In addition to facing risks such as labor and delivery difficulties, older women who become pregnant may also encounter infertility problems. From the perspective of eugenics, the optimal age for women to have children is 25 to 28 years old; after the age of 35, ovarian function begins to decline, and the chances of ovulation abnormalities, endometriosis, tubal obstruction and pelvic inflammatory disease increase, which are all common causes of infertility. Therefore, for older women pursuing a second child, both men and women should undergo a thorough physical examination and assessment. From the perspective of reproductive health and infertility specialties, pregnancy requires four basic conditions, so fertility assessment needs to focus on four indicators. 1, the male partner’s sperm condition: we know that the fertilization of the egg by the combination of sperm and egg, sperm produced in the male testicles, through the coitus into the female vagina, cervix, uterus, fallopian tubes and other reproductive systems. Therefore, in order for the woman to have a normal pregnancy, it is necessary to ensure that the man’s sperm reaches a certain number and viability, so the semen test of the man is one of the main tests for fertility assessment. 2, the female partner’s ovarian function: for older women, facing the irreversible fact of ovarian function decline, especially for irregular menstruation, or even amenorrhea older women, in the process of preparing for the second child, it is very important to clarify the ovarian function and ovulation. Generally, patients are required to check hormones clearly and/or anti-mullerian tube test (AMH test) and ovulation monitoring on the 2nd to 5th day of menstruation. 3, the woman’s uterine environment: the uterus is the part of the embryo bed. Many women have had improper contraception before, resulting in unwanted pregnancy, and have to take abortion, or a child to take a cesarean section. All these may cause damage to the uterus, such as uterine infection, cervical or uterine adhesions, scarred uterus, etc., leading to secondary infertility. Therefore, older second-trimester women should have a good uterine ultrasound during the preparation process, and even a hysteroscopy if necessary. 4, the woman’s fallopian tube situation: the fallopian tube is a pair of slender and curved muscular tubes, located in the upper edge of the broad ligament of the uterus, the inner side of the uterus is connected to the corner of the uterus, the outer end of the free, and the ovary close to the ovary, the length of the whole is 8 to 14 centimeters. It is the only channel for sperm-egg binding. The fallopian tube has extremely complex and delicate physiological functions, playing an important role in egg pickup, sperm capacitation, egg fertilization, transport of fertilized eggs, and survival and development of early embryos. Once the fallopian tube is blocked, impassable, adhesion and fluid accumulation may lead to infertility. Therefore, tubalography is also used as an important part of the fertility assessment test.