CNN
—
Catella Bentley couldn’t believe her eyes as she stared at the positive pregnancy test. She took her second test and then her third test. She had no questions. she was pregnant.
She called her husband at work and told him there was a giant spider in the house and he needed to come get rid of it. He hurries home and upon arrival Bentley reveals the news. We both started crying.
The couple, who live in Steele, Alabama, had been trying to have a child for more than two years, but Bentley’s doctor told her that she might not be able to conceive because of her history of polycystic ovarian syndrome, also known as PCOS. It is said that
Hearing the news made her feel aimless. “All I ever wanted was to be her mother and wife,” said Bentley, 25. “I was depressed all the time, very depressed all the time.”
Five months earlier, in October 2022, Bentley had started taking Munjaro to lose weight. In her first few months, she said, she lost about 40 pounds. Her menstrual cycles, which were irregular due to PCOS, are now normal. And she felt even happier.
“I felt like a whole new person,” she said. “I feel better every day.”
Bentley was hoping that losing weight might help her become pregnant, and had heard of other people who had successfully lost weight while pregnant. However, when she became pregnant earlier than expected, she worried about the effect it would have on the baby.
Bentley is never alone. Many women are sharing their stories of “Ozempic Babies” on social media. But these drugs haven’t been studied in pregnant people, so the joy you experience when you find out you’re pregnant may be accompanied by fear of the unknown.
“We don’t know the effects of early exposure on the fetus,” says Dr. Jodi Duchey, an internist specializing in endocrinology and metabolism at Beth Israel Deaconess Medical Center and an assistant professor at Harvard Medical School. Stated.
Duchey said women are recommended to stop taking these drugs two months before trying to conceive, as written on the prescription.
katela bentley
Katera Bentley said she was worried about her baby’s health before her daughter Ivy was born.
Ozempic and Mounjaro are part of a class of drugs called GLP-1 receptor agonists, which work by mimicking hormones in the intestine involved in regulating insulin and appetite. Both are approved for the treatment of type 2 diabetes, and two drugs are approved for each for weight loss. Ozempic uses the active ingredient semaglutide, and Wegovy is the version approved for weight loss. Mounjaro uses Tirzepatide, which also targets his second hormone called GIP, and Zepbound is the company’s brand name for weight loss.
These drugs have been shown to help people lose an average of 15% to 20% of their body weight in clinical trials.
Additionally, experts say that because of the mechanism of action of GLP-1 drugs, there is a reason why GLP-1 drugs not only have the potential to increase pregnancy rates, but also require caution when used in early pregnancy. Masu.
First, it states that weight loss may be commonly associated with improved fertility by restoring normal ovulation in people with PCOS and other causes of abnormal cycles. Dr. Daniel Druckera professor and researcher at the University of Toronto’s Mount Sinai Hospital, is a pioneer in GLP-1 research.
“If you start taking these drugs and you lose 5, 10, 15 percent of your body weight, very often your ovulation improves,” Drucker said.
One “very possible” scenario is that a person who is obese and has infrequent periods starts taking one of these drugs, loses weight over several months, but still finds that her periods are not regular. He said it’s about being aware of it. Maybe it’s because I’m pregnant now. ”
In addition to that, Mounjaro and Zepbound have warnings. Prescription information This means that oral contraceptives may be less effective.
Drucker said this may be because the drug works in part by slowing the rate at which food passes through the stomach. This may keep you feeling full longer, but it may also interfere with the absorption of other medications, such as oral contraceptives.
Although Mounjaro and Zepbound clearly warn about this on their labels. Ozempic and wegobee only Warning more broadly about the absorption of orally ingested drugs.
GLP-1 drugs may increase fertility, but little is known about their safety during pregnancy. Drugmakers Novo Nordisk and Eli Lilly have excluded people who are pregnant or planning to become pregnant from their clinical trials, a common practice when testing new drugs.
But that doesn’t mean there’s no information available.
“The more we use these drugs, the more women will become pregnant while taking them. As we do so, we will accumulate data on the risk of exposure during early pregnancy,” Duchey explained. did. In other words, “As with most pharmaceutical products, we essentially collect data from ‘accidents.'”
of a bit the study The available information about babies whose mothers took GLP-1 early in pregnancy does not show any major cause for concern, but researchers note that further research is needed and is currently underway.
Novo Nordisk has registry There, they are collecting data on the safety of Wegovy during pregnancy. A company spokesperson said the findings will be made public after the study is completed.Ann entry The government’s clinical trials database states that the study will enroll more than 1,100 participants and is expected to be completed by summer 2027.
An Eli Lilly spokesperson said the company also plans to open a pregnancy registry for Zepbound, which was approved late last year.
But Drucker said animal studies suggest some reasons for caution.
“When animals are given large doses of these drugs, the babies born from mice and rats are very small and may sometimes have some malformations,” he noted.
That’s probably because the drug has an appetite-suppressing effect.
“If you restrict a pregnant animal’s energy intake, the babies won’t get enough nutrition and won’t be able to grow properly,” Drucker says.
He also pointed to animal studies that suggest GLP-1 drugs may reduce the number of proteins responsible for transferring nutrients from mother to fetus, which are abundant in the placenta.
These concerns complicate research into infertility drugs, but some research is underway for one of the most common causes: PCOS. According to her, 12% of women of reproductive age in the United States suffer from this condition. Centers for Disease Control and Prevention.
The exact cause of PCOS is unknown, but it is thought to be associated with excess body weight, which causes the body to produce too much insulin. The result is a hormonal imbalance. Specifically, it has been reported that levels of hormones such as testosterone can become high, which can stop ovulation and cause irregular periods, acne, and excessive facial hair. CDC.
There is no cure, but simply losing weight can significantly improve symptoms, and regular ovulation and menstruation may resume. Dr. Anuja DoklasDirector of the PCOS Clinic at the University of Pennsylvania.
The first-line treatment for PCOS is lifestyle changes, but if those interventions are unsuccessful, doctors may prescribe Ozempic or other GLP-1 agonists, Dr. Doklas said.of 2023 International PCOS Guidelines It lists GLP-1 agonists among drugs for “management of weight gain in adults with polycystic ovary syndrome.”
He added that since GLP-1 agonists improve insulin resistance and lead to weight loss, it makes sense that they also improve PCOS symptoms. Dr. Melanie CreeDirector of the Multidisciplinary PCOS Clinic at Children’s Hospital Colorado.
“It is currently being used completely without any evidence. [obstetrics] “The field knows that reducing body weight by 5% in PCOS patients improves fertility,” she said.
Mr. Cree pointed out that: the study showed it liraglutidean early GLP-1 drug marketed as Victoza for type 2 diabetes and Saxenda for weight loss, is effective in lowering body weight and testosterone levels in women with PCOS and obesity.
Cree just finished clinical trial We are investigating the use of semaglutide, the active ingredient in Ozempic and Wegovy, to treat PCOS in adolescent girls. Preliminary findings, although unpublished, indicate that both semaglutide and a low-carbohydrate diet led to increased menstrual frequency, lower testosterone levels, and weight loss, with weight loss being more pronounced in the group taking semaglutide. Ta.
The study found that those who lost more weight, regardless of the method, had a greater decline in their testosterone levels.
Cree is currently Large-scale, long-term clinical trialsis funded by the National Institutes of Health and will specifically investigate fertility outcomes in young women with PCOS taking semaglutide.
And while drug makers are not currently conducting clinical trials for PCOS (which Cree believes is due to the fact that PCOS overlaps so much with obesity, the drug market won’t expand dramatically). The company pointed out that it has been approved for the same disease. This can have a significant impact on insurance coverage, which is difficult for many people who use insurance for weight loss purposes.
“For example, Colorado requires coverage for infertility treatment, so if it is approved as a fertility drug, it would be covered for that indication,” she said.
Separately, Cree pointed to another question regarding medications during pregnancy. The idea is that if a patient suddenly stops taking the drug, weight can come back quickly.
“What if that happens while you’re pregnant and gaining this much weight?” she said. “What does that mean? And we don’t know.”
Pharmaceutical companies are also tracking the “Ozempic Babies” phenomenon. Eli Lilly’s head of research, Dr. Daniel Skovronski, said the company has heard these types of stories from patients.
“One of the questions we’re asking is: Does reducing fat improve fertility and potentially reduce PCOS and other barriers to fertility?” Skovronski said. Told.
“Things like heart failure and sleep apnea,” he said, referring to conditions for which GLP-1 drugs have recently been indicated. It is shown positive results. “Another potential benefit of weight loss with this class of drugs remains to be tested.”
Get CNN Health’s weekly newsletter
He also emphasized how difficult it is to conduct fertility studies of drugs whose safety during pregnancy is unknown. Cree called the contraceptive requirement in studies of GLP-1 drugs a “catch-22” for fertility indications.
“Unfortunately, at the moment it is very difficult to study the effects of these drugs on fertility, because exposing women to drugs increases the risk of becoming pregnant during drug exposure and the risk of giving birth to a baby.” “It has not been fully analyzed yet,” Skovronski said.
Bentley, who became pregnant while taking Munjaro, said she stopped taking the drug as soon as she found out she was pregnant. But she said she continued to worry about the effect the drug would have on the baby.
“I was worried until the day I gave birth to her,” she said.
Her daughter Ivy was born healthy on her due date, weighing 7 pounds, 7 ounces. Bentley said six weeks after Ivy was born, she started taking Munjaro again.
