With the liberalization of the second child policy, more and more senior women are joining the ranks of the second child, ready to take the last train of childbirth, and the news of celebrities giving birth to their second child at an advanced age as reported by major media has encouraged a large number of people to go to fertility centers to seek children. I always hear people around me saying that they are pregnant with their second child in their 40s, and that they got pregnant with twins through IVF at an advanced age. At this time of the year, it is always easy to flood people’s minds with positive news, encouraging them and making everything seem so good and easy. However, the reality is harsh: as women age, their fertility decreases. Even if the face is pretty and well maintained, the age of the ovaries is not fooling anyone. We also know that cohabitation, having a normal sex life, and not having contraception for more than 1 year without pregnancy is called infertility. Research data shows that the incidence of infertility is 6% at age 20-24, 15% at age 25-29, 30% at age 35-39, and 64% at age 40-44. In general, we call women older than 35 years old as senior women. The conception rate of women decreases significantly at an advanced age, and 40 years is recognized as a target for low ovarian response. For women with poor ovarian reserve, regardless of age, as long as the AMH, basal FSH and basal sinus follicle count are assessed as poor ovarian function, they can be called “advanced”. Therefore, it is recommended that women over 35 years of age who have been trying to conceive for 6 months without pregnancy should actively visit a fertility center to evaluate ovarian function. In our life, we encounter not only senior women who are ready to have a second child, but also many senior intellectuals who stop to consider fertility only in their 40s for further study and career, as well as senior women who remarry and intend to have children, and even senior women who have lost their children, and their desire to have children is more urgent. The problems faced by senior women are not only the decline in ovarian function and fertility, but also the decline in egg quality, increased miscarriage rate, increased risk of complications during pregnancy, increased risk of offspring abnormalities, etc. Although IVF has a much higher chance of pregnancy than natural fertility, older women face the same risks of low pregnancy rates and high miscarriage rates even if they undergo IVF. The above graph shows that the clinical pregnancy rate of patients over 40 years of age is significantly lower. Further analysis of IVF in patients over 40 years of age in our center showed that the clinical pregnancy rate for IVF/ICSI in patients aged 40-46 years was 26.8% and the miscarriage rate was 35.7%. The maximum age for clinical pregnancy is 46 years, the maximum age for delivery is 45 years, and there are no clinical pregnancies in patients aged 47 years or older. With the increasing number of patients of advanced reproductive age, we need to focus not only on the clinical pregnancy rate, but also on the miscarriage rate, and more importantly, on the live birth rate, which is the rate of carrying babies. The process is a long one, from egg retrieval to carrying the baby home, and involves many trials. The literature reports that the live birth rate for IVF in women over 40 years old is about 3.5-10%. Therefore, women of advanced age should be cautious about assisted conception, especially women over the age of 43. In conclusion, women of advanced age should choose carefully whether to have a baby or not after ovarian function assessment, and choose the appropriate method of assisted conception.