Fertility Questionnaire
Fertility Insights Quiz
Take our Fertility Insights Quiz to assess your fertility health and gain valuable information tailored to your unique situation. This quiz is designed for couples trying to conceive and aims to identify factors that may impact fertility.
Discover your fertility potential and understand more about:
- Women's reproductive health
- Impact of age and weight
- Men's health factors
- Irregularities and medical conditions
Select Gender
0%
0
Female
0%
0
Male
Select the wife's age
0%
0
Below 35
0%
0
35 and above
How long have the wife been trying to get pregnant after having unprotected sex?
6 months or less
6 to 12 months
12 months or longer
I am not actively trying to get pregnant
Describe the wife's current weight
Underweight
Ideal weight
Overweight
Obese
Does the wife experience irregular menses?
Yes
No
Has the wife had a miscarriage or abortion?
Yes
No
Has the wife been diagnosed with any of these following conditions?
- Low ovarian reserve
- Poor egg quality
- PCOS
- Endometriosis
- Fibroids
- Hypothyroidism
- Celiac disease
- Hashimoto’s
- Low progesterone
- Infertility
Yes
No
Has the husband been affected by any of the following?
- Testicular trauma or surgery
- Previous chemotherapy or radiation
- Problems with erection or ejaculation
- Previous STDs
- Previous vasectomy
Yes
No
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