Take The Fertility Quiz! Bootstrap Example Calculating Your Results... 1Do you have any children? No Yes, just 1 Yes, more than 1 History of previous miscarriage(s) 2 How long have you been actively trying to conceive? Not Trying Yet On and Off for Years 6 Months or Less 6 Months to 1 Year 1 to 2 Years More than 2 years 3Do you experience any of the following? (Part 1 of 5) Joint pain, muscle spasms or weakness Gas, bloating, constipation, diarrhea, or discomfort in the belly Food allergies known or suspected Sensitivity to smells around you None of the Above 4Do you experience any of the following? (Part 2 of 5) Environmental allergies or asthma Anxiety or depression Lack of energy to do the things you love A family history of thyroid problems Cold hands or feet None of the above 5Do you experience any of the following? (Part 3 of 5) Thinning head hair, weight gain (or difficulty losing weight) Slow brain, slow thoughts, or difficulty concentrating Frequent infections, colds, or flu Dry skin or rashes Sugar or carb cravings None of the above 6Do you experience any of the following? (Part 4 of 5) PMS - physical or emotional (headaches, irritability, mood swings, bloating) Low sex drive and you're unsure why Fatigue or Sluggishness Feeling wired and tired at the same time Cravings for salt and junk food None of the above 7Do you experience any of the following? (Part 5 of 5) Ovarian cysts, fibroids, or PCOS Excess hair on your face, chest or arms Irregular menstrual cycles (or you have in the past) Heavy bleeding or scanty bleeding Endometriosis or painful periods None of the above 8 Has your partner had a sperm analysis? (what were the general results) Yes, but the results were unclear or poor Yes, sperm counts were great Yes, but sperm counts were ok No We are a same sex couple, using a sperm donor 9Which of the following do you consume regularly? Caffeine Alcohol Recreational drugs Meat Dairy Sugar Fried foods None of the above Cigarettes 10 On a scale of 1-10, 10 being super committed, how committed are you to having a baby as soon as possible? 1-2 3-4 5-6 7-8 9-10 Almost Done, Get Your Results! Name Please Enter Name Email Please Enter Email please choose one option © 2020 HOLISTIC FERTILITY CENTER | PRIVACY POLICY AND TERMS & CONDITIONS
