Theoretically, the ideal time for pregnancy is after the condition has stabilized and antithyroid medications have been discontinued. However, a full course of drug treatment typically takes 1.5 to 2 years, with a cure rate of only about 50%, and the recurrence rate is high. Some patients, due to factors such as advanced age, simply cannot wait for an extended period before considering pregnancy. Therefore, it is also an option to become pregnant while on medication. It is important to ensure that thyroid function is controlled within the normal range before pregnancy, and the drug dosage should not be too high. For those taking methimazole, it is advisable to switch to propylthiouracil before pregnancy. The period between 6 to 10 weeks of gestation is the critical window when antithyroid drugs can cause birth defects. The incidence of malformations associated with methimazole and propylthiouracil is similar, but the severity is milder with the latter, so propylthiouracil is preferred in early pregnancy. Additionally, it is crucial to use the smallest effective dose of antithyroid medication to maintain thyroid function at the upper limit of normal or in a state of mild hyperthyroidism. Regular thyroid function tests should be conducted to adjust the dosage as needed. With active management of hyperthyroidism, having a healthy baby is entirely achievable.