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January 2, 2024
GLP-1 agonist medications such as Ozempic, Wegovy, or Mounjaro are prescribed for diabetes management and weight loss. Excess weight and diabetes both impact sperm health and your ability to create a healthy pregnancy. Can managing these conditions with medication improve male fertility?
In this article, we will examine medications like Ozempic, Wegovy, and Mounjaro to understand their impact on sperm health, and whether you should take these medications while you’re trying to conceive.
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Ozempic, Wegovy, Mounjaro and similar weight loss and diabetes medications are GLP-1 (glucagon-like peptide 1) agonists/GLP-1 receptor agonists. GLP-1 is a hormone that’s released from the small intestine when we eat, and is responsible for increasing insulin. GLP-1 regulates blood sugar and digestion, as well as whether we feel “hungry” or “full.”
An “agonist” is a medication that mimics the action of a particular hormone — so in layman’s terms, GLP-1 agonists and receptor agonists mimic the actions of GLP-1 produced naturally in our bodies. Medications such as Ozempic slow digestion, lower blood sugar, and keep hunger levels at bay by maintaining a feeling of fullness between meals. This, in turn, contributes to weight loss and helps patients manage type 2 diabetes.
Ozempic is just one of the brand names for GLP-1 agonist medications, specifically semaglutide. Other medications in this category include:
You might be prescribed Ozempic, Mounjaro, or Wegovy by your doctor if:
Having diabetes does not necessarily mean you will experience infertility. However, for those who are not managing their diabetes well — or when there are corresponding lifestyle factors, such as a poor diet — the chances of infertility are greatly increased.
There are a number of ways diabetes can affect male fertility:
There is an established connection between obesity and male infertility. Obesity has been linked to many negative effects on male fertility, including:
Repeated research, outlined in one review of 9 studies, has found that:
Another review of 21 studies and over 13,000 men delved deeper into the connection between body weight and sperm count, finding that overweight and obesity was a risk factor for low sperm count and azoospermia, a condition in which no sperm is found in the semen. A separate study of nearly 4,00 sperm donors found that both underweight and overweight men had, on average, lower total motile sperm counts than men of normal weight.
One set of researchers speculate that it “is possible that the increasing prevalence of overweight and obesity accounts for a portion of the trend… of decreasing sperm counts over recent decades.” Additional studies have found that obese men typically have lower-than-normal testosterone levels.
These changes in sperm quality and hormone health do seem to impact likelihood of getting pregnant. One study found that obese couples take, on average, longer to get pregnant and are more likely to experience infertility. In another study, researchers found that birth rates were lower in couples with an overweight or obese male partner, even if the female partner’s weight was normal.
Will medications like Ozempic improve male fertility? Since these medications are fairly new, research is quite limited. Here’s what we know about weight loss and sperm health.
The first important thing to note is that, for overweight and obese patients, losing weight has been shown to improve male fertility health.
In one study of 43 obese men, weight loss was associated with an increase in total sperm count, semen volume, and testosterone levels. The group with the largest weight loss — 17–25% of total body weight — had a statistically significant increase in total sperm count and normal sperm morphology, the percentage of sperm that are the proper size and shape.
A case study of 6 obese, infertile men had promising results for the improvement of sperm DNA fragmentation. After several months of a lifestyle program, all 6 men lost abdominal fat, their level of sperm DNA fragmentation decreased, and all 6 of their partners got pregnant and had live births. Another study found similar results — a significant improvement in sperm DNA fragmentation after study participants lost weight.
A 2022 randomized controlled trial looked at the effect of weight loss on fertility and found that a significant weight loss improved sperm parameters. The 8-week study prescribed a low-calorie diet to achieve an average weight loss of 36 lbs. This weight loss resulted in an increase in sperm concentration of around 150%.
A recent review published by the team of Dr. Ranjith Ramasamy, a renowned male fertility urologist, examined the evidence around the use of GLP-1 agonist medications and their impact on sperm health. Their review looked at lab studies, animal studies, and human studies. Some findings highlighted in the review:
The bottom line? Wegovy and other weight loss medications effectively help people lose weight, and that losing weight can improve male fertility. We don’t yet know if these medications can improve male fertility aside from facilitating weight loss.
As of early 2024, there’s a lack of evidence specifically investigating the long-term effects of Ozempic and other GLP-1 agonist drugs on fertility or pregnancy.
If you’re taking Ozempic, Wegovy, or Mounjaro — or thinking about starting a GLP-1 agonist medication — and you’re trying to conceive or thinking about starting a family, talk to your doctor. They may recommend caution in the form of a period of 2–3 months between stopping the medication and trying to conceive.
The best way to understand how your sperm health is affected — for better or for worse — by weight loss or weight loss medication is to complete a semen analysis. This test will assess sperm count as well as additional measures of sperm health:
Legacy offers easy at-home sperm testing, so you can start understanding your sperm health today. Get started.
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