Female fertility declines gradually with age, especially after the age of 32 and more rapidly after the age of 37. Education and awareness of the impact of age on fertility is critical for women who are fertile. Given the decline in fertility with age, the increased incidence of conditions that impair female fertility, and the increased risk of pregnancy loss, women >35 years of age should be evaluated and treated quickly if they have been trying for more than 6 months to conceive. Women >40 years of age should be evaluated and treated promptly. Environmental, physiological, pathological, social and other factors influence the fertility of people. Age-related fertility in women is mainly reflected in ovarian reserve function and follicular age, for which the American College of Obstetricians and Gynecologists and the American Society for Reproductive Medicine formed a consensus on age-related female fertility loss in 2014. 1. For women with fertility requirements, increased education and awareness of the impact of age on fertility Naturally, as age increases, the number of oocytes in the ovary decreases through a spontaneous and progressive reduction and depletion by the process of atresia. The maximum number of oocytes in the ovary of a female fetus at 20 weeks of gestation is 6 to 7 million. The number of oocytes decreases to nearly 1 to 2 million at birth, to 300,000 to 500,000 at puberty, to 25,000 at age 37, and to 1,000 at age 51 (51 is the average age of menopause in the United States) [1-3], until the depletion of oocytes occurs with menopause. The normal female reproductive life is 20 years, of which 25 to 35 years is the optimal reproductive age, with increasing female fertility decreasing gradually with age, mainly in the form of a decrease in physiological ovarian reserve function. The decline is especially pronounced after 35 years of age. Since the number of eggs in the female ovary cannot be accurately measured, age combined with ovarian reserve (e.g., sinus follicle count, anti-Mullerian hormone and egg quality to describe a woman’s fertility potential) is currently a better method to comprehensively evaluate ovarian function. The underlying causes are not only related to a decrease in the number of fertile follicles retained in the ovary, but also to a decrease in egg quality, as evidenced by elevated follicle stimulating hormone (FSH) levels, anti-mullerian hormone and inhibin B levels, which lead to a decrease in egg quality. The mechanisms underlying this decrease remain unclear. The mechanisms involved remain unclear, but appear to include a variety of associated factors encoded by genes on the X chromosome as well as autosomes. Therefore, it is important to increase education for women with fertility requirements to fully understand the importance of the gradual decline in fertility with increasing female age and to evaluate and treat the fertility of infertile women as early as possible. 2. Women aged >35 years should receive rapid evaluation and treatment if they have been trying to conceive for more than 6 months. Fertility declines with increasing age, especially in women aged >35 years, and more rapidly after the age of 37 years, mainly related to a decrease in the number and quality of eggs, as well as an increased risk of other diseases affecting fertility, such as uterine fibroids (mainly affecting the uterus endometrium and fallopian tubes), fallopian tube disease and endometriosis. In particular, women with a history of surgery, radiation or chemotherapy to the ovaries and fallopian tubes, a history of severe endometriosis, a history of smoking, pelvic infections or a family history of early menopause are also at significantly increased risk of early follicular pool reduction and decreased fertility. Moreover, age-related fertility loss is accompanied by a significant increase in aneuploidy and spontaneous abortion rates, with autosomal trisomy being the most common form of aneuploidy, including multiple lethal chromosome trisomies, Down syndrome and other chromosome trisomies, which occur in part due to spindle non-segregation. Even when morphologically normal embryos are selected for IVF transfer, the incidence of embryonic aneuploidy remains high in women of advanced age. The results of one study showed that the rate of embryonic chromosomal aneuploidy increased significantly with increasing female age, with rates of 4%, 9.4%, and 37.2% in three groups of patients aged 20 to 34, 35 to 39, and 40 to 47 years, respectively. The incidence of fetal heart tube beats detected by transvaginal ultrasound and fetal loss was also significantly higher. the incidence of fetal heart beats detected at 7 weeks after gestation of transferred fresh embryos in IVF cycles but final abortion was 9.9% in women <33 years, 11.4% between 33 and 34 years, 13.7% between 35 and 37 years, 19.8% between 38 and 40 years, 29.9% between 41 and 42 years, and 36.2% between >42 years The percentage was 36.6% for >42 years old. These data are similar to nationwide statistics on the trend of increasing miscarriage rates in IVF cycles (13% for age <35 years and 54% for age >44 years). This shows that women’s fertility decreases with age, the incidence of fertility-impairing diseases increases, and the risk of pregnancy loss rates increases, especially for women >35 years of age, not only because of the ongoing atresia of the oocytes, but also because of the significant decrease in oocyte quality and increased rate of chromosomal abnormalities before the onset of perimenopausal menstrual disorders. Therefore, women should be evaluated and treated for infertility before the age of 35 years, and for women aged >35 years should receive rapid evaluation and treatment. 3. Women aged >40 years should be evaluated and treated more promptly Although infertility is defined as no pregnancy for more than 1 year without contraception, it may take more than 1 year for a normal woman of advanced age to become pregnant. Therefore, the consensus states that it is essential for women >35 years of age to be evaluated early for the possibility of pregnancy and to receive rapid infertility testing and assisted conception treatment in cases of unsuccessful attempts for more than 6 months; and even more so for women >40 years of age to receive timely infertility testing and assisted conception treatment. In a classic French study, the effect of age on female fertility was studied by using donor insemination for healthy women with azoospermia, which found that with increasing age, the pregnancy rate of women undergoing artificial insemination gradually decreased: after 12 cycles of artificial insemination, the cumulative pregnancy rate of women aged <31 years reached 74%, and the cumulative pregnancy rate of women aged between 31 and 35 years dropped to 62%. The cumulative pregnancy rate decreased to 62% for women aged 31-35 years and 54% for women aged >35 years after 12 IUI cycles. The 2012 Centers for Disease Control (CDC) Assisted Reproductive Technology (ART) annual report in the United States analyzed data from in vitro fertilization-embryo transfer (IVF-ET) treatments and obtained the same results: the live birth rate after IVF for women aged <35 years was 41.5%, 31.9% for women aged 35 to 37 years, and 22% for women aged 38 to 40 years. The live birth rate for women aged 38-40 years was 22.1%, for women aged 41-42 years was 12.4%, for women aged 43-44 years was 5%, and for women aged >44 years was 1%. In contrast, the live birth rate after IVF with oocytes from healthy young women was as high as 51%, regardless of the age of the recipient. As women age, not only does the decrease in egg quantity and quality severely affect fertility and reduce live birth rates, but maternal age may increase the risk of pregnancy, such as spontaneous abortion, embryonic aneuploidy, and increased incidence of birth defects, as well as a significant increase in the risk of hypertensive disorders of pregnancy and related complications (e.g., gestational diabetes, preterm delivery, low-birth-quality infants, and stillbirths). Numerous studies have shown an increase in the incidence of significant cytogenetic abnormalities in live births with increasing maternal age. The incidence of stillbirth after pregnancy is 4% in women aged 20-29 years compared to 10% in women aged >40 years. Therefore, infertile women aged >40 years should receive timely infertility evaluation and treatment in order to reduce the risk of pregnancy and improve fertility.