GLP-1-based drugs are not recommended in pregnancy, and their product information advises stopping them some weeks before a planned pregnancy because of their long duration of action. Weight loss itself can restore ovulation in women with obesity or polycystic ovary syndrome, so unplanned pregnancies occur.
Some of these drugs also slow gastric emptying, which can reduce absorption of oral contraceptives, particularly when starting or increasing the dose. The product information for some agents advises a barrier or non-oral method during those periods.
A short conversation at the start covers all of this: pregnancy plans, current contraception, and what to do if pregnancy happens.
- Ask about pregnancy plans and contraception before starting a GLP-1-based drug in a woman of reproductive age.
- Advise that fertility may return as weight falls, especially with polycystic ovary syndrome.
- Check the specific product information on oral contraceptive interactions and the advised stopping interval before pregnancy.
- Ask patients to stop and seek advice if they become pregnant.
Why it matters
Weight loss restores fertility in some women just as a drug unsuitable for pregnancy is on board.
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