Can I take a GLP-1 while pregnant, breastfeeding, or trying to conceive?

The clearest contraindication in the class, in all three timeframes: Pregnancy: animal studies showed fetal growth problems and structural anomalies at clinically relevant exposures; intentional human trials will never exist, and pregnancy registries are still accumulating. Independent of the drug, a calorie-restricted, rapidly-losing body is the wrong environment for a fetus. Every label says discontinue when pregnancy is recognized. Trying to conceive: the labels specify stopping at least 2 months before a planned pregnancy (semaglutide’s long washout; tirzepatide’s guidance is similar) — drug levels persist for weeks after the last dose (the half-life math). Telehealth intakes asking about fertility plans are doing their job, not prying. The interaction nobody warns you about loudly enough: GLP-1s can increase fertility — weight loss restores ovulation in many women (the PCOS story), and slowed gastric emptying may reduce oral contraceptive absorption, particularly around dose escalations. Tirzepatide’s label specifically advises a backup method for 4 weeks after starting and after each dose increase. “Ozempic babies” are a real phenomenon with a boring pharmacological explanation — if avoiding pregnancy, layer a non-oral method during titration. If you discover a pregnancy on the drug: stop now, call your OB promptly, and breathe — early-exposure outcome data so far hasn’t shown a clear malformation signal in humans, and your OB will simply monitor more closely. Report the exposure to the manufacturer’s pregnancy registry if invited; that data protects the next person. Breastfeeding: human-milk transfer and infant effects are unstudied (small peptides likely transfer minimally, but “likely” isn’t a safety standard, and maternal calorie suppression can also undercut milk supply). Standard advice: wait until weaning. Postpartum weight goals are real — the safe sequencing is breastfeeding first, GLP-1 after.