The review says that if you’re a woman of child‑bearing age using semaglutide (or similar GLP‑1 drugs) and you want to get pregnant, you should stop the drug well before trying – about 35 days for semaglutide and 25‑35 days for tirzepatide, based on how long they stay in the body. Early accidental exposure hasn’t shown clear birth defects, but the data are limited, so safer options like metformin, diet changes, or bariatric surgery are still preferred for pre‑pregnancy weight loss.

Obesity and associated metabolic disorders such as type 2 diabetes mellitus and polycystic ovary syndrome are rising globally, contributing to infertility and adverse pregnancy outcomes. This review synthesizes current evidence on pharmacokinetics, safety in preconception and early pregnancy, and clinical management strategies for glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy in women of reproductive age. Ethical and health system considerations are also explored to inform clinical practice and highlight future research priorities. A comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar identified 132 articles. After screening and full-text review, 9 studies met the inclusion criteria for synthesis. Semaglutide (~7 days) and tirzepatide (~5 days) have long half-lives, requiring discontinuation at least 35 days and 25-35 days, respectively, before conception, while liraglutide requires ≥3 days. Human data show no significant increase in congenital anomalies with inadvertent early exposure, although evidence is limited and observational. Alternatives such as metformin, lifestyle modification, and bariatric surgery remain safer options. GLP-1 RAs may aid preconception metabolic optimization; however, evidence remains limited and largely observational. Preconception discontinuation timed to each agent's half-life is prudent to minimize potential fetal exposure. Prospective studies and pregnancy registries are needed to confirm reproductive safety and refine guidance.