With the national two-child policy in place, many couples are feeling like they are catching the last train and want to have their second child before their fertility fails. We know that female fertility declines rapidly with age. If we take the fertility of a 25-year-old woman as a reference standard, a 35-year-old woman’s fertility is only 50% of that of a 25-year-old woman, a 38-year-old woman’s fertility is only 25% of that of a 25-year-old woman, and a 40-42-year-old woman’s fertility is only 5% of that of a 25-year-old woman, making it a challenge for women over 35 to have children. There is a relatively complete system of clinical assessment of fertility in women. In contrast, male fertility assessment is much more lacking. As a matter of fact, male fertility deteriorates as men age, due to illnesses, occupations, work-life stress, environmental and dietary pollution, and bad habits such as smoking, drinking, staying up late, and taking sauna baths. Research by the World Health Organization (WHO) shows that during the 50 years from 1940 to 1990, male fertility in the world declined by a factor of 1, and the decline has become more pronounced in the last 20 years. In China, male fertility has been declining at a rate of 1% per year, and the more industrially developed the region, the more pronounced the decline. For male fertility assessment, many second-born men have misunderstanding. Many will think that I am in good health, there is no discomfort ah, still need to do the examination? Some say, I have a child, and there is no disease, there must be no problem with fertility! Some say, “My sexual function is normal, and my fertility must be normal too! Even many of our male doctors do not have enough knowledge about male fertility assessment, and many of them take a normal semen checklist and tell the patient, “You are normal, there is nothing wrong with you, go home and wait to have a baby”. I have come across such a case of patients, daughter 10 years old, want to have a second child for four years without pregnancy, the woman to see a doctor, medication, injections, spent a lot of money did not see the effect. The man did not even check the semen routine, the reason is that I have a child, I am healthy. Later on, semen was checked at my request, and surprisingly, there was no sperm. This patient had severe varicocele, which had not yet had a serious impact on fertility 10 years ago, had a daughter, and ended up with no sperm as the varicocele continued to damage testicular function. If the man had been examined at the same time as the wife’s infertility visit 4 years ago to assess fertility, the wife would not have been infertile for 4 years. This is why we emphasize the importance of “couple testing and treatment” and preconception fertility and reproductive risk assessment.