GLP-1s and Fertility: A Primer on What We Know (and What We Don’t)

Since the first GLP-1 was approved for weight loss in 2014, these medications have yielded significant weight loss results for women across South Carolina and the U.S.

Despite their widespread availability, little remains known about how these medications impact a woman’s fertility, pregnancies and developing babies.

“These are common concerns I hear from patients about GLP-1s who are also thinking about starting a family,” says Dr. Tempest Allen, a board-certified physician who sees patients at Beaufort Memorial Obstetrics & Gynecology Specialists. “They want to continue benefiting from the medications but are concerned about long-term impacts. The good news is that with some planning, you and your provider can navigate this together.”

Here, we break down what’s currently known about GLP-1 medications and fertility and review important considerations to discuss with your provider if pregnancy is in your future.

The Link Between Fertility and Weight

To understand how GLP-1s influence fertility, it helps to understand how weight affects your ability to get pregnant. 

To get pregnant, you first need to ovulate. That’s when your ovaries release an egg that travels to your uterus to become fertilized. However, excess weight can interfere with that process. Fat cells produce estrogen, and too much estrogen can prevent you from ovulating. Your body reacts to extra estrogen produced by fat cells similar to how it reacts to hormonal birth control, reports the Office on Women’s Health.

Every woman is different, but studies show that for women who are overweight or obese, losing weight can increase their chances of becoming pregnant.  

GLP-1s and PMOS: Another Avenue for Improved Fertility

Polycystic metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS), is also closely linked to pregnancy challenges. PMOS is one of the most common causes of infertility, caused by a hormone imbalance that may prevent eggs from developing normally or ovaries from releasing eggs during ovulation.

PMOS can be connected to obesity, and losing weight is an effective way for women with PMOS to improve their fertility.

Recent research from 2025 suggests that GLP-1s show “promising potential” specifically for addressing the metabolic dysfunction associated with PMOS. The medications could potentially improve menstrual cycle regularity, but the researchers noted that more studies are needed on larger sample sizes to confirm their benefits.

Read More: Getting GLP-1 the Natural Way: How to Do It and How It Helps

GLP-1s and Birth Control: What You Need to Know

If you’re taking a GLP-1 and not trying to conceive, have a conversation with your healthcare provider about your birth control method and whether it’s still the right fit for you.

One particular GLP-1, tirzepatide, could reduce the effectiveness of hormone-based birth control methods, like the pill, patch and ring. Your provider may recommend using a different method, at least for a few weeks after you start the medication or change doses.

Additional research suggests that tirzepatide can affect how birth control and other medications are absorbed, while other types of GLP-1s (semaglutide, liraglutide and dulaglutide) do not.

Ultimately, your healthcare provider knows you and your health and can help you navigate your options if you want to use birth control and take GLP-1s.

When to Stop GLP-1s Before Pregnancy

Semaglutide and liraglutide should not be used while pregnant. If you take semaglutide, it’s advised to stop for two months before becoming pregnant. It can be difficult to follow that guideline, since not all pregnancies are deliberately planned, and some evidence suggests that exposure early during pregnancy may not be harmful.

Aside from knowledge gaps regarding GLP-1 use during pregnancy, providers generally recommend against weight loss during pregnancy. Doing so may pose safety risks to you and your baby.

Read More: Weight-Loss Drugs: Separating Fact From Fiction

The Bottom Line: Talk With Your Healthcare Provider 

Whether your GLP-1 was originally prescribed for Type 2 diabetes or for weight management, any decision about starting, stopping or continuing the medication while planning for (or trying to prevent) a pregnancy should be shared between you and your women’s health provider. Research on GLP-1s and pregnancy is still evolving, and there currently isn’t enough evidence to say definitively how safe these medications are for women who are pregnant or trying to conceive or their developing babies. 

Keep these facts in mind as you weigh your decisions:

1. GLP-1 medications aren’t fertility treatments, but they can help you lose weight or address PMOS, which may improve your chances of getting pregnant.  
2. Certain GLP-1s may interfere with birth control effectiveness.
3. Current guidelines state that these medications shouldn’t be used during pregnancy. 

Request an appointment with a Beaufort Memorial Women's Health provider to talk more about family planning, improving your fertility and getting a jump on improving your overall health.