Ozempic and IVF Cycle Timing: The 2026 Guidance

By late 2025, GLP-1 medications (semaglutide/Ozempic/Wegovy, tirzepatide/Mounjaro/Zepbound, and compounded versions) had become the single most-taken class of medications among IVF patients presenting for cycles. This wasn't planned; it reflects the broader population's rapid adoption of these medications for weight loss and diabetes. It created a specific clinical question that every REI now faces: how do you handle GLP-1 medications around egg retrieval?

This piece walks through the current 2026 guidance from anesthesia and reproductive medicine societies, the specific concerns during retrieval, and what patients should discuss with their prescribing physicians before starting an IVF cycle.

Why GLP-1 Medications Matter for IVF Anesthesia

GLP-1 medications slow gastric emptying — that's part of how they produce the fullness and appetite reduction that drives weight loss. In routine daily life, slower gastric emptying isn't a safety issue. During anesthesia for a procedure like egg retrieval, it becomes one.

Anesthesia lowers the reflexes that normally prevent stomach contents from being aspirated (breathed in) if regurgitation occurs. A patient with delayed gastric emptying may have retained food or fluid in the stomach even after standard fasting periods — leading to aspiration risk during anesthesia.

Egg retrieval is typically performed under IV sedation or general anesthesia. The risk of retained gastric contents in a GLP-1 user is real, which is why the pause protocol matters.

The Current 2026 Guidance

The American Society of Anesthesiologists (ASA) issued preliminary guidance in 2023 and updated it in subsequent years. As of 2026, the general framework:

These are general framework guidelines. Individual programs and anesthesiology teams may have slightly different specific protocols. Follow your program's specific instructions.

What Restarting Looks Like

Restart timing is typically determined by your prescribing physician (endocrinologist, primary care, or weight-management specialist), not your REI. Common practice:

• Weekly injectable: resume normal schedule the week after retrieval
• Daily formulations: resume 24–48 hours after retrieval, once you're eating normally
• If pregnancy occurs, discontinue GLP-1 medications entirely per current pregnancy contraindication guidance

What the Evidence Supports About Fertility Effects

The Coordination Problem

IVF cycles typically involve multiple physicians:

• Your reproductive endocrinologist (REI)
• Your prescribing physician for GLP-1 medication (endocrinologist, PCP, weight-management clinic)
• The anesthesiologist performing egg retrieval

None of these physicians has complete visibility into what the others are doing unless you explicitly coordinate. Common failure mode: patient reports GLP-1 use to REI but forgets to mention to prescriber that IVF is planned, or vice versa. Result: no coordinated pause protocol, potential anesthesia complications.

Should You Stay on GLP-1 During IVF at All?

This depends on why you're taking it and your specific case.

Weight-loss maintenance context

Patients who have achieved significant weight loss on GLP-1 medications and are maintaining that loss face a specific decision: pausing the medication for IVF often produces rebound weight gain during the cycle, which some patients want to avoid. The pause protocol addresses only the retrieval anesthesia risk; whether to remain on the medication generally during the IVF process is a separate discussion with your prescriber.

Diabetes management context

Patients on GLP-1 medications for type 2 diabetes management face different considerations. Blood sugar control matters for IVF outcomes; abrupt medication changes can affect that. Coordinate with your endocrinologist about alternative diabetes management during the cycle if the standard medication is being paused.

Pre-conception weight optimization

Some patients use GLP-1 medications specifically to lose weight before IVF, then plan to discontinue before conception. This can be a legitimate strategy but requires realistic timing — discontinuation should occur before the IVF cycle rather than during it in most cases.

Colombia-Specific Considerations

Colombian IVF programs are current with international anesthesia society guidance on GLP-1 medications. The specific pause protocols vary somewhat between programs but generally follow the ASA framework.

For international patients traveling to Colombia:

• Coordinate the pause with your U.S. or Canadian prescribing physician before travel — ensure the medication is paused at the appropriate time before your retrieval date
• Bring a written list of your current medications (in English or Spanish) for your Colombian care team
• Discuss restart timing before returning home so your prescribing physician can pick up the plan

Colombia holds the WHO's #1 healthcare ranking in the Western Hemisphere and #22 globally per the 2000 World Health Report. Six Colombian hospitals hold JCI accreditation. Anesthesiology at accredited facilities follows current international guidelines including on GLP-1 medications. Verifying that your IVF program uses appropriately trained anesthesiologists registered with ReTHUS (rethus.gov.co) is worth doing at consultation.