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What is your age?
How long have you been trying to get pregnant?
Have you ever been diagnosed with a health condition that could result in abnormal hormone levels or impact your reproductive system such as Thyroid disease or PCOS?
Have you ever been diagnosed with any gynecological problems such as fibroids, endometriosis or pelvic inflammatory disease?
Have you experienced any miscarriages?
Do you get PMS symptoms like acne or migraines before your period, mood swings, bloating, or breast tenderness?
Do you ever get menstrual cramps and/or heavy bleeding?
Do you have any digestive symptoms like constipation, diarrhea, bloating, gas, heartburn, reflux, nausea, or vomiting?
Do you smoke cigarettes or marijuana?
Do you drink 1 alcoholic drink or more a day? Or 7 for the whole week?
Does your partner smoke cigarettes or marijuana?
Does your partner drink 1 alcoholic drink or more a day? Or 7 for the whole week?
Does your partner have low sex drive or difficulty with getting erections?
Does your partner have low energy without caffeine?
Does your partner have any digestive symptoms like constipation, diarrhea, bloating, gas, heartburn, reflux, nausea, or vomiting?
Have you been diagnosed with Unexplained Infertility?
