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The Complete Guide to GLP-1 Medications and Fertility

If you are trying to fall pregnant — or preparing for IVF — and you are taking a GLP-1 medication like Ozempic, Wegovy, Mounjaro, Saxenda or Rybelsus, you are not alone in feeling uncertain. More and more South African fertility patients are asking the same questions: Should I stop? Is it safe? Will it help me conceive? Will my doctor refuse to treat me until I lose weight?

There is a lot of clinical chatter, a lot of social media noise, and very little clear guidance written specifically for fertility patients. This guide brings together international guidance, manufacturer information and published research, and explains it in plain language for South Africans.

What is a GLP-1 medication, in plain English?

GLP-1 stands for glucagon-like peptide-1. It is a hormone your gut already makes after you eat. It tells your pancreas to release insulin, slows down how quickly your stomach empties, and signals to your brain that you are full.

GLP-1 medications are synthetic versions of this hormone, designed to last much longer in the body. They were originally developed for type 2 diabetes, but doctors quickly noticed that patients also lost significant amounts of weight. That is why these medications have become so popular for obesity, insulin resistance and metabolic syndrome.

The most common GLP-1 medications you may have heard of

  • Ozempic (semaglutide) — weekly injection, originally for type 2 diabetes.
  • Wegovy (semaglutide, higher dose) — approved specifically for weight loss.
  • Mounjaro (tirzepatide) — a dual GLP-1 and GIP receptor agonist, often producing greater weight loss than semaglutide.
  • Zepbound (tirzepatide) — the weight-loss-specific branding of tirzepatide.
  • Saxenda (liraglutide) — daily injection used for weight management.
  • Victoza (liraglutide) — daily injection for type 2 diabetes.
  • Rybelsus (oral semaglutide) — a daily tablet form.

Why are fertility specialists suddenly talking about GLP-1 medications?

For decades, fertility clinics have known that body weight matters. Higher BMI is linked to lower IVF success, irregular ovulation, poorer egg quality, increased miscarriage risk and greater pregnancy complications. The problem is that telling a patient to “lose weight” has historically done little — most people cannot reach a meaningful weight loss target through diet and exercise alone, especially when they are also navigating PCOS, insulin resistance, age and the emotional weight of infertility.

GLP-1 medications changed this. For the first time, many people with obesity or insulin resistance can achieve clinically significant weight loss — often 10% to 20% of body weight — relatively quickly. For some women, this is the difference between not ovulating and having a regular cycle. For others, it is the difference between being turned away from IVF for a high BMI and being accepted.

But — and this is critical — GLP-1 medications are not fertility treatments. They do not directly improve egg quality. They do not fix every cause of infertility. And there is still an important unanswered question about how safe they are during conception and early pregnancy.

Can GLP-1 medications help you get pregnant?

Indirectly — yes, for some people. The effect is not magical. It works through weight loss and improved metabolic health.

For women with PCOS or insulin resistance

Insulin resistance is one of the biggest hidden drivers of ovulation problems. When insulin runs high, the ovaries produce extra androgens (male-pattern hormones), and ovulation becomes irregular or stops altogether. Reducing insulin resistance — which GLP-1 medications help to do — can restore ovulation in many women.

International studies have shown that women with PCOS who lose 5–10% of their body weight often see meaningful improvements in cycle regularity, ovulation and natural conception. GLP-1 medications make that 5–10% achievable for many women who could not get there before.

For women with obesity who do not have PCOS

Even without PCOS, excess body weight can affect hormone balance, egg quality and IVF success. Modest weight loss before fertility treatment may improve outcomes — although the evidence here is more nuanced than people sometimes claim. Studies on delaying treatment to lose weight have produced mixed results, particularly for women over 35, where the cost of delay can outweigh the benefit.

For men

Male obesity is associated with lower testosterone, lower sperm count, lower sperm motility and higher DNA fragmentation. Weight loss — including weight loss assisted by GLP-1 medications — has been shown to improve several of these. However, the direct effect of GLP-1s on sperm is still being studied.

The big question: are GLP-1 medications safe during conception and pregnancy?

This is where honest writing matters most. The short answer is: there is not yet enough data to say they are safe in pregnancy, and the general guidance is to stop them before trying to conceive.

The prescribing information for semaglutide (Ozempic and Wegovy) advises stopping the medication at least 2 months before a planned pregnancy. Tirzepatide (Mounjaro) is also not recommended in pregnancy, and a similar washout period is commonly advised. This is partly because these drugs have a long half-life — they stay in your system for weeks after your last dose — and partly because animal studies have shown some concerning effects on developing embryos.

It helps to be clear about what we do and don’t know:

  • What we know: GLP-1 medications are not approved for use in pregnancy, and the product information advises against using them while pregnant or trying to conceive.
  • What we don’t know: Whether brief exposure in very early pregnancy (before a woman knows she is pregnant) causes harm. The limited human data so far is cautiously reassuring, but not definitive.
  • What the general guidance says: Stop at least 8 weeks (2 months) before actively trying to conceive, and ideally before any IVF cycle begins — but confirm the timing with your own doctor.

How long before IVF or trying to conceive should you stop?

Fertility specialists generally follow international and manufacturer guidance, which points to stopping GLP-1 medications at least 8 weeks before starting an IVF cycle or actively trying to conceive. Some clinics prefer a longer gap, such as 12 weeks, to be extra cautious. The washout matters because semaglutide and tirzepatide have half-lives of around a week, which means the drug is still measurably in your system for several weeks after your last dose.

We have written a dedicated guide on the timing question — including how to plan the washout without regaining all the weight you have lost.

What about the weight you have lost? Will you regain it?

This is the fear nobody wants to talk about, but it is real. GLP-1 medications work while you are taking them. Once you stop, appetite tends to return and weight often comes back unless you have built strong lifestyle foundations during the medication period.

This is one of the most important reasons not to view GLP-1s as a quick fix before IVF. Many people use the medication window to:

  • Establish sustainable eating patterns they can maintain after stopping.
  • Build muscle through resistance training — muscle helps protect metabolic rate.
  • Address underlying drivers such as insulin resistance, sleep, stress and thyroid health.
  • Work with a registered dietitian who understands fertility.

Does losing weight actually improve fertility treatment success?

The honest answer is: sometimes, and the picture is more complicated than is often suggested. A 2022 randomised trial published in PLOS Medicine (the FIT-PLESE trial) challenged the long-held assumption that losing weight before fertility treatment improves live birth rates. In that trial, women with obesity and unexplained infertility who followed an intensive weight loss programme before fertility treatment did not have better live birth rates than women who followed a standard exercise programme without targeted weight loss — although the weight loss group did see improvements in their general metabolic health.

Other studies show clearer benefits, particularly for women with PCOS or a very high BMI. The truth lies somewhere in between: weight loss probably helps some people, but the size of the benefit depends on your starting BMI, your age, the cause of your infertility, and how long the weight loss process delays treatment.

For women over 35, the balance is especially delicate. Egg quality declines with age, and a 6-month delay to lose weight may cost more in egg quality than it gains in BMI improvement. This is a conversation to have openly with your fertility specialist.

PCOS is now PMOS — what does that mean?

In 2026, following a global consensus process published in The Lancet, polycystic ovary syndrome (PCOS) was officially renamed polyendocrine metabolic ovarian syndrome (PMOS). You will still see both names used for a while as clinics, medical aids and websites catch up.

The new name reflects what specialists have known for years: this is not simply a condition about cysts on the ovaries. It is a hormonal, metabolic and ovulatory condition in which insulin resistance often plays a central role.

For women with PMOS/PCOS, GLP-1 medications can be particularly useful because they target a metabolic root cause — insulin resistance — rather than only managing symptoms. Some women with PMOS who were not ovulating on their own begin ovulating again after sustained weight loss and improved insulin sensitivity. Read more in our guide to PMOS, fertility and GLP-1 medication.

Myths versus facts

Myth: “Ozempic makes you more fertile.”
Fact: Ozempic does not directly increase fertility. It can indirectly improve fertility by reducing insulin resistance and supporting weight loss in some people. The viral phrase “Ozempic babies” reflects this indirect effect — women who were not ovulating started ovulating again, sometimes unexpectedly.

Myth: “You only need to stop Ozempic the week before IVF.”
Fact: The drug has a long half-life and stays in your system for weeks. The general guidance is to stop at least 2 months in advance — your doctor will confirm the right timing for you.

Myth: “GLP-1 medications cause birth defects.”
Fact: This is not currently supported by the limited human data available. There are theoretical concerns and animal data, which is why these medications are not approved for pregnancy — but there is not yet evidence of harm from accidental early exposure.

Myth: “If I lose weight on Ozempic, my IVF will definitely work.”
Fact: Weight is one factor among many. Egg quality, sperm quality, age, embryology and chance all play a role.

If you are feeling overwhelmed

If you are reading this guide, you may be tired. You may have been told to lose weight before treatment. You may feel ashamed of your body. You may have tried every diet. You may be scared that you are running out of time. Please hear this clearly: needing help with weight loss is not a moral failing, and choosing to use a GLP-1 medication under your doctor’s care is not cheating. Obesity is a complex metabolic condition. So is infertility. You deserve modern, evidence-based help — and a specialist who treats you with respect.

It is also okay to grieve the years you may have spent blaming yourself. For many people, finally having an effective tool — and a kind explanation — is the first time they have felt hopeful in a long while.

Questions you may want to discuss with a fertility specialist

Every person’s situation is different. These are common areas people choose to raise with their fertility team — not a treatment plan.

  • Booking a consultation with a fertility specialist (not only your GP) to discuss your individual situation.
  • Which blood tests make sense for you — for example fasting insulin, HbA1c, AMH, thyroid function and prolactin.
  • If you are on a GLP-1, when and how to stop it — before changing anything yourself.
  • Building a support team — fertility specialist, endocrinologist if needed, dietitian and emotional support.
  • How your age and ovarian reserve should shape your timeline, not only your BMI.

Looking for a specialist? Browse our directory of fertility specialists.

Frequently asked questions

Can I take Ozempic while trying to conceive?

Ozempic is generally stopped at least 2 months before trying to conceive. It is not approved for use in pregnancy and has a long half-life, meaning it stays in your system for several weeks after the last dose. Speak to your doctor before stopping.

Does Mounjaro improve IVF success rates?

Mounjaro may indirectly support IVF outcomes by promoting weight loss and improving insulin sensitivity, particularly in people with PCOS/PMOS. However, it is not a fertility medication and is usually stopped before IVF — commonly at least 2 months in advance.

How long before IVF should I stop GLP-1 medication?

The general guidance is at least 8 weeks (2 months) before starting an IVF cycle. Some clinics prefer 12 weeks. Confirm the exact timing with your fertility specialist.

Will losing weight on GLP-1 medication help me get pregnant naturally?

It can, particularly if you have PCOS/PMOS or insulin resistance. Even 5–10% weight loss has been shown to restore ovulation in many women. However, weight loss alone does not address every cause of infertility.

Can men take Ozempic while trying for a baby?

Guidance for men is less restrictive, but some specialists suggest pausing GLP-1 medications a few months before conception, as sperm take roughly 70–90 days to develop. Discuss this with your doctor.

What happens if I fall pregnant while still on Ozempic?

Speak to your doctor as soon as possible. The medication is usually stopped straight away and your pregnancy monitored. The limited human data so far is cautiously reassuring, but these medications are not approved for use in pregnancy.

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References

 

Disclaimer: This content is for educational purposes only and does not constitute medical advice. Fertility Solutions is not a medical provider and cannot be held responsible for any decisions made based on this article. The medications mentioned are prescription-only and should only be started, stopped or changed under the guidance of your doctor. Always consult with a qualified healthcare provider before making decisions about your medication or fertility treatment.

About the Author

Leigh-Ann Geydien is the founder of Fertility Solutions, South Africa’s only dedicated fertility directory. With a deep commitment to patient advocacy, she built the platform to bridge the gap between those navigating fertility challenges and the clinics and reproductive health specialists best placed to help them.

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