Research objective: The aim of this study is to provide a comprehensive and systematic overview of the impact of different classes of psychotropic medications on male and female fertility. Based on the currently available data, the hypothesis is that certain classes of psychotropic medications may have adverse effects on male and female fertility. Materials and methods: The research conducted for this final specialist paper was of a theoretical nature and involved a detailed review of professional and scientific literature on the impact of psychotropic medications on fertility. Data on indications, mechanisms of action, and studies on the effects on fertility were collected. Available books in this field, the Croatian Agency for Medicinal Products and Medical Devices (HALMED) and the European Medicines Agency (EMA) databases, publications from professional associations and institutions, scientific articles, and other relevant sources were searched. Keywords used for database searches (PubMed, UpToDate, ScienceDirect, Cochrane, Google Scholar) included terms such as antidepressants, antipsychotics, anxiolytics, bipolar disorders, mood stabilizers, lithium, fertility, fecundity, benzodiazepines, psychiatric illness, psychotropics, schizophrenia, hypnotics, side effects, reproductive system, etc. The collected data from the literature review were organized, processed, and presented in an interpretive manner. Results: Research indicates that certain antipsychotics can cause hyperprolactinemia as a side effect, which can lead to reproductive system problems and reduced fertility in both males and females. Studies have shown that risperidone, paliperidone, and haloperidol are the most common causes of hyperprolactinemia, while the risk is very low with aripiprazole. IV There is limited research on the impact of anxiolytics, sedatives, and hypnotics on fertility, and the existing results are inconclusive, making it difficult to draw definitive conclusions about their effects on fertility. Sexual dysfunction as a side effect of antidepressants can have a negative impact on reproduction, but further research is needed to confirm the effects of antidepressants on fertility. According to current data, selective serotonin reuptake inhibitors (SSRIs) have a negative impact on fertility, while data on other classes of antidepressants are scarce. Currently, there is no evidence suggesting a negative impact on fertility in women for medications such as lithium and carbamazepine, but some studies suggest a negative effect on sperm quality in males. Regarding valproate, data indicate a negative impact on reproductive health in humans. Conclusions: Mental disorders represent a significant burden on the healthcare system, with an estimated one in eight individuals suffering from a mental disorder. It is important to note that most mental disorders first emerge at a younger age, meaning that individuals affected are in their reproductive years and may be considering starting a family. The selection of therapy for patients of reproductive age with mental disorders is challenging. Factors such as the patient's current condition, therapeutic goals, and desires for starting a family should be taken into account. If a patient plans to start a family, medication with the least potential for adverse effects on fertility should be chosen.