In clinical work, many patients with ankylosing spondylitis are very concerned about the topic: Does ankylosing spondylitis affect fertility? This is completely understandable, because the age of onset of ankylosing spondylitis is mostly concentrated in young men, and most young patients are not yet married. Naturally, this issue of passing on the family name to the next generation is a concern that is of particular importance to our patients with ankylosing spondylitis. At present, there are really not many studies conducted in this area, especially in women with ankylosing spondylitis, which is also related to the fact that the disease is more prevalent in men. In brief, fertility is affected in two ways: 1. by the disease itself: sperm motility and viability are significantly reduced in patients with SpA. 2. 2, the impact of treatment drugs: in patients with ankylosing spondylitis, if improperly received some drugs that affect fertility, may lead to a decrease in sperm quality in men and amenorrhea in women. For example, salazosulfapyridine, which is commonly used, can reduce sperm in men and may lead to infertility with long-term application, but this effect is reversible and can be restored after discontinuation of the drug. Methotrexate, which causes congenital malformations mainly in the central nervous system, is a class X pregnancy drug and should be avoided by patients of childbearing age with ankylosing spondylitis who wish to have children. And although methotrexate treatment has been reported to be associated with oligospermia, it has also been reported in the literature that methotrexate has little effect on male sperm volume and motility, and on the basis of the limited data available to support this, it can be concluded that low doses of methotrexate appear to have only a mild effect on male fertility. There is also tretinoin, the application of which in female patients can lead to amenorrhea or infertility, and therefore female patients with fertility medications should avoid this drug. Of course, emotions such as pain, fatigue, anxiety and depression during the course of the disease can also affect the patient’s fertility to a greater or lesser extent. They should be actively treated under the guidance of a doctor to improve such symptoms and adjust their mindset to cope positively.