Can I get pregnant on Ozempic?

Yes, pregnancy can occur while on Ozempic -- and may actually be more likely because weight loss and improved insulin sensitivity can restore ovulation, especially in women with PCOS or obesity-related hormonal disruption. However, semaglutide must be stopped at least 2 months before attempting to conceive, as animal studies show potential harm to foetal development. Use reliable contraception while on GLP-1 medications if pregnancy is not desired.

Does Ozempic help with fertility in PCOS?

Weight loss through Ozempic can significantly improve fertility in women with PCOS. Even a 5-10% reduction in body weight can restore menstrual regularity, lower androgen levels, improve insulin sensitivity, and increase the chance of ovulation. Some women with PCOS have reported spontaneous conception after starting semaglutide, emphasising why reliable contraception is essential if pregnancy is not planned.

When should I stop Ozempic before trying to conceive?

Current guidance recommends stopping semaglutide at least 2 months before attempting to conceive. This accounts for the elimination half-life of the drug. Some specialists recommend a longer pause of 3-6 months to allow full metabolic stabilisation and weight maintenance before pregnancy. Discuss timing with your gynaecologist or reproductive specialist.

Is Ozempic safe during pregnancy?

No. Semaglutide (Ozempic, Wegovy, Rybelsus) is not approved for use during pregnancy and animal studies showed foetal harm. If you discover you are pregnant while on Ozempic, stop the medication immediately and contact your obstetrician. The majority of available human data does not show a dramatically elevated risk, but the precautionary principle applies and no GLP-1 drug should be continued into pregnancy.

GLP-1 Weight Loss Drugs and Fertility in South Africa: What You Need to Know (2026)

By Weight Loss Diets SA | Updated June 2026 | 10 min read

GLP-1 medications like Ozempic and Wegovy are reshaping weight management across South Africa — and for many women of reproductive age, their impact on fertility is a critical question. The relationship between these drugs and fertility is complex: weight loss can dramatically improve your chances of conception, but semaglutide itself must be stopped before you try to get pregnant.

This guide covers everything South African women (and their partners) need to know about GLP-1 drugs and fertility in 2026.

Critical safety notice: Semaglutide (Ozempic, Wegovy, Rybelsus) must be stopped at least 2 months before attempting to conceive and must not be used during pregnancy. Animal studies show potential foetal harm. If you discover you are pregnant while on a GLP-1 medication, stop immediately and contact your doctor.

How Obesity Affects Fertility

Before understanding how GLP-1 drugs affect fertility, it helps to understand how excess weight disrupts it in the first place. Obesity impairs female fertility through several mechanisms:

Hormonal disruption: Excess adipose tissue converts androgens to oestrogens via aromatase, disrupting the hormonal balance needed for regular ovulation
Insulin resistance: Drives elevated insulin levels, which stimulate the ovaries to overproduce androgens and suppress ovulation
Irregular or absent periods: Obesity is a leading cause of anovulation (failure to ovulate) even in women without PCOS
Reduced IVF success rates: Obesity is associated with lower egg quality, poorer embryo development, and reduced implantation rates
Male factor: Obesity in men reduces testosterone, increases scrotal temperature, and impairs sperm quality

The Fertility Benefits of Weight Loss

The good news: even modest weight loss produces meaningful fertility improvements. Research consistently shows:

A 5-10% reduction in body weight can restore ovulation in anovulatory obese women
Weight loss improves menstrual regularity in the majority of obese women with irregular cycles
IVF success rates improve significantly with even moderate pre-procedure weight loss
In men, weight loss improves testosterone levels and sperm parameters

This is where GLP-1 medications offer genuine fertility-related value: as an effective weight loss tool that creates conditions favourable to conception. But the medication must be stopped before attempting pregnancy.

GLP-1 Drugs and PCOS Fertility

Polycystic ovary syndrome (PCOS) affects an estimated 1 in 10 South African women of reproductive age and is one of the most common causes of female infertility. PCOS and obesity are tightly linked — around 50-70% of women with PCOS are overweight or obese, and the insulin resistance driving PCOS worsens with excess weight.

GLP-1 medications address PCOS at several levels:

Insulin sensitisation: Reducing insulin resistance lowers androgen production from the ovaries
Weight loss: Even small losses restore menstrual regularity and ovulation in many PCOS patients
Androgen reduction: Studies show semaglutide reduces free testosterone in women with PCOS
Restored cycles: Multiple clinical reports and emerging trial data show GLP-1 drugs restore menstrual regularity in a significant proportion of PCOS patients

Important PCOS warning: Restored ovulation on GLP-1 medications means unprotected sex carries a real pregnancy risk. Many women with PCOS assumed they couldn't conceive due to irregular cycles — GLP-1 therapy changes this. Use reliable contraception while on semaglutide if pregnancy is not intended.

The Contraception Issue on GLP-1 Drugs

There is an additional concern with oral contraceptives and semaglutide: because Ozempic slows gastric emptying, it may affect how oral contraceptive pills are absorbed. Some data suggests reduced absorption of oral hormonal contraceptives, potentially reducing their effectiveness.

If you are using oral contraceptives and starting semaglutide, discuss this with your doctor. You may be advised to:

Switch to a non-oral contraceptive method (IUD, implant, injectable)
Add barrier methods as backup during the first few months
Take the pill at least 1 hour before injecting semaglutide

Planning a Pregnancy on GLP-1 Medications: A Step-by-Step Approach

Step	Action	Timing
1	Discuss conception plans with your prescribing doctor	As soon as you're considering pregnancy
2	Achieve target weight loss on GLP-1 medication	6-12 months before planned conception
3	Stop semaglutide (at least 2 months before trying)	Minimum 2 months pre-conception
4	Start prenatal folate (5mg/day for obese women)	At least 3 months before conception attempt
5	Establish healthy eating habits to maintain weight	During and after stopping medication
6	Monitor weight — some regain is common	Ongoing post-medication
7	Seek fertility specialist referral if needed	After 6 months of trying without success

What Happens to Weight When You Stop for Pregnancy?

This is a real concern. Clinical data shows significant weight regain occurs after stopping semaglutide. For women who lose 15-20% of body weight on Ozempic, stopping to conceive may result in regaining 5-10% within 6-12 months. This is not failure — it reflects the ongoing nature of obesity as a chronic condition.

The strategy is to use the weight loss window to:

Establish sustainable dietary habits
Build regular exercise into your routine
Conceive, carry a healthy pregnancy, and then discuss restarting GLP-1 therapy postpartum (once breastfeeding is complete)

PCOS and Weight Loss

PCOS is one of the most treatable causes of obesity-related infertility. Read our complete guide.

PCOS Weight Loss: The SA Guide

Medical disclaimer: This article is for information only. Fertility and pregnancy planning require personalised medical advice. Always consult your gynaecologist, reproductive specialist, and prescribing doctor before making decisions about GLP-1 medications and fertility. Never stop or start medication without medical guidance.