IgA nephropathy (IgAN) is the most common cause of primary glomerulonephritis, with complex pathogenic mechanisms involving abnormal B cell activation. As a novel biologic agent, Telitacicept inhibits both B-lymphocyte stimulator and a proliferation-inducing ligand, can reduce B cell-mediated autoimmune responses, suppressing the production of galactose-deficient IgA1 and thereby inducing disease remission. Women with IgAN are at a higher risk of adverse pregnancy outcomes such as preeclampsia and miscarriage, especially those with uncontrolled massive proteinuria and advanced chronic kidney disease. Therefore, IgAN disease control before and during pregnancy is essential. We report the case of a female patient who was effectively treated with Telitacicept and subsequently successfully conceived. This case report also reviews the characteristics and outcomes of pregnancy in patients with IgAN and explores the value of Telitacicept in women of childbearing age, suggesting effective and safe treatment options for women who wish to conceive.