This sheet is about exposure to semaglutide in pregnancy and while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.
What is semaglutide?
Semaglutide is a medication that has been used to improve blood sugar control in adults with type 2 diabetes. It is available as an injection (given by shot) or by tablet (taken by mouth). The injectable form is sold under the brand name Ozempic®. The tablet form is sold under the brand name Rybelsus®.
Semaglutide can also be used as an injection to treat obesity. A brand name for semaglutide used for weight management is Wegovy®. Weight loss is not recommended during pregnancy. Talk with your healthcare providers about using Wegovy® and what treatment is best for you.
It is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.
Obesity and high/uncontrolled blood sugar can make it harder to get pregnant, and increase the chance of miscarriage, birth defects, or other pregnancy complications. MotherToBaby has fact sheets on diabetes https://mothertobaby.org/fact-sheets/type-1-and-type-2-diabetes/ and obesity https://mothertobaby.org/fact-sheets/obesity-pregnancy/.
I am taking semaglutide, but I would like to stop taking it before getting pregnant. How long does the drug stay in my body?
People eliminate medication at different rates. In healthy adults, it can take up to 6 weeks, on average, for most of the semaglutide to be gone from the body. The product labels for Ozempic®, Wegovy®, and Rybelsus® recommend people who are planning a pregnancy to stop this medication 2 months before a pregnancy.
I take semaglutide. Can it make it harder for me to get pregnant?
It is not known if semaglutide can make it harder to get pregnant.
Does taking semaglutide increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done in humans to see if semaglutide increases the chance of miscarriage. Animal studies have reported a higher chance for miscarriage. It is unclear if this finding was due to the medication or from weight loss. As there can be many causes of miscarriage, it is hard to know if the medication, the medical condition, or other factors are the cause of a miscarriage.
Does taking semaglutide increase the chance of birth defects?*
Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Research studies have not been done to see if semaglutide increases the chance of birth defects in humans. There has been one report of a person who got pregnant while taking semaglutide. The person stayed on semaglutide for the first 3-4 weeks of pregnancy and gave birth to a child without reported birth defects.
In animal studies done by the manufacturer, an increased chance for some birth defects was seen. However, this happened when the amount of semaglutide given was toxic to the mother animal. Also, it is unclear if the reported birth defects were due to the medication or other factors in the study (such as weight loss).
Because high/uncontrolled blood sugar can increase the chance of birth defects and other pregnancy complications, it is important to weigh the benefit of using semaglutide against the risks of the untreated condition. Talk with your healthcare provider about the best way to treat your condition in pregnancy.
Does taking semaglutide in pregnancy increase the chance of other pregnancy-related problems?
Human studies have not been done to see if semaglutide increases the chance for pregnancy-related problems such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). Animal studies reported offspring that were smaller than usual when the parent animal was exposed to doses higher than the dose used in humans. It is unclear if this was due to the medication, weight loss, or that the study animals were healthy and did not need to take semaglutide to stay healthy.
Does taking semaglutide in pregnancy affect future behavior or learning for the child?
Studies have not been done to see if semaglutide can cause behavior or learning issues for the child.
Breastfeeding while taking semaglutide:
There is no available information about semaglutide and human breastmilk. Based on an animal study, semaglutide is expected to get into breastmilk in small amounts. Your healthcare providers can talk with you about using semaglutide and what treatment is best for you. Be sure to talk to your healthcare provider about all your breastfeeding questions.
The product label for Rybelsus® recommends that people who are breastfeeding not use the tablet form of the medication if they are breastfeeding an infant. This is because there is a theoretical concern that using the tablet form of this medication could lead to higher levels in a nursing infant. However, the benefit of using semaglutide may outweigh possible risks. Your healthcare provider can talk with you about using semaglutide in these other forms (tablet versus injectable) and what treatment is best for you.
If a male takes semaglutide, could it affect fertility or increase the chance of birth defects?
Studies have not been done in humans to see if semaglutide could affect male fertility (ability to get partner pregnant) or increase the chance of birth defects above the background risk. There were no changes in male fertility reported in one animal study using the dose of semaglutide that would be used in humans. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
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OTIS/MotherToBaby encourages inclusive and person-centered language. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Use of the term mother or maternal refers to a person who is pregnant. Use of the term father or paternal refers to a person who contributes sperm.
