This questionnaire is going to help you and your partner think about and identify some important areas of opportunity and/or concern that you you could address in order to improve your chances of becoming and staying pregnant.
If you are a client, this questionnaire is a good starting point for me to assess your unique situation and help me to understand out what could have been missed and what needs to be addressed.
The questionnaire assesses the key areas of my FERTILE system which include Food, Exercise, Rest/sleep/stress, Timing, Investigations, Lifestyle and Environment. All my FERTILE programs that teach natural fertility will help you make beneficial changes in relation to the key areas set out in this questionnaire.
Please complete the questionnaire and ask your partner to complete the questionnaire as well (it takes two to make a baby!).
What you eat each day not only affects your overall health, but also affects your fertility including hormone balance and egg and sperm quality. Following a fertility diet to prepare yourself for conception and pregnancy will get your body into peak health, correct any nutritional deficiencies you might have, help you reach a fertile weight and give you more energy. What you eat (and what you choose to not eat), is so important when it comes to improving your fertility and during medical fertility treatments.
Every question answered below with a ‘no’ is an opportunity for you (and your partner), to make some beneficial dietary changes that will help to balance your hormones, improve egg and sperm health and boost your fertility.
- Have you removed all processed, convenience and take-away foods from your fertility diet so that you are eating a natural, unprocessed and majority unpackaged, plant-based diet?
- Do you always consume a nourishing breakfast to start your day?
- Do you always consume a nourishing lunch?
- Do you always consume a nourishing dinner that is mainly protein and vegetables?
- Does each of your main meals (breakfast, lunch and dinner) always contain an animal protein food, for example a serve of meat, poultry, fish, eggs, organic tofu or protein powder)?
- Does each of your main meals always contain a healthy fat source (for example a serve of oily fish, cold pressed oil, nuts, seeds, pure butter or avocado)?
- Do you include at least 2 tablespoons of flaxseed oil in your fertility diet daily?
- Have you removed margarine and any blended spreads that contain vegetable oil from your fertility diet?
- Have you removed all processed soy, vegetarian or vegan products such as yoghurts, cheese, sausages, patties etc. from your fertility diet? Note that organic tofu, Miso and tempeh is ok to have once a week.
- Does each of your main meals always contain at least 2 (or more), cups of vegetables comprised of at least 3 different colors?
- Do you consistently eat 3 main meals a day and perhaps 2 to 3 small snacks in between your main meals, if you are hungry?
- Do you eat only wholegrains (for example brown rice, quinoa, oats) at least once a day and not more than 3 times a day?
- Have you removed ‘white, processed’ carbohydrates from your fertility diet (including white bread, rice, pasta and baked items)?
- Do you consume but have no more than 2 serves of fruit each day?
- If you have been struggling to become pregnant for over 12 months have you tried removing all dairy foods from your fertility diet?
- If you have been struggling to become pregnant for over 12 months have you tried removing all foods containing gluten from your fertility diet?
- Do you consume fresh fish that is low in the food chain at least twice a week?
- Do you consume red meat at least, but no more than three times a week?
- Do you regularly consume legumes as part of your fertility diet including peas, beans and lentils?
- Do you consume a serve of nuts and seeds daily?
- Do you use coconut oil, olive oil, cold pressed oils or pure butter for dressing salads and for cooking?
- Do you consume one to two serves of a fertility friendly protein powder each day to boost your daily protein intake?
- Have you taken all sauces and condiments that are high in sugar out of your fertility diet?
- Do you include a healthy, homemade fertility treat each day so that you don’t feel you are missing out and to help manage any cravings?
- Do you plan your meals for the week, ensuring your pantry has everything you need for the week ahead and perhaps you also do some meal prep?
- Do you try and make more at dinner time so that you can put a serve or two aside for lunches or for meals in the fridge and freezer to consume when you are busy or tired?
- Do you sit down at each main meal and slowly chew your food while eating and drinking mindfully?
- Do you cook or prepare 99% of your meals, snacks and treats in your home?
- Do you know how to, and do you make healthy, homemade versions of takeaway including pizza, burgers and fish and chips.
- Have you given up coffee, tea, coke, energy drinks, sports drinks, commercial fruit juices, soda and soft drink?
- Do you use a high quality (non-jug) water filter to purify your drinking water?
- Do you drink at least 2 liters (or more), of filtered water each day that hasn’t been stored in plastic?
- Do you know how to read food labels to check a packaged food for sugar and trans fat content as well as nasty food additives (artificial colors, flavors and preservatives)?
- Do you know what a portion size and serve is for protein foods, carbohydrates and fats?
- If you are following a vegetarian or vegan diet are you aware that this is not the best dietary option for improving fertility?
- Do you follow the dirty dozen and clean 15 list?
- Do you cook or heat food in a microwave?
- Do you store food in plastic containers, or do you use plastic cling wraps?
- Are you and your partner taking a female and male specific prenatal multivitamin and mineral supplement specifically designed for conception and pregnancy?
- Are you and your partner taking an omega 3 supplement (fish oil etc.) each day?
- Have all the supplements you take been approved by your doctor and checked to ensure that they are appropriate for you and that the dosage is correct?
Make a note of all the ‘no’ answers, highlight them and put some steps in place to change these behaviors to boost your fertility.
When it comes to exercise and fertility you want to ensure that you are active most days and that you take the opportunity to move your body whenever you can. Exercise is a great way to help you lose any excess body fat and manage any body fat gains if you are taking hormone medication during medical fertility treatments. Overall, exercise has so many benefits for your health. When it comes to your fertility, it is going to help you get fresh, healthy, oxygenated blood pumping through your reproductive organs to keep them healthy, it is going to keep you fit, strong and supple in preparation for your pregnancy and birthing, it helps you manage stress and it tires you out so that you sleep better.
One of the most common reasons for people to not exercise consistently is that they are busy. The truth is that we are all busy, it’s just that some people make exercise a priority and they get it done, no excuses. There are 24 hours in a day so finding the time to exercise for even just 10 to 20 minutes (which is better than 0 minutes), shouldn’t be an issue, if it is important to you.
Also, you don’t need motivation to exercise. Your motivation to exercise will come and go. What you need is discipline. It is discipline that makes you turn up for your session regardless of how motivated or demotivated you are, how tired you might be, what the weather is like and if your mindset is focusing on Netflix and chill or some social media scrolling instead. All types of exercise (high impact, low impact and resistance exercise), should form part of your overall plan of attack to improve your health and fertility to prepare for conception and pregnancy.
If you answer ‘no’ to any of the questions below, then these are the areas of opportunity for you to act on and make some beneficial changes that will improve your health and fertility.
- Do you exercise at least 4 times a week for a minimum of 20 minutes?
- Does your exercise regime include weekly resistance-based exercise such as using weights, exercise that utilises your body weight, bands or Pilates etc?
- Does your exercise regime include weekly cardio-based exercise or anything that gets you huffing and puffing and working your heart and lungs?
- Does your exercise regime include weekly low impact, relaxation type exercises (walking, stretching, yoga, tai-chi etc)?
- Have you been exercising consistently at least 4 times a week for the past 6 months?
- Do you walk whenever it is possible to walk somewhere, rather than taking the car or public transport?
- Do you schedule your exercise in your calendar each week as an appointment that you make, and you reschedule it if you miss it?
- Do you have an active job where you move around throughout the day?
- Have you given up any very high intense exercise, overtraining or training for fitness events like marathons or triathlons when trying to conceive?
- If you are having medical fertility treatments have you cleared your exercise with your doctor?
- If you are having medical fertility treatments do you know what type and amount of exercise is safe to do during your treatment and the two-week wait?
- Is exercise important to you and do you make it a priority for your health and fertility?
REST AND SLEEP
Your body needs rest. If you don’t rest your body, your body will ensure that you do rest it. You’ll feel fatigued and slow during the day and possibly become run down and sick. When it comes to the quality and quantity of sleep you get each night, this also has an impact on your health and fertility. When you’re tired, you’re more likely to have cravings for foods and drinks that contain caffeine and sugar or simple carbohydrates and you won’t have the energy to exercise or have intercourse with your partner. When it comes to fertility, a lack of sleep can affect your hormones including the ones that trigger ovulation in women and the sperm maturation process in men which are thought to be tied to the body’s sleep-wake patterns.
If you answer ‘yes’ to any of the questions below then you could benefit from improving your sleep and your sleep environment to help boost your fertility.
- Is your sleep schedule irregular, that is you go to bed at different times each night and wake up at different times in the morning?
- Are you a shift worker?
- Do you struggle to wake up and you take a while to get going in the morning?
- Are you usually still awake at some point during the hours between the 10pm and 2am?
- Does it take you longer than 15 minutes to fall asleep?
- Do you frequently wake up during the night?
- Do you frequently wake up during the night and have problems falling back to sleep?
- Do you frequently wake up to go to the toilet?
- Do you frequently wake up early in the morning before your alarm clock?
- Do you sleep less than 7 hours a night?
- Do you sleep more than 9 hours a night?
- Do you have naps during the day that last for more than 30 minutes?
- Do you snore, have difficulty breathing, sleep apnoea or do you have restless legs at night?
- Do you use electronic devices (phones, tablets, laptops), in the 90 minutes before you go to bed?
- Do you use your phone, tablet or computer while you are in bed?
- Do you watch TV while in bed?
- Do you use your bedroom for any other reason apart from sexual intercourse, sleep and reading a book before bed?
- Is your bed old and/or uncomfortable?
- Is your bedroom messy and cluttered?
- Does sunlight penetrate through your curtains or blinds in the morning?
- Do you often feel hot or cold in your bedroom?
- Do you drink alcohol in the evening?
- Do you drink coffee or have other caffeinated drinks or foods in the evening?
- Do you exercise in the evening within 2 hours of your bedtime?
- Does your partner wake you up or disturb your sleep for any reason?
- Do you sleep with a pet on your bed?
- Do you frequently have bad dreams?
- Do you take sleep medication to help you sleep, either herbal or prescribed?
- Do you wake up feeling tired and unrefreshed?
- Do you feel fatigued during the day and rely on caffeine and carbohydrates that contain sugar to give you energy?
In the 1970s, two American psychiatrists came up with a scale for measuring stress. The test helps us to understand the impact of long-term stress. The stress scale consists of a list of 43 stressful life events a person can experience, which may lead to illness. Stress can directly impact your fertility by disrupting your hormonal balance and ovulation. To do the assessment you simple mark down the point value of each of the life events in the questionnaire and then total them to find out your score.
Download and complete The Holmes-Rahe Life Stress Inventory
Timing (also known as charting your fertility or the fertility awareness method), is something you must know if you are trying to conceive naturally and you want to make sure that you are trying to conceive at the right time in your cycle, that is when you are fertile and ovulating. When it comes to a successful conception, getting the timing of intercourse correct is one of the key factors and one of the most common reasons why a normal, healthy couple don’t seem to be able to become pregnant. An Australian study found that 70% of women thought they know how to accurately pinpoint their fertile window when in fact only 13% of the women in the study accurately knew how to do this.
If you answer ‘no’ or ‘not sure’ to any of the questions below, you could benefit from learning how to chart your fertility. If you learn more about your menstrual cycle and how to identify non-fertile and fertile cervical fluid, know how to identity your fertile window, and learn to pinpoint when ovulation is approaching, it has been shown that pregnancy rates significantly increase.
- Do you have sex at least 3 times a week on average?
- To become pregnant in any given cycle do you always time intercourse to coincide with the two days before you ovulate or the day of ovulation?
- Do you know how to identify when your fertile window is in each cycle?
- Do you know how to identity when you are about to ovulate in a cycle?
- Do you know what fertile cervical fluid looks and feels like?
- Do you know what non-fertile cervical fluid looks and feels like?
- Do you always take notice of your cervical fluid patterns to pinpoint when you are producing fertile cervical fluid so that you can time intercourse around this time to maximise a conception occurring?
- Do you know how to take your basal body temperature?
- Do you have a regular menstrual cycle that is between 26 and 33 days?
- Is your luteal phase long enough for implantation of a fertilised egg to occur?
- Are you aware that you may be ovulating much earlier or later then day 14 in your cycle?
- Are you aware that ovulation prediction kits and similar devices only tell you that you might ovulate, they don’t confirm that you did ovulate in a cycle?
- Do you know how to chart your cycle by observing and recording both your cervical fluid and basal body temperature?
- Do you use a charting APP or a manual chart to help you chart your fertility?
- Do you feel confident that you can interpret your chart data and what it means in relation to your fertility status at any given time in your cycle?
When it comes to investigating the cause of infertility or frequent miscarriages there are standard checks and tests that fertility doctors will perform. If you are not getting any answers and/or you want to investigate further, there are tests that you can arrange privately through a nutritionist or naturopath via an independent provider. Below is a list of standard and optional tests that can help you to narrow down what might be happening with your general health, nutrition status, hormones, gut health as well as male specific tests. This list is comprehensive, but not conclusive. It is a good place to start to help you to identity what might have been missed and other diagnostic tests that you may want to explore based on your individual circumstances.
If you answer ‘no’ to any of the questions below, these are tests that you might want to consider now or in the future if appropriate.
- Have you had physical examinations done of your reproductive organs to look for structural problems that may be preventing implantation or blockages in your fallopian tubes or that could be stopping the egg or sperm progressing, for example a Hysterosalpingogram, Hystero-Contrast Sonography, Laparoscopy or Hysteroscopy?
- Have you and your partner been checked for all sexually transmitted diseases and infections (STD’s or STI’s) and all genito-urinary infections (GUI’s) that affect the urinary tract and genitals, for example pelvic inflammatory disease, chlamydia, gonorrhoea, bacterial vaginosis (gardnerella), trichomonas, cytomegalovirus (CMV), mycoplasma and ureaplasma, candida albicans (thrush), syphilis, rubella, genital herpes and human immunodeficiency virus (AIDS)?
- Have you been checked for endometriosis?
- Have you both had a full blood count in the last 6 months to check general health status?
- Have you had hormone testing done?
- Have you had a PCOS check?
- Have you had an ovulation check?
- Have you had an ovarian reserve check?
- Have you had a menopause check?
- Have you had an MTHFR check?
- Have you had your thyroid tested?
- Have you had an insulin or diabetes check?
- Have you had a Coeliac check?
- Have you had a gut health check?
- Have you had a leaky gut check?
- Have you had a FODMAP check?
- Have you had checks for intestinal parasites etc.?
- Have you had food intolerance or allergy testing?
- Have you had a Methylation cofactors check?
- Have you had a homocysteine check?
- Have you had an autoimmune check?
- Have you had an adrenal stress check?
- Have you had a nutrition check to find out your nutritional status and whether you have any nutrient deficiencies?
- Have you had a hair mineral analysis to check your nutrient status and the heavy metal levels in your body?
- In the last 6 months have you had the following tested, iron, vitamin B12, vitamin D and Folate?
- Have you had an essential fatty acids check?
- Have you had a copper to zinc ratio check?
- Has your male partner had a semen analysis done?
- Has your male partner had a sperm DNA fragmentation test done?
- Has your male partner had hormone testing done?
- Has your male partner had physical checks checking for example, blockages, damage or varicocele infections?
When it comes to living a fertile lifestyle there are some substances that may negatively impact your health and fertility. Even if the evidence is inconclusive, if you have been struggling to conceive for over 12 months, it might be best to err on the side of caution and cut these substances out just in case. It is best to steer clear of these substances for at least three months or more before a conception attempt.
When it comes to weight and fertility for both men and women you want to aim to fall within a healthy range for Body Mass Index (BMI) and have as little body fat around your waist as possible (measured by your hip to waist ratio). The amount of fat that you have around your stomach indicates an increased risk for health conditions like high blood pressure, type 2 diabetes and heart disease and may impact your fertility. A waist to hip ratio of under 80cm (and ideally 70cm for women), and under 90cm for men, is associated with improved health and fertility. A waist to hip ratio higher than 80cm for women is associated with lower pregnancy rates. A waist to hip ratio of higher than 90cm for men is associated with reduced fertility.
Do you need to make lifestyle changes to improve your chance of becoming pregnant? Every ‘yes’ is an opportunity to change your behaviour and optimise your fertility.
- Do you drink alcohol?
- Do you smoke cigarettes?
- Do you smoke marijuana?
- Do you use any recreational drugs?
- If you take any over the counter drugs have you checked with your doctor whether it is safe to take them when trying to conceive and during pregnancy?
- If you take any prescription medication have you checked with your doctor whether it is safe to take them when trying to conceive and during pregnancy?
- Do you drink coffee?
- Do you drink decaffeinated coffee?
- Do you drink green or black tea?
- Are you in a healthy and fertile BMI range? You can work out your BMI here or here with these online BMI calculators. For health and fertility, you want to aim to be in a BMI range between 18.5 and 25.
- Do you have a healthy waist measurement? You can work out your waist to hip ratio here or here using an online waist to hip ratio calculator. For health and fertility optimisation, you want to aim to have a waist to hip ratio of less than 80cm for women or 90cm for men.