Long-term hemodialysis patients can have reduced fertility due to a variety of hormonal and some unspecified non-hormonal causes. Male infertility is more common in hemodialysis patients, with 50% of patients having reduced sperm count, reduced motility and morphological abnormalities. The incidence of testicular atrophy, interstitial fibrosis and testicular interstitial cell dyscrasia is significantly increased. Pregnancy in women with end-stage disease is rare, but with the improvement of dialysis protocols and techniques, the strengthening of prenatal care and the use of EPO in recent years, the number of reported pregnancies in women on dialysis has increased. Successful pregnancies are mostly seen in women who have conceived before dialysis treatment The success rate of pregnancy is as high as 88% for women who conceived before dialysis treatment, while the success rate for those who conceived after dialysis is only 50%. For women on dialysis during pregnancy, dialysis should be intensified to keep the BUN below 17.8 mmol/L to create a relatively good internal environment to ensure the normal development of the fetus. At the same time, the dialysis fluid composition should be adjusted, and the bicarbonate content in the dialysis fluid must be reduced to the ideal level of 25 mmol/L in order to avoid alkalosis. In addition, most pregnant women on dialysis deliver prematurely due to hypertension, high intrauterine pressure, intrauterine distress, and premature labor initiation, so they should be monitored for contractions as early as 24 weeks of pregnancy for early detection and timely treatment.