A certain school of thought holds that actual legitimate science exists only in a lab with a lot of fancy equipment, and that “anecdotal evidence” is trash, unworthy of even a glance. But there are times when anecdotal is the only type of evidence on offer. This is because of the ethics, or rather the lack of ethics, that would be involved in knowingly testing unproven drugs on pregnant women.
As an example of the type of problem that can arise, polycystic ovary syndrome (PCOS) makes a woman particularly vulnerable to unexpected pregnancy when inner conditions change, like when taking weight-loss drugs — which indirectly attests to the usefulness of social media. A troubling connection between drugs, pregnancy or lack thereof, and PCOS, is just the kind of detail that can be usefully shared in an online forum.
Social media to the rescue
Utilizing available platforms, women have taken it upon themselves to communicate with each other, sharing good news and bad news, fears, regrets, and fluctuating emotions. For instance, after two C-sections, someone had been assured that she was now infertile, except she wasn’t.
After being on Ozempic for four months, this woman turned up pregnant — not a circumstance to be taken lightly. Even a healthy unplanned child can seriously affect a family’s well-being, let alone an unexpected baby with a birth defect — the possibility of which has not yet been ruled out.
For the foreseeable future, the majority of available data might continue to be of the anecdotal variety. If there is one thing the World Wide Web excels at, that function is providing a way for all sorts of like-minded people to connect with each other. Women seem eager to share their stories and opinions with others who have been through the experience of GLP-1 plus pregnancy, or who might be likely to accidentally or purposely embark on it.
For instance, in March of this year, a Healthline article reported that TikTok was abuzz with reports of surprise pregnancies associated with Ozempic, to the point where such conceptions are called “Ozempic babies” regardless of which pharmaceutical product or brand is in use.
There are reports from women who tried for years to start a family, then lost (even just a relatively small amount of) weight due to a GLP-1 preparation, and had what some call miracle babies. As for what problems might come along with such a “miracle,” that story will take many years to unfold.
Of course, part of this trend must be attributed to weight loss alone, because it was happening even before these particular GLP-1 drugs hit the market. Texas endocrinologist Dr. Neha Lalani notes that weight loss alone can lead to improvement in the patient’s metabolic health to the point where ovarian function might be spontaneously restored:
[I]ncreased fertility and surprise pregnancy has been well-reported in previously infertile patients, even with modest weight loss (approximately 5%) with lifestyle modification as well as other weight loss medications.
For The Washington Post, journalist Amy Klein looked into the anecdotal reports which have appeared on TikTok, Reddit, and in a Facebook group called “I got pregnant on Ozempic” that boasts over 500 members. A typical history is offered by a woman who had been taking semaglutide for diabetes and incidentally lost around 80 pounds. She initially thought her nausea was drug-induced, but it was morning sickness.
Another, because of polycystic ovary syndrome, had been unable to conceive for 10 years. In her words, “My little Mounjaro baby is almost 6 months old.” PCOS is often found concurrent with obesity, and the profession has already learned that losing as little as 5% of body weight can improve the odds of successful conception.
PCOS, with its insulin resistance, weight gain and infertility, is a risk factor that can portend the development of type 2 diabetes, so GLP-1 receptor agonists are often prescribed. For Pharmacy Times, doctoral candidate Alejandra C. Nogueira explained in more depth:
[A] recent metanalysis highlighted that even significant weight loss did not improve clinical pregnancy or live birth rates. Therefore, increased unplanned pregnancies with concurrent semaglutide use in women who are not receiving fertility treatments could be indirectly tied to the drug’s ability to promote weight loss rather than a direct effect on fertility.
It has been understandably feared that the GLP-1 drugs might harm fetuses. A recent study of 168 women who, unsuspecting of pregnancy, took such drugs in their first trimester, found pregnancy outcomes no worse than those of women with diabetes or obesity. Nevertheless, many authorities point out that a developing fetus needs sufficient nutrition, so anything that impairs an expectant mother’s appetite is probably not a good idea.
Ozempic and Wegovy, prescribed for type 2 diabetes and obesity respectively, are both made by Novo Nordisk. Whenever a member of the press asks, company representatives specify that any drug trials have specifically excluded women who were either pregnant or trying to be, so “not enough human data is available to establish whether semaglutide is associated with major birth defects, miscarriage, or adverse outcomes for either the mother or the baby.”
The company does not recommend its products to be used during breastfeeding, either. In lab rats, semaglutide shows up in the mama rats’ milk, and the implications of this regarding humans are not known. And now that these drugs are accepted for teens and even children, there is no way of knowing what effect this will have on their future ability to bear healthy babies.
Importantly, the consensus seems to be that if there is any possibility of pregnancy when a woman is using these medications, contraception not connected with the gastrointestinal tract should definitely be chosen. Plenty of alternatives exist, including good old-fashioned condoms.
Your responses and feedback are welcome!
Source: “’Ozempic Babies’: How Weight Loss Drugs Can Interfere with Birth Control and Boost Fertility,” Healthline.com, 03/26/24
Source: “An Ozempic baby boom? Some GLP-1 users report unexpected pregnancies,” WashingtonPost.com, 04/05/24
Source: “So-Called “Ozempic Babies” Raise Questions About Unintended Effects of GLP-1 Agonists,” PharmacyTimes.com, 10/03/24
Image by Pat Hartman
