Recently, more and more women are asking, “Can I have a second child? Today, another old patient came to ask solemnly, “Can I have another child? I had to think seriously about this question. How should I answer the question to give the counselor more feasible guidance or insight? Today’s consultant is 48 years old, has regular menstruation, heavy periods, moderate anemia, and a past history of fibroids and adenomyosis. First of all, as long as you have a regular natural menstrual cycle, you have a chance to have a second child, regardless of your age. The second thing is that the older you are, the less chance you have of conceiving, so you should not be in a hurry and let nature take its course. Once you get pregnant, you should go to the hospital to see if it is a normal intrauterine pregnancy, and to rule out ectopic pregnancy before continuing the pregnancy. This is because as a woman’s age increases the chance of abnormal pregnancy, such as ectopic pregnancy and gravidity, increases. During the continuation of pregnancy, it is important to insist on regular checkups for early detection of pregnancy complications, timely diagnosis and timely treatment. This is because as women age, the incidence of complications during pregnancy increases rapidly and the rate of refractory disease increases significantly, even at the risk of costing lives. In addition, the incidence of complications during delivery also increases significantly, especially the chance of postpartum hemorrhage due to placental residue, placental adhesions, and weak uterine contractions. Third, for the fetus, as the mother’s age increases, the possibility of conceiving an abnormal fetus also increases significantly, and the rate of spontaneous abortion and birth defects increases significantly. Do you have the appropriate psychological preparation and financial reserves in case a child with a congenital disease is born?! Fourth, the treatment of the mother’s current disease is also a matter of concern, such as anemia, the cause of which should be actively identified and treated as fundamental; then again, fibroids, which generally grow in the direction of the uterine cavity, will affect conception and should be dealt with first, while adenomyosis will not necessarily affect conception and can be left untreated for the time being. Fourth, what tests should be done before preparing for pregnancy? First of all, general routine checkups are necessary, such as blood pressure, heart rate, weight and height measurement. Secondly, routine auxiliary examinations are also necessary, such as liver, gallbladder, spleen, pancreas and kidney ultrasound, thyroid and breast ultrasound, gynecological ultrasound, etc. There are also some routine tests, such as blood biochemistry, blood routine, thyroid function and gonadal hormone tests, and the four eugenics tests. If all these tests are passed and no conception occurs within one year, it is considered secondary infertility and further investigation of the cause is needed. In summary, the influx of older mothers in clinical medicine is a rare opportunity and a serious challenge. For women and their families who are ready to have a second child, it will be a long and adventurous journey, facing a dilemma and a life and death test at any time. Are you ready?