At present, low fertility has become one of the focuses of attention of all sectors of society. As part of the childbearing age group, medical school teachers encounter strong developmental conflicts and fertility challenges under the dual pressure of “fertility and education”. In order to understand the current situation and influencing factors of this group"s fertility intention, the article utilizes theoretical sampling to select 22 teachers from a medical school in Nanjing to conduct semi-structured interviews, and conducts a qualitative study of the original data through the rootedness theory. Based on the three-level coding, 30 conceptual categories, 9 initial categories, 3 main categories and 1 core category were sorted out and a theoretical model was constructed by developing a story line. The study found that the reasons for the low fertility intention of medical school teachers included insufficient endogenous drive, low self-efficacy, and weak external control. It is suggested that the construction of a friendly fertility culture can stimulate the internal drive to have children, career incentives can enhance the sense of obtaining and being respected, and the sound supporting measures can strengthen the external control of fertility to reduce the burden of childbearing and increase the willingness to have children.