To help us continue the development and evaluation of the FertiSTAT your responses will be retained. The data you provide will be anonymous, which means that no one can trace your answers back to you.

Please provide us with your date of birth

(This field is required)

Please provide us with your initials

(This field is required)

Please provide us with your country of residence

(This field is required)

Please answer all the questions below to calculate your FertiSTAT

The questions are colour coded into the following categories which will be further explained once you receive your FertiSTAT score:

B
lue
Y
ellow
O
range
R
ed

 

Remember if you are not trying to get pregnant, choose your age group and consider yourself trying for under 12 months (or 6 months if you are over 34 years of age) in the 'About trying' section.

 

About trying to get pregnant
B
34 years of age or younger and trying for 0-12 months
B
Over 34 years of age and trying for 0-6 months
R
Over 34 years of age and trying for 6 or more months
R
Any age and trying for more than 12 months

 

Your reproductive history
  Yes No  
O
I suffer from severe period pains
O
I had pelvic surgery
O
My menstrual cycle is unpredictable. My period often comes more than 5 days earlier or later than expected (When I am not using contraceptives)
O
My menstrual cycle lasts less than 21 days (When I am not using contraceptives)
O
My menstrual cycle lasts more than 35 days (When I am not using contraceptives)
O
I suffer from endometriosis
O
I have had pelvic inflammatory disease (PID)
R
I do not have a period (When I am not using contraceptives)

 

Your lifestyle
  Yes No  
Y
I have unprotected sex with multiple partners
Y
I smoke regularly (more than 10 cigarettes per day)
Y
I cannot cope with the stress I am currently experiencing
Y
I drink more than 14 units of alcohol per week (1 unit = a small glass of wine, 1/2 pint of beer, single measure of a spirit)
Y
I drink more than 7 units of caffeine per day (1 unit = a cup of coffee, 1/2 unit = a cup of tea or a can of soft drink such as cola)
Y
I smoke marijuana frequently (more than four times a week)
O
I have had a sexually transmitted infection
O
I am more than 13 kilos (28 pounds/2 stone) overweight
R
I have used class A drugs in the past (e.g., heroin, cocaine, ecstasy)
R
I am currently taking anabolic steroids (for non-medical uses)

Please make sure you have answered all the FertiSTAT questions otherwise your FertiSTAT score will not be accurate.

Please click the "Submit" button to submit your answers.

Alternatively, click "Reset" to clear the form and restart.