GLP-1 Medications and Fertility: Key Nutrition Risks
Whether you’re using semaglutide (Ozempic, Wegovy) or liraglutide (Saxenda, Victoza) for weight loss, PCOS, or insulin resistance, and especially if you’re trying to conceive, this guide is for you.
We’ll walk through what GLP-1 medications do, how they impact fertility, and what nutritional strategies you need to consider to support a healthy pregnancy journey.
What Are GLP-1 Receptor Agonists?
GLP-1 receptor agonists are medications initially developed to manage type 2 diabetes. They mimic the action of glucagon-like peptide-1, a hormone that:
- Slows gastric emptying
- Reduces appetite
- Stimulates insulin secretion
- Lowers blood glucose levels
Due to their appetite-suppressing and metabolic benefits, they are now frequently prescribed off-label for weight loss and increasingly used by women with PCOS or obesity-related infertility. While these medications may offer reproductive benefits, they also introduce essential nutrition considerations.
What the Research Says: GLP-1s and Fertility
Emerging research highlights how GLP-1 medications may support fertility in women with PCOS or weight-related reproductive challenges.
1. Restoring Ovulation in PCOS
GLP-1 receptor agonists may restore ovulation by improving insulin sensitivity, reducing inflammation in the body, and lowering excess androgen levels. Three main drivers of menstrual dysfunction in PCOS (Wojda, et al., 2025).
2. Potential Better Outcomes than Metformin
Another study found that women with PCOS who received a combination of liraglutide and metformin before IVF achieved significantly better pregnancy outcomes than those treated with metformin alone, even with similar weight loss across both groups (Janež & Jensterle, 2018).
3. Improved Hormone Regulation
GLP-1 therapy also supports menstrual regularity and reduces testosterone levels, an important improvement for women with androgen-driven infertility (Papaetis & Kyriacou, 2022).
4. Possible Benefits for Implantation
Preliminary evidence suggests GLP-1s may improve endometrial receptivity, which refers to the uterus’s ability to support embryo implantation. Although the data are preliminary and mixed, this area shows promising potential (Sola-Leyva et al., 2024).
Here’s What You Need to Know First
If you’re preparing to conceive, planning a washout period is essential.
GLP-1 medications remain in your system for several weeks, and current clinical guidelines recommend discontinuing them at least 1–2 months before trying to conceive.
These medications are not approved for use during pregnancy, and their safety profile in early gestation remains unclear.
While there have been reports of unplanned pregnancies while on GLP-1s, this does not confirm safety. It’s essential to work closely with your fertility doctor to create a tailored exit strategy before attempting conception.
What to Watch for Nutritionally on GLP-1
A common issue I see in practice is inadvertent undernutrition. Because GLP-1 significantly reduce appetite, many women unintentionally consume fewer calories, especially when preparing their bodies for pregnancy.
Some of the most common nutrient gaps I see include:
- Protein
- Iron
- Vitamin B12
- Zinc
- Omega-3 fatty acids
These nutrients are essential for egg health, hormone production, and early embryo development.
Practical Nutrition Tips:
Even if your appetite is lower, the nutrient density must increase. I recommend following a Mediterranean-style pattern focused on:
- Lean proteins such as eggs, tofu, legumes, and oily fish
- Healthy fats like olive oil, avocado, and nuts
- Colourful vegetables
- Low-GI whole grains
Aim for small, frequent, and nutrient-rich meals that nourish your body without overwhelming your digestive system.
Don’t Forget Folate Supplementation
Folate is a critical nutrient for all women planning to become pregnant. It plays an essential role in DNA synthesis, cell division, and early fetal development.
It is naturally found in leafy greens, legumes, and citrus fruits; however, most women require supplementation in addition to their food sources.
Supplement forms include folic acid, folinic acid, and methylfolate. Some individuals, such as those with MTHFR gene variants, may benefit more from active forms like methylfolate.
Current international guidelines recommend 400 mcg of folic acid supplementation per day, starting at least one month before conception and continuing through the first trimester to reduce the risk of neural tube defects. Some may require higher doses based on their medical history or nutritional blood work.
Waiting until after discontinuation may delay critical nutrient support during the early stages of conception.
A fertility dietitian can help you determine the correct dose, form, and duration of supplementation to suit your individual needs. Check out our Express Supplement Review Session.
The Bottom Line
- GLP-1 medications may offer powerful fertility benefits, especially in women with PCOS or insulin resistance. But success depends on more than just weight loss.
- Work closely with your doctor to plan a safe transition off the medication, including a washout period of at least 2 months before trying to conceive
- Follow a nutrient-dense, balanced diet to offset reduced appetite
- A dietitian-customised supplement regimen to support key preconception nutrients
