Collecting this in one place because it comes up every few weeks and the answer is always assembled from scratch. It is about fertility and pregnancy, and it is deliberately narrow — everything I am not confident about is marked as such.
What is actually established
The class is not used in pregnancy, and the practical points are a washout before conception and the fact that reduced appetite is not contraception. Improved insulin sensitivity in PCOS can restore ovulation, so fertility frequently increases as a side effect — people conceive unexpectedly on these drugs, which is a reason to sort contraception out at the start rather than after.
The condition it depends on
Washout intervals differ by agent because half-lives differ. That is a conversation with a prescriber, not a forum number.
What I am not sure about
What I actually want to know is what the washout thinking is before trying to conceive, and why nobody mentions that fertility often increases as a side effect. I would rather have one careful answer than five confident ones.
PedsEndoPhilly said:The class is not used in pregnancy, and the practical points are a washout before conception and the fact that reduced appetite is not contraception.
PedsEndoPhilly said:...everyone should be on fertility and pregnancy...
I understand the enthusiasm, but "everyone" is too broad. Contraindications exist: personal/family history of MTC or MEN2, history of pancreatitis, pregnancy/breastfeeding, and certain GI conditions.
Beyond contraindications, clinical judgment matters. A 22-year-old with BMI 28 and no comorbidities has a different risk-benefit calculation than a 55-year-old with BMI 38 and metabolic syndrome.
Let's advocate for ACCESS without advocating for UNIVERSAL use. They're different things.
PedsEndoPhilly said:The class is not used in pregnancy, and the practical points are a washout before conception and the fact that reduced appetite is not contraception.
Pushing back on PedsEndoPhilly here. The objection nobody has made: this only works if the measurement is doing what we assume it is doing, and that assumption has not been tested here.
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View ResultsTaking the question as asked, rather than the general version of it. Whatever the answer turns out to be, the method for getting there is the same: state the assumption, do the arithmetic in public, and invite the correction. That is slower than asserting, and it is the only version that survives being wrong.
If somebody has the primary source to hand I would rather cite it than paraphrase it.
Dr.BariatricHTX said:PedsEndoPhilly said: ...everyone should be on fertility and pregnancy...
Adding a me-too, because a thread of one person's experience is not much use.