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Reproductive Health Survey

Your gender

Male Female
  • 1. My testicles were undescended when I was a kid.

  • 2. I had mumps after puberty.

  • 3. I had varicocele surgery, but my sperms did not get better.

  • 4. I smoke more than ten cigarettes a day.

  • 5. I cannot cope with my daily stress.

  • 6. I consume more than two glasses of alcohol beverage a day.

  • 7. I drink more than 5 cups of tea, coffee, and cola a day.

  • 8. I am 10 kg above than normal weight range..

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  • 1. I am younger than 35 years old and I have been wishing to have a baby for a year.

  • 2. I am more than 34 years old and I have been wishing to have a baby for 6 months.

  • 3. I cannot have my periods without taking my medications.

  • 4. My periods are painful.

  • 5. I had a gynecological operation.

  • 6. My periods are irregular.

  • 7. My periods take less than 24 days.

  • 8. My periods take longer than 32 days.

  • 9. I have endometriosis.

  • 10. I smoke more than ten cigarettes a day.

  • 11. I cannot cope with my daily stress.

  • 12. I consume more than two glasses of alcohol beverage a day.

  • 13. I drink more than 5 cups of tea, coffee, and cola a day.

  • 14. I am 10 kg above than normal weight range..

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