Pregnancy Planning on GLP-1s: Stop Timelines and Safer Conception Windows.

TL;DR

Use label-backed stop windows when available. Otherwise use a conservative washout based on half-life (≈5 half-lives). Normalize nutrition and hydration before trying. Stop immediately if pregnancy occurs.

Exact Stop Windows by Medication

• Semaglutide (Wegovy, Ozempic, Rybelsus): Stop ≥2 months before trying. Long half-life and tissue persistence.

• Tirzepatide (Zepbound, Mounjaro): Plan ≥1 month before trying based on clearance. If you use oral birth control, use a barrier for 4 weeks after starting and after each dose increase.

• Dulaglutide (Trulicity): Plan ≈1 month.

• Liraglutide (Saxenda): Plan ≥1 week.

• If pregnancy is recognized at any time: discontinue and contact your clinician.

Why the spread? Semaglutide persists longer. Liraglutide clears fastest. Weekly injectables sit in the body longer than daily.

Side-Effect Reality During Wind-Down

Most side effects are GI and dose-related. Plan so you are symptom-free before trying.

Common while tapering or right after stopping

• Nausea or reflux after heavier meals

• Constipation or, less often, loose stools

• Early fullness that fades as appetite returns

• Headache if dehydrated

Reduce the noise

• Taper if possible: Step down for 2–4 weeks instead of stopping at a peak dose.

• Meals: 4–6 small, protein-first meals. Go light on fried or very fatty foods.

• Hydration: 2–3 L/day. Add electrolytes on high-nausea days.

• After-meal walks: 10–15 minutes lowers reflux and bloat.

• Over-the-counter aids: Short courses for reflux or nausea if your clinician agrees.

• Red flags: Severe, persistent upper-abdominal pain, repeated vomiting, dehydration, fever with right-upper-quadrant pain, yellowing skin/eyes, black stools → seek care.

ScriptScores™: Family-Planning Fit (0–100)

Higher = simpler timing, fewer side-effect days during washout, clearer guidance.

Weights: required stop interval 45%, label clarity 35%, washout side-effect burden 20%.

*Tirzepatide has specific oral-contraceptive guidance during dose escalations, which improves clarity but lengthens planning.

How to use this table

• Want the shortest off-drug window? Liraglutide and dulaglutide rank higher.

• Want the clearest label direction? Semaglutide is explicit but demands the longest stop.

Week-by-Week Planner

T-8 to T-6 weeks

• If on semaglutide, target your last dose now.

• Begin prenatal vitamins, iron if needed, DHA.

• Book preconception visit and labs if you haven’t.

T-5 to T-4 weeks

• If on tirzepatide or dulaglutide, plan last dose.

• If you rely on oral birth control and used tirzepatide, keep a barrier method for 4 weeks after your last dose increase before trusting pills alone.

T-3 to T-2 weeks

• If on liraglutide, wrap up now.

• Normalize meals, sleep, bowel habits. Track nausea days; aim for zero.

T-1 to T-0 weeks

• Green-light trying once you have 1–2 symptom-free weeks with normal hydration and regular meals.

If positive test at any point

• Stop the medication and contact your clinician.

Side-Effect Playbook for Sensitive Stomachs

• Micro-steps: If your program allows, use smaller dose drops to avoid rebound.

• Trigger audit: High-fat meals and alcohol are the usual culprits for next-day nausea.

• Constipation protocol: Fluids, cooked produce, gentle soluble fiber; consider a stool softener if cleared by your clinician.

• Diarrhea protocol: Pull back on fats and lactose; rehydrate.

FAQ

Do I need to wait a full cycle after the stop window?
Not required by labels. Many wait until they feel fully normalized for 1–2 weeks.

Can I breastfeed on these medications?
These drugs are generally not used while breastfeeding; discuss safer alternatives.

Will stopping affect weight quickly?
Some appetite returns. Keep protein high, plan meals, and walk after eating to reduce rebound.

What about PCOS or insulin resistance?
Coordinate with your clinician on non-GLP-1 options during preconception and pregnancy.

Safe-to-Try Checklist

• Completed stop window for your medication

• Zero nausea days for 1–2 weeks

• Normal hydration and bowel routine

• Prenatal vitamins started

• Contraception transition planned if relevant to tirzepatide

Disclaimer: Educational content, not medical advice. Use these timelines to structure a plan with your own clinician.