What is the main reason why a woman who is older than 35 years may have difficulty achieving pregnancy?

Choice A reason: This is not the main reason, as the use of contraceptives for an extended time does not necessarily affect the fertility of a woman. Most contraceptives are reversible and do not cause permanent damage to the reproductive system. However, some contraceptives may take longer to wear off than others, and some may have side effects that can interfere with ovulation or implantation.

Choice B reason: This is the main reason, as the aging process can affect the ovaries and the quality and quantity of the eggs. As a woman ages, her ovarian reserve (the number of eggs in the ovaries) declines, and the eggs become more prone to chromosomal abnormalities. This can reduce the chances of conception and increase the risk of miscarriage or birth defects.

Choice C reason: This is not the main reason, as prepregnancy medical attention is not a prerequisite for achieving pregnancy. However, prepregnancy medical attention can be beneficial for a woman who is older than 35 years, as it can help identify and manage any existing or potential health problems that may affect the pregnancy, such as diabetes, hypertension, or thyroid disorders.

Choice D reason: This is not the main reason, as personal risk behaviors are not specific to a woman who is older than 35 years. Personal risk behaviors are factors that can negatively affect the fertility of any woman, regardless of age. Some examples of personal risk behaviors are smoking, drinking, using drugs, having multiple sexual partners, or having sexually transmitted infections.

Choice A reason: HSV-2 is a viral infection that causes genital herpes. It is transmitted through sexual contact and can cause painful blisters and ulcers in the genital area. The primary infection is usually the most severe and lasts for several weeks. After the primary infection, the virus remains dormant in the nerve cells and can reactivate periodically, causing recurrent episodes of genital herpes. The frequency and severity of the recurrences vary from person to person.

Choice B reason: HPV is a viral infection that causes genital warts and cervical cancer. It is transmitted through sexual contact and can infect the skin and mucous membranes of the genital area. The primary infection is often asymptomatic and may clear spontaneously or persist for years. HPV does not cause recurrent episodes of genital warts or cervical cancer, but it can increase the risk of developing these conditions over time.

Choice C reason: CMV is a viral infection that causes flu-like symptoms and can affect various organs. It is transmitted through bodily fluids such as saliva, urine, blood, and semen. The primary infection is usually mild and may go unnoticed. After the primary infection, the virus remains latent in the body and can reactivate in people with weakened immune systems, causing serious complications. CMV does not cause recurrent episodes of flu-like symptoms or organ damage, but it can worsen the condition of people with HIV or AIDS.

Choice D reason: HIV is a viral infection that causes acquired immunodeficiency syndrome (AIDS). It is transmitted through sexual contact, blood transfusion, or sharing of needles. The primary infection is often accompanied by flu-like symptoms and lasts for a few weeks. After the primary infection, the virus gradually destroys the immune system and makes the person vulnerable to opportunistic infections and cancers. HIV does not cause recurrent episodes of flu-like symptoms or AIDS, but it can progress to AIDS over time.