As weight loss improves fertility, an unplanned design can occur. It is important to inform women under incretinomimetic that they can become more fertile thanks to weight loss, and therefore fall pregnant. It is essential to provide them with good contraception. Furthermore, in the absence of studies, leading a pregnancy under analogues of GLP-1 is not recommended. Any desire for a child must lead to stop them at least 2 months before any design attempt.
For Dre Laubner, we can expect an increase in the number of women starting pregnancy (planned or not) while they are treated by incretinomimetics.
Negative effects of obesity and type 2 diabetes on reproductive health
The press reported for two years of (supposedly) “baby ozempic”: women who do not manage to start a pregnancy for several years and who resort to the semaglutide to lose weight and finally fall pregnant. “At the start, these were only isolated cases, but reports are multiplying, in particular via social networks,” explains the Dre Katharina LaubnerDeputy Director of the Endocrinology and Diabetology Service of the Friborg University Hospital Center.
Katharina Laubner explained the context surrounding the birth of these “Ozempic babies” during an online press conference jointly organized by the German endocrinology company (DGE) and the German diabetes company (DDG) [1]. “We have long known that obesity and type 2 diabetes have negative effects on the reproductive health of women and men,” she explains. These two diseases are often associated with a desire for an unrealized child. “One in five women in this situation presents a BMI greater than 25.”
The specialist also recalls that overweight, obesity and type 2 diabetes play an important role in the development of polycystic ovary syndrome (SOPK) through increased resistance to insulin, and that they are associated with an increased risk of cycle disorders, anovulation and fertility reduction.
Weight loss of 5 to 10 % improves insulin sensitivity
“A moderate weight reduction (5 to 10 %) is often enough to improve insulin sensitivity,” also recalls Katharina Laubner. It can also lead to normalization of ovulation and regular cycles. A rapid improvement in amenorrhea and therefore of fertility is also observed in obese women after bariatric surgery.
Like GLP-1/GIP co-agonists, GLP-1 receptors (GLP-1RA) lower blood sugar levels by increasing insulin secretion, promote the feeling of satiety, inhibit appetite and slow down gastric emptying. Many studies show that it follows a reduction in energy intake and clinically significant weight loss.
GLP-1RA and GLP-1/GIP co-agonists are increasingly used in the treatment of type 2 diabetes. The semaglutide and shooting are also authorized and can be prescribed in the treatment of obesity as well as, to a certain extent, overweight. These substances are therefore increasingly used by young obese women, with or without type 2 diabetes, and of childbearing age. As weight loss improves fertility, an unplanned design can occur under incretinomimetic. Furthermore, their typical adverse effects possible such as vomiting, diarrhea and slowdown in gastric emptying compromise the effectiveness of hormonal contraception.
For Katharina Laubner, we can expect an increase in the number of women starting pregnancy (planned or not) while they are treated by this class of substances.
On the theoretical level, the high molecular mass of incretinomimetics pleads against a significant placental passage at the start of pregnancy.
GLP-1’s analogues are probably not directly teratogenic
So far, few studies have been carried out on taking an incretinomimetic during pregnancy. In 2024, two articles were published on this subject, with the analysis of data from national registers (Nordic countries, United States, Israel) or from consulting centers of the European Network of Information Services in Teratology (Germany, Israel, Italy, Switzerland and England). The results of these analyzes suggest that GLP-1ra are probably not teratogenic in themselves: no increased risk of malformations, spontaneous false layers or intrauterine death has been observed. Confirmation by other studies remains necessary, however, because the available data is currently limited. That said, on the theoretical level, the high molecular mass of incretinomimetics pleads against a significant placental passage at the start of pregnancy.
The data on exposure during the 2nd and 3rd quarter are almost nonexistent. It therefore remains to be seen whether (and, if necessary, to what extent) incretinomimetics influence risks such as prematurity, growth disorders in children (high size for gestational age – Teag:> percentile 90; low size for gestational age: