Ozempic Babies
I am board-certified in OB/GYN and Obesity Medicine and have practiced in both fields for over 10 years. I can’t tell you how many times I’ve had a patient tell me, “I can’t get pregnant, so I don’t use contraception.”
There aren’t many of us who have been in the trenches of both fields, but every last one of us could have seen this coming a mile away. My team in my Obesity Medicine clinic knows to ask about this over and over again – because it’s always been a huge concern of mine and I’ve drilled it into their heads during training.
In fact, we get a lot of referrals from the REI (“infertility”) clinics in town. About half of the patients get pregnant while working with us and never need to be sent back to the clinic.
The only time I have ever taken money from big pharma was last summer when I was part of a 2-day “think tank” to weigh in on and improve the content in the provider training deck for Zepbound. Although I had always wanted to know what happens in those meetings, I only agreed to participate because I wanted to make sure the warnings about the decreased efficacy of oral contraceptives with Zepbound were put in that slide deck. And I was vocal about the importance. Last I heard, I had been successful in getting that point brought into the deck, although I haven’t sat through any type of formal Zepbound presentation and have no idea if it’s still in there.
“I can’t get pregnant, so I don’t use contraception.”
Let’s unpack this:
Some people CAN’T get pregnant. Women who don’t have a uterus, who are not sexually active, or who are post-menopausal can’t get pregnant.
Women who have undergone bilateral tubal ligation, who have a (non-expired) intrauterine device, or who are only sexually active with a partner who has undergone a vasectomy (and verified that it worked) are very unlikely to get pregnant (although I’ve seen it happen).
Women using hormonal contraception and whose partners use condoms (i.e., those actively preventing pregnancy) are less likely to get pregnant, but again, definitely not impossible.
Having irregular cycles, PCOS, a history of infertility, and/or obesity does NOT make pregnancy impossible. Especially when someone is actively changing their body. The way we live our lives affects the amount of hormones we produce, the concentration of molecules that carry those hormones around, and the way the hormones interact with the organs. Sometimes, the medications we take alter those things too – or, as is the case with tirzepatide, they alter the absorption of other medications.
Taking medications without a thorough conversation with a clinician who knows you and understands the whole picture is irresponsible. Getting them online or from an aesthetician after filling out a short questionnaire isn’t any better.
