Ozempic ‘oops’ babies spark debate about use as fertility drug

A surprising thing is happening to some women on weight-loss drugs who’ve struggled with fertility issues: They’re getting pregnant. That’s leading to questions about the safety of medications from Novo Nordisk A/S and Eli Lilly & Co. during pregnancy.

“I thought I couldn’t have any more kids,” said Torria Leggett, 40, who had been trying for another after her first child was born in 2018. In 2022, the social worker from Whiteville, N.C., began taking Novo’s Ozempic to treat obesity, then switched to Lilly’s Mounjaro. As the pounds melted off, there was soon another reason to celebrate. She was expecting.

“The weight loss, that’s likely what jump-started it,” she said. “I couldn’t believe it.”

Stories like these are encouraging doctors to use GLP-1 drugs to treat polycystic ovary syndrome, one of the leading causes of infertility in US women. Yet they’re doing so without much data on the drugs’ impact on pregnancy.

“The ‘oops’ babies on Ozempic and Wegovy are happening all over the place,” said Melanie Cree, director of the PCOS clinic at Children’s Hospital Colorado in Aurora. “It’s very exciting, but it’s a bit scary because we’re moving forward without all the data.”

The need for treatments is severe. Despite its prevalence, no drugs are approved for PCOS, and experts are divided on whether commonly recommended diet programs work. Some doctors and patients are willing to try almost anything, and the successes are tantalizing.

GLP-1 drugs have been marketed for nearly 20 years to treat diabetes, and their use in obesity is fueling a new market that’s expected to hit $100 billion in 2030. The problem is, companies haven’t systematically studied GLP-1’s use in PCOS — and don’t plan to anytime soon.

In the absence of data, researchers are doing studies of their own to figure out if the drugs work for PCOS, and US regulators have asked the companies to collect any information they can about their use during pregnancy.

So far, the safety data look promising. A recent study of the health records of 50,000 women with Type 2 diabetes found no increase in birth defects among those who used the drugs in very early pregnancy compared with those who took insulin.

Still, the study’s authors said additional confirmation is needed, especially in women without diabetes. Researchers from Copenhagen concurred last year in a review of GLP-1 drugs, saying that there’s “limited information on their long-term safety, particularly concerning pregnancy outcomes.”

Reasons for concern come mostly from animal experiments. The active ingredient in Novo’s drugs, semaglutide, has been linked to increased birth defects in animals.