When Dr. Shahrad Taheri looks at the millions of women taking GLP-1 medications like Ozempic or Wegovy, he sees a gap in medicine that needed filling fast. These popular weight-loss drugs have spread rapidly across the world, but doctors have had almost no clear guidance on how to advise women who might become pregnant. Now, that is finally changing.
Taheri, a professor and vice dean at the Marshall University Joan C. Edwards School of Medicine in West Virginia, was the only U.S.-based researcher among experts from Europe, North America and the Middle East who worked together to create the first international guidelines for using these medications across a woman's reproductive years. Their findings were published in the journal Obesity Reviews.
The team analyzed 34 studies involving women before, during and after pregnancy. These studies came from 23 institutions around the world. The guidelines cover everything from contraception and planning for pregnancy, to care during pregnancy, breastfeeding and the postpartum period.
One encouraging finding: the research did not show an increased risk of major birth defects when women were accidentally exposed to these medications early in pregnancy. The experts also found that GLP-1 medications may actually help improve fertility in women with polycystic ovary syndrome, recently renamed polyendocrine metabolic ovarian syndrome, and obesity before pregnancy.
However, the researchers are quick to point out that the evidence is still limited. Current guidance says there is not enough evidence to recommend using these medications during pregnancy or while breastfeeding. Nearly half of the most important clinical questions about these drugs and reproduction still have no answer.
"The rapid adoption of GLP-1 medications has outpaced the evidence available for women who are planning pregnancy or becoming pregnant," Taheri said. "This work provides clinicians with up-to-date, evidence-informed guidance while highlighting urgent research priorities needed to ensure these therapies can be used as safely and effectively as possible in women of reproductive age."
The team hopes their work will become a foundation for doctors and open the door to more research. For women in West Virginia and beyond who are navigating these questions, having any official guidance is a meaningful step forward. As more studies are completed in the years ahead, the recommendations will grow stronger and clearer.