Rheumatoid arthritis is systemic inflammatory disease, presenting as symmetrical polyarthritis, mainly affecting hands and feet. Female patients with rheumatoid arthritis have also decreased fertility and premature ovarian failure. Methotrexate is used in treatment of rheumatoid arthritis. However, single treatment of Methotrexate is not ideal and often needs to be combined with other drugs like Iguratimod for intensive treatment of refractory rheumatoid arthritis. We aim to explore efficacy of combined use of MTX and IGU for female patients with rheumatoid arthritis and its impact on ovarian reserve function. Total 80 female patients with moderate to severe active rheumatoid arthritis were selected and randomly divided into MTX and MTX + IGU groups. The MTX + IGU group showed lower levels of IL-1β, IL-6, IL-17 and TNF-α after treatment as compared to MTX group. The MTX + IGU group showed significantly higher level of AMH at the end of treatment. However, no statistical differences were observed in FSH, LH, E2 and AFC levels between the two groups. The combined therapy of MTX and IGU has better efficacy with less impact on ovarian function, even improving ovarian reserve function through effective control of rheumatoid inflammatory activity.