GLP-1s and Pregnancy: Fertility, Contraception, and Discontinuation

GLP-1 receptor agonists are used to treat type 2 diabetes and help with weight management. Common brand names include Wegovy (semaglutide, injection or tablet), Zepbound (tirzepatide), Trulicity (dulaglutide), and Saxenda (liraglutide). These medications work by mimicking a natural hormone in your body that helps control blood sugar, appetite, and weight. If pregnancy is anywhere in your plans, here is what you need to know.

Can I Take GLP-1 Medications During Pregnancy?

No. GLP-1 medications are not approved for use during pregnancy. Animal studies have raised concerns about possible effects on a developing baby, including reduced growth and bone development.[1] While recent large human studies have been somewhat reassuring and have not found a clear increase in birth defects, there is still not enough evidence to say these medications are safe during pregnancy.[4][5] Your doctor will recommend stopping these medications before you try to conceive.[3]

When Should I Stop My GLP-1 Before Trying to Get Pregnant?

Because these medications stay in your body for different lengths of time, you need to stop them well before conception:[3]

• Semaglutide (Wegovy): stop at least 2 months before trying to conceive. This medication has a long half-life of about 7 days, meaning it takes several weeks to fully leave your body.[9]
• Tirzepatide (Zepbound): stop at least 1 month before trying to conceive. Its half-life is about 5 days.[3][6]
• Liraglutide (Saxenda): has a much shorter half-life (about 13 hours), so it clears from your body faster. Your doctor will advise you on timing.[6]
• Dulaglutide (Trulicity): has a half-life of about 5 days. Your doctor will advise you on timing.[6]

In practice, your doctor may recommend stopping several months before conception — not just for the medication to leave your body, but also to allow time to:[3]

• Switch to pregnancy-safe medications (such as insulin, if needed for diabetes)
• Make sure your blood sugar is well controlled before pregnancy
• Reach a stable weight and nutritional status

Why Is Planning Ahead So Important?

Stopping a GLP-1 medication can lead to:[3]

• Weight regain — some weight may return after stopping the medication.
• Rising blood sugar — if you have diabetes, your blood sugar may increase and will need to be managed with other medications.
• Excess weight gain during pregnancy — studies have shown that women who stop GLP-1 medications before or early in pregnancy may gain more weight during pregnancy than expected.

Good blood sugar control before and during early pregnancy is one of the most important things you can do for your baby's health. That is why your care team will want to make sure your blood sugar is stable on pregnancy-safe medications before you start trying to conceive.[3]

What About Birth Control While Taking a GLP-1 Medication?

Using reliable birth control while on a GLP-1 medication is strongly recommended, even if you have had difficulty getting pregnant in the past.[1][2] Here is why:

• These medications can improve fertility. Weight loss and improved insulin sensitivity from GLP-1 medications can restore ovulation, especially in women with polycystic ovary syndrome (PCOS). This means you could become pregnant unexpectedly, even if you were previously told you might have trouble conceiving.[3]
• GLP-1 medications may affect how well birth control pills work. These medications slow stomach emptying, which can reduce how well your body absorbs oral birth control pills. This effect is strongest when you first start the medication or increase your dose.[8]
• If you take tirzepatide (Zepbound): use a backup method of birth control (such as condoms) for at least 4 weeks after starting the medication or after each dose increase, until you have been on a stable dose for at least 4 weeks.[8]
• If you take semaglutide, liraglutide, or dulaglutide: the effect on oral birth control appears to be smaller, but talk to your doctor about whether a backup method is needed.[8]
• Non-oral birth control options — such as an IUD, implant, injection, or patch — are not affected by GLP-1 medications and may be a more reliable choice while you are on these medications.

What If I Find Out I'm Pregnant While Taking a GLP-1 Medication?

• Stop the medication right away and contact your doctor as soon as possible.[1]
• Do not panic. Recent large studies of women who were accidentally exposed to GLP-1 medications around the time of conception have not found a clear increase in major birth defects or pregnancy complications. While this is reassuring, it does not mean the medications are proven safe — it means the risk, if any, appears to be small.[4][5][7]
• Your doctor will monitor your pregnancy closely and may refer you to a maternal-fetal medicine specialist.

Key Takeaways

1. Stop GLP-1 medications before trying to get pregnant — at least 2 months for semaglutide, at least 1 month for tirzepatide, and as directed by your doctor for other medications.[3]
2. Plan ahead: you will need time to switch to pregnancy-safe medications and stabilize your blood sugar and weight.[3]
3. Use reliable birth control while on a GLP-1 medication. These medications can restore fertility, and they may reduce the effectiveness of birth control pills.[8]
4. If you become pregnant unexpectedly, stop the medication and call your doctor — but know that accidental early exposure has not been clearly linked to harm.[4][7]
5. Talk to your doctor before making any changes to your medications.