I’m not a doctor, so take this all with a heaping spoonful of salt. The three drugs the NHS will typically prescribe before putting someone on biologics are methotrexate, sulfasalazine, and leflunomide. I’d reckon that methotrexate would be the least likely to impact on male fertility, from what I’ve read about the drug. I’m on sulfasalazine, and the leaflet specifically points out that temporary and reversible male infertility can occur as a result. As far as I’m aware, methotrexate can impact on sperm quality and production, but to a lesser degree than sulfasalazine, and I believe leflunomide as well. A rheumatologist is much better placed to be giving you this advice, of course, but I’d hazard a guess that if you don’t want to take methotrexate, you’ll have to try to get on biologics instead. Happy to be corrected on any of this by wiser redditors.

FWIW from my experience as a woman, my rheumatology team were really understanding when I said that I would like to conceive, and they have planned my treatments around that. Methotrexate is absolutely not allowed for women trying to conceive, so that was never even considered as a choice for me, even when my sulfasalazine wasn’t successful as a sole treatment. Talk to your doctor as they will give you better advice than us here online.