Are weight loss injections indirectly linked to fertility?

An article titled 'Ozempic Babies' in People magazine featured stories of women who unexpectedly conceived while using the weight loss injection, some of whom had struggled with infertility for years and others who were on birth control pills; Has a potent solution to fertility issues been discovered? Yes... and no
In the early 90s, right around the time Dylan and Brenda were becoming an item on Beverly Hills 90210, Pfizer was embarking on a project to develop a drug named "Sildenafil." This drug was intended to combat high blood pressure. However, during clinical trials conducted on a group of men in Britain, an unexpected but thoroughly welcome side effect emerged.
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אישה בהיריון
אישה בהיריון
Pregnancy can occur because of Ozempic?
(Photo: Shutterstock)
These men reported experiencing significant erections while on the drug! Pfizer quickly delved into this "side effect," discovering that the active ingredient in the drug increased blood flow to the penile arteries. Consequently, the drug was repurposed and marketed under the trade name Viagra, providing a solution for men struggling with impotence.
Fast forward to the present day, we find ourselves pondering whether we are on the brink of another scientific miracle. Could the weight loss drugs Ozempic and Wegovy, which have revolutionized the dieting world, also be a boon for women grappling with fertility issues? This theory is stoked by numerous reports from women worldwide who, against all odds, became pregnant after taking these injections.
In an article titled "Ozempic Babies," featured last month in People magazine, various women shared their experiences of becoming pregnant while undergoing treatment with Ozempic injections. Some of these women had spent years in futile fertility treatments and had resigned themselves to the idea of menopause, while others were on birth control at the time.
One woman shared: "Since I needed to undergo a long series of fertility treatments for my last pregnancy, I thought that after turning 40 it would be impossible for me to get pregnant naturally. But here I am, pregnant. It's not what my husband and I planned, but it's definitely a pleasant surprise."
Another woman who had been battling infertility for 14 years revealed that "two months after Ozempic injections and I'm pregnant. To say I'm shocked is an understatement." Interestingly, there were also several accounts from women who were taking birth control during the injections. "I was on birth control pills and this pregnancy was definitely unplanned," one woman admitted. "I have a long history of miscarriages and stillbirths, and because of this, I decided to stop trying to conceive two years ago. During this time, I started with Ozempic, lost 68 lbs., and despite taking the pills I became pregnant."
Social media platform TikTok has recently been inundated with videos of mothers and newly pregnant women jubilantly sharing their "Ozempic babies" stories. American content creator Raven Rechelle wrote on her TikTok account: "Thank you very much to Ozempic, my weight loss journey has become a pregnancy journey for me." Rechelle, 26, who is married and a mother to a nine-year-old son born on Purim night during her final year of high school, has always struggled with excess weight. Her current pregnancy, as she mentioned, was unexpected, and came about as she was using the Ozempic drug during her dieting phase.
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התייעצי עם הרופאה שלך על אמצעי מניעה
התייעצי עם הרופאה שלך על אמצעי מניעה
Consult your doctor
( Picture: Shutterstock)
Is there indeed a magic solution for fertility issues? Should women who aren't overweight but struggle to conceive also start using these injections?
Regrettably, the optimistic narrative might be misleading. According to endocrinologist Dr. Gabriella Lieberman-Segal, the answer is a resounding no. "Personally, I have not come across women in Israel who, while taking Ozempic, unexpectedly became pregnant after suffering from infertility. However, I have certainly heard of such cases," she says. "The reason for these unexpected pregnancies is indirectly related to weight loss."
Meaning? "It's well-known that obesity can lead to fertility problems. I've seen many of my patients who, after unsuccessful attempts at conceiving, managed to do so after losing weight through diet, medication or bariatric surgery," she explains.
"The reason is that women with obesity often suffer from insulin resistance, which can decrease ovulation and even affect the quality of the eggs. Additionally, estrogen is produced in fat tissue. Therefore, the more fat cells in the body, the higher the estrogen level, which can harm the lining of the uterus. It's also been shown that even when performing IVF treatments on women with obesity, the quality of the eggs is lower, and the uterine lining, which is supposed to support the pregnancy, struggles to do so."
Does obesity also impact the ability to sustain a pregnancy? "Indeed it does. These women are likely to experience gestational diabetes, high blood pressure, protein in the urine, and more during pregnancy. The likelihood of the pregnancy surviving to term without complications is significantly reduced. This is why gynecologists advise women with excess weight who wish to conceive to lose weight. I suspect the rise in reports of women becoming pregnant while using Ozempic is linked to the fact that these injections enable significant weight loss in a relatively short time: about 15% of body weight in the first year. Prior to the use of these weight loss injections, such a weight loss could only be achieved in such a short time through bariatric surgeries. However, the proportion of women undergoing bariatric surgery is significantly lower compared to women taking injections."
This raises the question - how did women who were on birth control pills become pregnant while using these injections? "One of the common side effects of Ozempic injections is digestive system issues, such as accelerated bowel emptying, diarrhea, etc. Therefore, the medication can sometimes also impair the absorption of birth control pills, reducing their effectiveness."
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תינוק לאחר לידה
תינוק לאחר לידה
Unexpected fertility?
(Photo: shutterstock)
Ozempic is a medication centered around the active substance semaglutide, which was approved for use in 2019. Dr. Yael Sofer points out that this drug echoes the story of Viagra, but not in the sense of it becoming a fertility drug.
"The drug was initially designed for diabetes treatment," she clarifies. "During clinical trials, it was observed to have a notable impact on weight loss, as it was shown that, in addition to lowering blood sugar levels, the treatment leads to appetite suppression. In 2021, Ozempic was also approved for obesity treatment through injections, and now Wegovy, intended solely for those battling obesity, is anticipated to become available. Both medications contain the same active ingredient, but at different doses. Wegovy has a higher semaglutide dosage, standing at 2.4 mg compared to 1 mg."
Sofer believes that the primary reason for unexpected pregnancies among women who had fertility problems and started using weight loss injections is the weight loss. "Numerous studies have proven a direct link between obesity and fertility issues, and between obesity and polycystic ovary syndrome," she says. "A significant aspect of this syndrome is the overproduction of male sex hormones (androgens), which interferes with the ovulation cycle. Also, obesity raises inflammation markers that result in insulin resistance, a condition that in itself adversely affects fertility. Therefore, it is almost certain that the significant weight loss is the cause of the unexpected pregnancies."
What does "almost certainly" mean? "Currently, it's unclear whether the substance in the medication has a direct connection to ovarian function. Studies have only been conducted on laboratory animals so far, so it remains a hypothesis. We're a long way from proclaiming that a miracle fertility drug has been discovered."
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זריקת אוזמפיק מתוצרת נובו נורדיסק
זריקת אוזמפיק מתוצרת נובו נורדיסק
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So, you wouldn't advise women who aren't overweight but struggle to conceive to take these injections?
"Absolutely not! If a slim woman takes these injections, she could very quickly reach a state of malnutrition. This is far from an ideal condition for pregnancy, as malnutrition can lead to complications during pregnancy and birth defects in the fetus. Furthermore, these medications are not deemed safe during pregnancy. That's why women who are using them and planning to get pregnant are advised to stop taking them two months before they start trying to conceive. There have been reports of birth defects in studies conducted on laboratory animals where these drugs were injected during pregnancy."

Do these injections pose a risk to the fetus?

Dr. Micha Baum, a specialist in obstetrics, gynecology and pregnancy at the Sheba Medical Center, says it is not clearly known what the impact of the injections are on a fetus.
"At present, the information about the impact of these injections on human fetuses is very limited. A woman who discovers she has become pregnant while taking these injections should, of course, stop using them immediately. As a precaution, it's strongly recommended that she seek private consultation that includes an evaluation of the pregnancy and the fetus, so she can make an informed decision about continuing the pregnancy," according to Baum.
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