says Paulus. "However, we cannot directly transfer animal data to humans. Even though it causes no damage in animal tests, one would not use a medication on a large scale for pregnant women based on that alone."
Despite justified caution, pregnancy expert Weschenfelder from the University of Jena sees great opportunities for overweight women with a desire for children through the treatment with the weight loss spray. Many complications during pregnancy, such as high blood pressure, diabetes, and an increased cesarean section rate, are a direct result of obesity. If women go into pregnancy leaner and maintain their weight through exercise and proper nutrition during this time, the complication rate can be significantly reduced. Weschenfelder states: "This is the greatest advantage we see in this medication. If women go into pregnancy healthier and leaner, it is the best prerequisite for the healthy development of the child and a complication-free pregnancy."
Following the initial observations, some women using medications like Ozempic and Wegovy for weight loss have reported unexpected pregnancies. This surge in pregnancies among these women could be attributed to the medication itself or the associated weight loss, as hormonal imbalances often prevent ovulation in women with obesity. For women with Polycystic Ovarian Syndrome (PCOS), the weight loss injection has been shown to significantly improve hormonal balance, leading to regular ovulation and an increased likelihood of pregnancy.
