As a gynecologist who has dealt with infertility for a decade, I often wonder if God is playing a cruel joke: some women who don't want children keep getting pregnant unexpectedly, while others who desperately long to be mothers face countless setbacks and trials.
Often, I observe intelligent, charming women around me enjoying love and pursuing success. Since pregnancy seems distant, they pay little attention to it. When utterly exhausted, they light a cigarette and think, "I'll quit six months before trying to conceive!" Little do they realize they're unknowingly depleting their most vital gift—their fertility.
I long to shout a warning to them: "Perhaps one day in the future, you'll deeply yearn to be a mother!"
Major Depletion: Abortion
Abortion can cause pelvic inflammatory disease, which damages the fallopian tubes—our body's vital reproductive pathways, each as thin as a ballpoint pen tip. Inflammation leads to blockages, resulting in infertility.
Medical abortions carry greater risks than surgical ones, as they involve longer bleeding periods and higher infection rates.
Furthermore, repeated abortions deplete the uterine lining. During pregnancy, the embryo struggles like a sapling in barren soil, forcing its roots to penetrate deeper to secure nutrients.During delivery, the placenta may fail to expel spontaneously. In severe cases, "placenta accreta" occurs where the placenta fuses with the uterine wall, necessitating hysterectomy. The risk of complications increases proportionally with the number of abortions performed.
Second Major Health Hazard: Smoking
Pregnancy is a natural physiological process that most women navigate effortlessly over ten months. However, smoking significantly elevates the risk of pregnancy complications.
Nicotine and other toxins cause systemic vascular damage, including to uterine blood vessels. This increases the risk of miscarriage in early pregnancy and preeclampsia in mid-pregnancy—a dangerous condition involving systemic vasospasm and elevated blood pressure. Preeclampsia ranks among the most severe pregnancy complications.
Long-term smoking further damages the entire hormonal system, impairing ovarian function and leading to endocrine-related infertility. We all know that smoking women age prematurely, yet this is merely an external manifestation reflecting the internal devastation of the hormonal system—a woman's radiant complexion is nourished by estrogen.One of my patients had a happy family and a successful career, yet she felt an irreparable regret. Since turning 37, she had spent three full years battling infertility.
Initial tests revealed blocked fallopian tubes: one completely obstructed, the other with adhesions—likely complications from an abortion years prior, despite her quick recovery at the time.Consequently, she opted for in vitro fertilization (IVF). Unfortunately, further tests revealed endocrine system dysfunction that not only disrupted ovulation but also made it difficult to sustain a pregnancy even if artificial insemination succeeded and the fertilized egg implanted in the uterus. One hormone—follicle-stimulating hormone (FSH)—was elevated beyond normal levels, a condition typically seen only in postmenopausal women.Her abnormal hormone levels were largely linked to her long-term smoking habit. Although she had quit completely three years prior to conceive, the residual effects of nicotine still lingered in her body.
When she came to see me, she was deeply distressed, confiding, "For me, getting pregnant isn't the main issue anymore. But I'm only 40, and my body is aging like that of a menopausal woman—psychologically, I just can't accept it!"

Three Major Factors: Age Over 35 When I became a gynecologist in 1990, women typically gave birth around age 25. Ten years later, the average childbearing age had shifted back by about five years, making it common to have children in one's 30s.
Biologically, a woman's fertility peaks at age 25, declines gradually after 30, drops sharply after 35, and by age 44, 87% of women lose their ability to conceive.
A recent international study conducted in vitro fertilization experiments: one group used eggs from women over 40 with sperm from young men, while another group used eggs from women under 30 with sperm from men over 50. The success rate in the latter group was significantly higher than in the former.This demonstrates that aging impacts female fertility more profoundly than male fertility. While men renew their sperm every 30 days, women carry their eggs from birth. Lifestyle, environment, and age all affect egg quality. After age 35, eggs have endured 35 years of air pollution, ionizing radiation, and chemical exposure, significantly increasing the risk of chromosomal abnormalities.Women conceiving after age 35 often do so after careful planning, making the impact particularly devastating. Therefore, if you plan to become a mother, the ideal childbearing age is between 26 and 30. If conditions aren't yet ripe, you can still delay age-related changes by adopting healthier lifestyle habits and behaviors.
Four Major Risks: Menstrual Period Sex
Trendy women boldly proclaim, "Menstrual period sex is no fun, wasting precious time," shattering the ancient taboo against intercourse during menstruation. Some fashionable doctors also claim, "As long as you feel good, there's nothing wrong with having sex during your period."
I cannot agree with this stance. Menstrual intercourse carries two significant risks: pelvic infections and endometriosis—both devastating threats to fertility.
Normally, the cervix is sealed by a mucus plug that prevents vaginal bacteria from entering the pelvic cavity. During menstruation, however, the cervix becomes more relaxed, reducing its protective function. Furthermore, during sexual climax, the body generates negative pressure that can draw bacteria and blood into the pelvic cavity.Bacteria can cause infections, while retrograde menstrual blood may implant in the pelvic cavity. It is best to avoid sexual intercourse during menstruation. If unavoidable, it may lead to endometriosis.
Personally, I believe intercourse is only safe toward the end of menstruation, when only minimal coffee-ground-like discharge is present. Moreover, condoms must be used to prevent infection.
Top Five Risks: Sexually Transmitted Diseases
Among all STDs, chlamydia and gonorrhea pose the greatest danger. Often asymptomatic, they can silently trigger pelvic inflammatory disease (PID), leading to infertility.
Therefore, carefully choosing sexual partners is essential. The price of love should not be the sacrifice of future motherhood.
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