Do I need to stop my GLP-1 before TTC?
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12 peer-reviewed research articles
2 professionally-backed sources
Overview
You might want to consider stopping GLP-1 receptor agonists (such as semaglutide, liraglutide, or tirzepatide) before trying to conceive (TTC). These medications are not recommended for use during pregnancy due to limited safety data, and most guidelines suggest discontinuing them before conception.
Key Points
Why Stop GLP-1 Agonists Before TTC?
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Lack of Safety Data: There is very limited human data on the safety of GLP-1 agonists during pregnancy. Most available evidence comes from animal studies, which have shown potential risks such as reduced fetal growth and skeletal changes, especially when exposure occurs during early development. Because of this, these medications are not approved for use in pregnancy and are generally classified as contraindicated during pregnancy by regulatory agencies like the FDA and EMA.
1ArticleEffects of GLP-1 agonists and SGLT2 inhibitors during pregnancy and lactation on offspring outcomes: a systematic review of the evidence - PMCGlucagon-like peptide 1 (GLP-1) agonists and sodium-glucose co-transporter-2 (SGLT2) inhibitors are novel drugs which have recently seen rapid uptake in the treatment of type 2 diabetes and obesity. The paucity of data regarding their safety during ...→
PubMed Central
2ArticlePregnancy after exposure to GLP-1 receptor agonists. A case report and literature review | ECE2023 | 25th European Congress of Endocrinology | Endocrine AbstractsIn subsequent trimesters, ... 2750 g. GLP-1 agonists have been classified by the FDA and EMA as group C, which means that they are contraindicated during pregnancy....→endocrine-abstracts.org
3ArticleFrontiers | Effects of GLP-1 agonists and SGLT2 inhibitors during pregnancy and lactation on offspring outcomes: a systematic review of the evidenceAims/hypothesis: Glucagon-like peptide 1 (GLP-1) agonists and sodium-glucose co-transporter-2 (SGLT2) inhibitors are novel drugs which have recently seen rapid uptake in the treatment of type 2 diabetes and obesity. The paucity of data regarding their safetyduringpregnancy and lactation causes ...→Frontiers
4ArticleGlucagon‐like peptide 1 (GLP‐1) receptor agonists' use during pregnancy: Safety data from regulatory clinical trials - Parker - 2025 - Diabetes, Obesity and Metabolism - Wiley Online LibraryA review of the safety of GLP1-RAs in the context of pregnancy was thus required. Diabetes and obesity are common during pregnancy, and the prevalence of both conditions is increasing in women of reproductive age.7 The importance of the gut–brain axis in both diabetes and obesity and improved mechanistic understanding of the roles of several gut peptides have increased recently. Incretin hormones, such as Glucagon-like peptide-1 ...→Diabetes, Obesity and Metabolism
5ArticleGlucagon-like peptide-1 receptor agonists and safety in the preconception period - PubMedThere are limited data from human studies to guide decision-making regarding timing of discontinuation of GLP-1 RA before conception. Studies focused on pregnancy and neonatal outcomes would provide additional information regarding a safe washout period. Based on the available literature a ...→PubMed
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Guideline Recommendations: Clinical guidelines and expert consensus recommend stopping GLP-1 agonists before trying to conceive. The typical advice is to discontinue these medications at least 1–2 months before attempting pregnancy, to allow the drug to clear from your system. For example, semaglutide specifically has a recommended washout period of 2 months before conception.
2ArticlePregnancy after exposure to GLP-1 receptor agonists. A case report and literature review | ECE2023 | 25th European Congress of Endocrinology | Endocrine AbstractsIn subsequent trimesters, ... 2750 g. GLP-1 agonists have been classified by the FDA and EMA as group C, which means that they are contraindicated during pregnancy....→5ArticleGlucagon-like peptide-1 receptor agonists and safety in the preconception period - PubMedThere are limited data from human studies to guide decision-making regarding timing of discontinuation of GLP-1 RA before conception. Studies focused on pregnancy and neonatal outcomes would provide additional information regarding a safe washout period. Based on the available literature a ...→6ArticleGLP-1 Agonists and Fertility: What Physicians Need to KnowAdditionally, if a patient is planning to get pregnant, Younglove recommends they stop taking GLP-1 medications at least 2 months before trying to conceive. · If a patient is considering starting in vitro fertilization (IVF), there’s also a cause for concern about how the medications will ...→
medscape.com
What If Conception Occurs While on a GLP-1 Agonist?
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Inadvertent Exposure: Some recent studies and case reports have not shown a clear increase in major birth defects or adverse pregnancy outcomes with early, unintentional exposure to GLP-1 agonists. However, these studies are small, and larger studies are needed to confirm safety. The current approach is to stop the medication immediately if pregnancy is detected.
1ArticleEffects of GLP-1 agonists and SGLT2 inhibitors during pregnancy and lactation on offspring outcomes: a systematic review of the evidence - PMCGlucagon-like peptide 1 (GLP-1) agonists and sodium-glucose co-transporter-2 (SGLT2) inhibitors are novel drugs which have recently seen rapid uptake in the treatment of type 2 diabetes and obesity. The paucity of data regarding their safety during ...→3ArticleFrontiers | Effects of GLP-1 agonists and SGLT2 inhibitors during pregnancy and lactation on offspring outcomes: a systematic review of the evidenceAims/hypothesis: Glucagon-like peptide 1 (GLP-1) agonists and sodium-glucose co-transporter-2 (SGLT2) inhibitors are novel drugs which have recently seen rapid uptake in the treatment of type 2 diabetes and obesity. The paucity of data regarding their safetyduringpregnancy and lactation causes ...→4ArticleGlucagon‐like peptide 1 (GLP‐1) receptor agonists' use during pregnancy: Safety data from regulatory clinical trials - Parker - 2025 - Diabetes, Obesity and Metabolism - Wiley Online LibraryA review of the safety of GLP1-RAs in the context of pregnancy was thus required. Diabetes and obesity are common during pregnancy, and the prevalence of both conditions is increasing in women of reproductive age.7 The importance of the gut–brain axis in both diabetes and obesity and improved mechanistic understanding of the roles of several gut peptides have increased recently. Incretin hormones, such as Glucagon-like peptide-1 ...→5ArticleGlucagon-like peptide-1 receptor agonists and safety in the preconception period - PubMedThere are limited data from human studies to guide decision-making regarding timing of discontinuation of GLP-1 RA before conception. Studies focused on pregnancy and neonatal outcomes would provide additional information regarding a safe washout period. Based on the available literature a ...→7ArticleUse of GLP1 receptor agonists in early pregnancy and reproductive safety: a multicentre, observational, prospective cohort study based on the databases of six Teratology Information Services - PMCGlucagon-like peptide 1 receptor agonists (GLP1-RA) are indicated for the treatment of type 2 diabetes and more recently for weight loss. The aim of this study was to assess the risks associated with GLP1-RA exposure during early pregnancy. This ...→
- Precautionary Principle: Because of the lack of robust data, the recommendation to stop GLP-1 agonists before conception is based on caution rather than proven harm.
Impact on Fertility and Preconception Health
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Fertility Effects: GLP-1 agonists may improve fertility in women with obesity or polycystic ovary syndrome (PCOS) by promoting weight loss and improving ovulation. However, these benefits are best realized before conception, and the medication should be stopped once you are actively trying to conceive.
8ArticleThe hidden impact of GLP‐1 receptor agonists on endometrial receptivity and implantation - Sola‐Leyva - 2025 - Acta Obstetricia et Gynecologica Scandinavica - Wiley Online LibraryUnderstanding these mechanisms ... and adverse developmental outcomes for children born to women conceiving during or soon after GLP-1RA treatment. ... Glucagon-like peptide-1 receptor agonists hold promise for improving female fertility, especially in obese or PCOS ...→
Wiley Online Library - Obstetrics & Gynecology
9ArticleThe role of glucagon-like peptide-1 in reproduction: from physiology to therapeutic perspective - PubMedGLP-1 RAs and DPP-4 inhibitors show promise in the treatment of diabetes and obesity-related subfertility. Larger interventional studies are needed to establish the role of preconception intervention with GLP-1 based therapies, assessing fertility outcomes in obesity, PCOS, and diabetes-related ...→10ArticleFor some women with infertility, GLP-1s may hold an unexpected benefit: PregnancyIf you continue to have this issue please contact customerservice@slackinc.com. Back to Healio · GLP-1 use may improve fertility for some women with obesity or polycystic ovary syndrome. Clinicians should counsel women about risk for unintended pregnancy when starting GLP-1 therapy.→healio.com
11ArticleRELEVANCE of GLP-1 AGONISTS FOR INFERTILITY PRACTICE - ScienceDirectAlthough available evidence indicates that acute weight loss interventions before fertility treatment, aside from GLP-1agonists, do not increase live birth rates and may even increase the risk of pregnancy loss (12, 13), achieving an optimal weight before pregnancy is crucial to prevent ...→sciencedirect.com
12ArticleEffects of GLP1RAs on pregnancy rate and menstrual cyclicity in women with polycystic ovary syndrome: a meta-analysis and systematic review | BMC Endocrine Disorders | Full TextPurpose This study was aimed to assess the effectiveness of Glucagon-like peptide 1 receptor agonists on pregnancy rate, menses, anthropometric and hormonal parameters in PCOS patients. Methods We conducted searches of the published literature in PubMed, EMBASE, Cochrane Library, Web of Science ...→bmcendocrdisord.biomedcentral.com
13ArticleRELEVANCE of GLP-1 AGONISTS FOR INFERTILITY PRACTICE - Reproductive BioMedicine OnlineGLP-1 RAs can be used in polycystic ... sex hormone-binding globulin levels (15). These properties make GLP-1 agonists an excellent alternative to improve fertility in obese women with PCOS....→rbmojournal.com
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Weight Regain: Some people experience weight regain after stopping GLP-1 agonists. This is a consideration for preconception planning, as maintaining a healthy weight before and during pregnancy is important for maternal and fetal health.
14ArticlePreconception glucagon-like peptide-1 receptor agonist use associated with decreased risk of adverse obstetrical outcomes - ScienceDirectHowever, future research is needed to define how this class of medication is best incorporated clinically into preconception health optimization. ... Glucagon-like peptide-1 receptor agonists (GLP-1RAs) were approved by the Food and Drug Administration (FDA) in 2005 for use in the management ...→
Summary
- It’s recommended to stop GLP-1 agonists before trying to conceive, typically at least 1–2 months prior, due to limited safety data in pregnancy and potential risks seen in animal studies.
- If you become pregnant while on a GLP-1 agonist, the current guidance is to discontinue the medication immediately.
- GLP-1 agonists may help with fertility and weight loss before pregnancy, especially in women with obesity or PCOS, but should not be continued once you are actively trying to conceive.
- For specific guidance on timing and managing your health goals, you might want to consult with your OB/GYN or endocrinologist, who can work with you on your personal course of care.