A conversation with the Bay Area’s premier endocrinologist, Dr. Chhaya Makhija

‍

How do weight loss meds like Ozempic fit into your IVF plan? With the rise of GLP-1 medications like Ozempic and Wegovy, many people trying to conceive have questions about how these drugs affect fertility, pregnancy, and treatment planning. To help break it all down, we spoke with Dr. Chhaya Makhija, founder of Unified Endocrine & Diabetes Care, a triple board-certified endocrinologist, lifestyle medicine specialist, and educator, about how medications like semaglutide work, what the science says, and what patients should know as they plan for pregnancy and fertility treatments.

‍

First, can you tell us a bit about your background?

Dr. Makhija:
I’m a triple board-certified endocrinologist, lifestyle medicine specialist, and internal medicine physician. I run a boutique, patient-centered practice in both Central and Northern California and also serve as an associate professor, teaching medical students in the state. My approach combines evidence-based medicine with lifestyle and prevention to empower patients to take control of their health.

‍

Who do you typically work with in your practice?

Dr. Makhija:
I see a wide range of patients, men and women, dealing with hormonal imbalances, PCOS, prediabetes, type 2 diabetes, thyroid disorders, and weight challenges. My goal is to combine medical science with personalized lifestyle changes, so patients feel empowered and supported in transforming their health, not just managing symptoms.

‍

How does Ozempic affect fertility in women?

Dr. Makhija:
Ozempic (semaglutide) is a GLP-1 receptor agonist initially approved to treat type 2 diabetes. Later, it was approved for weight loss under the brand name Wegovy. These medications don’t directly impact fertility, but they can help improve it indirectly, especially in women with conditions like obesity, insulin resistance, or PCOS.

By improving insulin sensitivity and supporting weight loss, semaglutide can help restore ovulation and regulate cycles, increasing the chances of natural conception for some women.

‍

Can someone get pregnant while taking Ozempic?

Dr. Makhija:
Yes. Ozempic does not prevent pregnancy. Because it can restore ovulation, people who previously weren't ovulating regularly may conceive while taking it, sometimes unexpectedly.

‍

Is it safe to take Ozempic during pregnancy?

Dr. Makhija:
No, it is not considered safe to use during pregnancy. While we don’t have human studies for ethical reasons, animal studies suggest a risk of fetal harm, including organ development issues and increased fetal mortality. If someone becomes pregnant while taking Ozempic, they should stop the medication and consult their doctor.

‍

What’s the recommended timeline for stopping Ozempic before trying to conceive?

Dr. Makhija:
The American College of Obstetricians and Gynecologists recommends stopping Ozempic at least 8 weeks before attempting conception. That gives the body time to fully clear the medication and reduce any risk of fetal exposure.

‍

Can Ozempic affect male fertility?

Dr. Makhija:
Ozempic doesn’t directly negatively impact male fertility. It doesn’t alter testosterone, estrogen, or pituitary function. In fact, for men with type 2 diabetes or obesity-related low testosterone, weight loss from GLP-1 medications can improve hormone levels and sperm quality, potentially boosting fertility.

‍

What is an “Ozempic baby,” and is that a real medical term?

Dr. Makhija:
It’s not a clinical term; it’s a media buzzword. It refers to pregnancies that happen after starting Ozempic, often unexpectedly, due to improved ovulation and fertility. It reflects the drug’s indirect effects on reproductive health but has no official medical meaning. Hence, clinicians should have this conversation if prescribing to women in the reproductive phase of their lives and recommend precautionary measures to avoid pregnancy.

‍

What happens if someone becomes pregnant on Ozempic?

Dr. Makhija:
They should stop taking it and consult their doctor. There are no specific tests for Ozempic exposure; however, their care team can monitor the pregnancy closely through ultrasounds and other screenings. It’s also important to ensure proper nutrition, as low caloric intake, familiar with GLP-1s, can affect fetal development.Your doctor can help you safely discontinue the medication and recommend alternative methods for managing blood sugar and weight during pregnancy.

‍

Can patients continue Ozempic while preparing for IVF or IUI?

Dr. Makhija:
Yes, patients can typically continue GLP-1 medications like Ozempic during the early planning and evaluation phase of fertility care, including genetic testing and initial consultations. However, anesthesiologists recommend stopping the medication when IVF stimulation medications begin, about two weeks before egg retrieval. This is due to the risk of delayed gastric emptying, a known side effect of GLP-1s, which can increase the risk of aspiration under anesthesia.

‍

If patients are planning to freeze all embryos for genetic screening (PGT), a longer washout period isn't necessary at this stage. However, when preparing for a frozen embryo transfer (FET) and planning for pregnancy, they should discontinue GLP-1 medications at least 8 weeks before conception to ensure the medication is fully cleared from the body.

‍

For patients taking it to manage diabetes, it’s essential to plan ahead with their doctor to switch to a safer alternative, such as insulin, before moving forward with fertility treatment.

‍

What other medications are in the same class as Ozempic?

Dr. Makhija:
Ozempic belongs to a class of medications called GLP-1 receptor agonists. These drugs mimic a naturally occurring hormone that helps regulate blood sugar, insulin levels, and appetite. While Ozempic is commonly known for its role in treating type 2 diabetes, and increasingly, its off-label use for weight loss, there are several other medications in the same class that work similarly.

‍

Here are some commonly used GLP-1 receptor agonists in injectable formulation:

‍

• Wegovy (semaglutide): Contains the same active ingredient as Ozempic but is FDA-approved specifically for weight loss.
  
  
• Mounjaro (tirzepatide): A dual GIP and GLP-1 receptor agonist approved for type 2 diabetes. Its weight loss counterpart is Zepbound.
  
  
• Trulicity (dulaglutide): A weekly injection used for type 2 diabetes management.
  
  
• Victoza (liraglutide): A daily injectable for type 2 diabetes; Saxenda is the version approved for weight loss.
  
  

• Bydureon BCise (exenatide ER): A once-weekly injection, generally less potent than newer options like semaglutide.
  
  

All have similar mechanisms but differ in dosing, side effects, and insurance coverage.

‍

Final Thoughts

Medications like Ozempic come with questions and risks that deserve thoughtful, personalized guidance. We're grateful to Dr. Makhija for helping break down this complex topic and reaffirming the importance of collaborative care.

‍

If you’re planning a pregnancy or considering fertility treatment while using a GLP-1 medication, talk to us. We’re here to help you navigate your options safely, confidently, and with compassion.

‍

Related reading

Check out our preview blog on this topic, Does Ozempic affect fertility? What you need to know and don’t miss Dr. Makhija’s podcast, which will feature an interview with Dr. Segal soon!

‍

About Dr. Chhaya Makhija, M.D., DipABLM, Unified Endocrine & Diabetes Care

Dr. Chhaya Makhija is a leading endocrinologist and lifestyle medicine specialist with over 20 years of clinical experience and a passion for prevention-focused, patient-centered care. She is triple board-certified in Endocrinology, Diabetes & Metabolism; Internal Medicine; and Lifestyle Medicine, and also holds a certification in plant-based nutrition from eCornell.

‍

In 2021, Dr. Makhija founded Unified Endocrine and Diabetes Care, the first direct care private practice in California to integrate endocrinology and lifestyle medicine. With offices in Fresno and the Bay Area, her boutique practice offers patients personalized care, direct access, and a holistic approach to managing hormonal and metabolic conditions.

‍

Dr. Makhija’s clinical expertise includes thyroid disorders and thyroid cancer, Type 2 diabetes prevention and management, PCOS, metabolic syndrome, and osteoporosis. Her care model blends advanced diagnostics with evidence-based lifestyle interventions, including nutrition, movement, mindfulness, and behavior change.

‍

A dedicated educator, Dr. Makhija serves as Adjunct Associate Professor at California Health Sciences University and Assistant Clinical Professor at UCSF Fresno, where she trains the next generation of physicians. She previously spent over eight years at Sierra Endocrine Associates and is widely recognized as a premier specialist in California’s Central Valley and Bay Area.

‍

Dr. Makhija’s mission is to empower patients to understand their bodies, reverse chronic conditions when possible, and build long-term wellness, supporting not only individual health but also healthier families and communities.

‍

________________________

Proudly Supporting Local Communities
Collab Fertility is honored to serve families in the East Bay like Danville, Alamo, Orinda, Lafayette, Moraga, Piedmont, and Walnut Creek, as well as many other communities in the Bay Area and beyond, including Oakland, San Ramon, Concord, Pleasant Hill, Santa Rosa, Novato, Napa, Sonoma, and more.

‍

‍

‍

‍