Fertility Treatments and IVF While on GLP-1s: Timing Cycles and Medication Holds

If you're using a GLP-1 medication like Ozempic or Wegovy and planning for IVF, you'll need to pause your injections before your egg retrieval procedure. This is a crucial safety step to prevent complications with anesthesia. You should also plan to stop the medication well before trying to conceive, with recommended washout periods ranging from one to two months depending on the specific drug.

Fertility treatments are a deeply personal journey, and adding GLP-1 medications into the mix can feel overwhelming. You might be using these drugs to improve your metabolic health and optimize your weight before pregnancy; a goal that can significantly benefit fertility.

However, timing their use correctly with procedures like IVF is essential for both your safety and the success of your treatment.

Key Takeaways

• Pausing GLP-1s before egg retrieval is non-negotiable to prevent anesthesia risks caused by slowed digestion.
• You must stop these medications 1-2 months before trying to conceive due to a lack of safety data in early pregnancy.
• GLP-1s can indirectly boost fertility by improving metabolic health and restoring ovulation, especially for those with PCOS.
• Open communication between you, your fertility doctor, and the doctor who prescribes your GLP-1 is essential.
• The specific timeline for pausing your medication depends on which one you're taking, as some stay in your system longer than others.

How Do GLP-1 Medications Affect Fertility Treatments Like IVF?

GLP-1 medications can be a powerful tool in your preconception journey. By promoting significant weight loss, they can help reset your metabolic health, which is often a key factor in fertility challenges. For individuals, especially those with Polycystic Ovary Syndrome (PCOS), losing even 5-10% of body weight can help restore regular ovulation and improve the chances of conception.

However, when it comes to the specific procedures involved in IVF, these medications introduce important considerations. The very mechanism that makes them effective; slowing down digestion, becomes a potential risk during the egg retrieval process, which is performed under sedation. Your fertility team's goal is to balance the benefits you've gained from weight loss with the need to ensure a safe and successful cycle.

Why Do Doctors Recommend Pausing GLP-1s Before Egg Retrieval?

The short answer is anesthesia safety. The egg retrieval procedure requires sedation to keep you comfortable. When you are sedated, your body's natural reflexes that prevent you from choking are suppressed.

GLP-1 medications slow down how quickly food and liquid leave your stomach. This means that even if you follow the standard "nothing by mouth" instructions before your procedure, there could still be food or liquid in your stomach. If this contents were to come up while you're sedated, it could be inhaled into your lungs, a serious complication called pulmonary aspiration.

Because of this risk, fertility clinics and anesthesiologists have established clear guidelines. Most will require you to hold your GLP-1 medication for a specific period before your retrieval; often about one week. As one clinic notes, while there's a lack of large studies on GLP-1s in IVF patients, it's best to "play it safe" with a precautionary pause.

What’s the Link Between GLP-1s and Delayed Gastric Emptying During IVF?

Delayed gastric emptying is not a side effect; it's a core part of how GLP-1 medications work. By mimicking the natural GLP-1 hormone, these drugs tell your stomach to slow down, which helps you feel full longer and leads to more stable blood sugar levels after eating.

This is a great benefit for managing appetite and diabetes, but it poses a unique challenge for surgery. Normal fasting (not eating or drinking) for 8-12 hours is usually enough to ensure an empty stomach. For someone on a GLP-1 drug, this might not be sufficient. The medication can cause food to remain in the stomach for a longer, unpredictable amount of time, making the standard fasting rules less reliable.

This is why the pause is so important. Stopping the medication for several days to a week allows its effects to wear off and your digestive system to return to its normal pace, significantly reducing the risk during your egg retrieval.

How Long Should You Wait Before Trying to Conceive After Stopping GLP-1s?

This is one of the most common questions, and the answer depends heavily on which specific medication you are taking. The "washout period," the time it takes for the drug to fully leave your system – varies.

Official guidelines, including those from the UK government, provide clear recommendations. The following table breaks down the typical advice:

Your fertility clinic may have its own specific protocol, sometimes suggesting a conservative 4-5 week washout for most medications. It's crucial to have this conversation with your doctor early to plan your timeline correctly.

What Do We Know About GLP-1 Safety in Early Pregnancy?

The current official stance from health regulators is that GLP-1 medications are not recommended during pregnancy. This is primarily because there is not enough human data to confirm they are safe for a developing fetus.

The information we have comes from a few sources:

• Animal Studies: Some studies in animals have shown potential risks at very high doses, but it's unclear how this translates to humans.
• Pregnancy Registries: Drug companies run registries to track outcomes of women who accidentally took the medication during pregnancy. Early data from these registries has not shown a strong signal for major birth defects, but the numbers are still too small to be definitive.

Because of the uncertainty, the precautionary principle applies. The goal is to have the medication completely out of your system before an embryo implants or a pregnancy begins. This protects both you and your future baby from any unknown risks.

How Should You Talk With Your Fertility Doctor About GLP-1 Timing?

Being proactive and open in your communication is the key to a smooth process. Schedule a specific appointment to discuss your GLP-1 use with your fertility doctor, and make sure your endocrinologist or prescribing doctor is also in the loop.

To get the conversation started, here are some key questions to ask your fertility team:

• "What is your clinic's specific protocol for holding my medication before an egg retrieval?"
• "Based on my specific drug and dose, when should I take my last injection before we start an IVF cycle?"
• "Who do I need to notify when I pause my medication—you, or my other doctor?"
• "If we don't achieve pregnancy this cycle, when would it be safe to restart my GLP-1 medication?"
• "Do you recommend any specific nutritional supplements or assessments while I'm off the medication?"

This collaborative approach ensures that your weight management and fertility goals are working in harmony, not against each other.

What to Do Next

1. Schedule a Planning Session: Book an appointment with your reproductive endocrinologist specifically to discuss your GLP-1 medication timeline.
2. Inform Your Prescriber: Let the doctor who manages your GLP-1 know that you are planning for fertility treatment so they can support your pause.
3. Mark Your Calendar: Based on your doctor's advice, note when you need to take your last dose before starting an IVF cycle or trying to conceive.

When to Seek Help

Contact your doctor immediately if you:

• Discover you are pregnant while still taking a GLP-1 medication.
• Experience severe nausea, vomiting, or abdominal pain after pausing or restarting your medication.
• Have questions or feel uncertain about the timing plan you've been given.

Reference: https://www.sciencedirect.com/science/article/abs/pii/S1521690X25000715