In women, GLP-1 agonists can actually increase fertility by improving ovulation in those with obesity-related anovulation or PCOS. This has led to unplanned pregnancies—sometimes called "Ozempic babies." In men, current evidence doesn't show significant negative effects on sperm quality or testosterone, though large long-term studies are limited. If you're actively trying to conceive, discuss timing with your doctor. If you're not trying to conceive, be aware that weight loss can make you more fertile than before.