What is the choice of treatment for women with Graves’ disease before pregnancy? If a patient with Graves’ disease chooses surgical thyroidectomy or 131 iodine treatment, the following recommendations are made: (1) If the patient has a high TRAb titer and plans to become pregnant within two years, surgical thyroidectomy should be chosen. This is because TRAb remains high titers for several months after the application of 131 iodine treatment, which affects the quality of the fetus [57]; (2) 48 hours before 131 iodine nail elimination treatment, a pregnancy test is required to verify pregnancy to avoid the radiation effects of 131 iodine on the fetus; and (3) pregnancy should not occur until 6 months after thyroid surgery or 131 iodine nail elimination treatment. This stage is treated with L-T4 replacement therapy to maintain serum TSH at 0.3 to 2.5 mIU/L levels. If patients with Graves’ disease choose ATD treatment, the following recommendations are important: (1) methimazole (MMI) and propylthiouracil (PTU) have risks for both mother and fetus; (2) MMI has the risk of fetal malformation, so it is recommended to stop MMI and switch to PTU before planning pregnancy; PTU is preferred during T1 of pregnancy, and MMI is the second-line choice; (3) after T1, switch to MMI to avoid the occurrence of hepatotoxicity of PTU. Thyroid functional status during pregnancy is directly related to pregnancy outcome [58,59]. Poorly controlled thyrotoxicity is associated with miscarriage, gestational hypertension, preterm delivery, low birth weight, intrauterine growth restriction, stillbirth (fetal death at delivery), thyroid crisis, and maternal congestive heart failure [60]. Recommendation 7-4: Women with established hyperthyroidism should preferably become pregnant after thyroid function has been controlled to normal to reduce adverse pregnancy outcomes. (Recommendation level A)