Baby Readiness Assessment (Female)

1
How would you describe your current state of health?* This field is required.
Excellent
Good
Fair
Poor
2
On a scale from 1-10, how much do you think your overall health affects the ability to conceive for you and your partner?* This field is required.
Please Select
Please Select
1
2
3
4
5
6
7
8
9
10
3
Have you been diagnosed with any of the following?* This field is required.
Anemia
Inherited blood disorder (e.g., sickle cell, thalassemia)
None
4
Do you have any of the following symptoms?* This field is required.
Fatigue / weakness
Headache, dizziness or lightheadedness
Cold hands and feet
Pale skin
Chest pain, fast heartbeat, or shortness of breath
Brittle nails
None
5
Image Field
6
Have you been diagnosed with any of the following conditions?* This field is required.
Autoimmune disease (e.g., Crohn's, rheumatoid arthritis, MS, Celiac)
Cancer
Sexually transmitted infection(s)
None
7
Do you experience any of the following symptoms?* This field is required.
Fatigue
Joint pain and swelling
Skin problems
Abdominal pain or digestive issues
Swollen glands
None
8
Have you been diagnosed with or experienced any of the following?* This field is required.
Low testosterone
Hypothyroid / thyroid disorder
None
9
Image Field
10
Do you experience any of the following symptoms?* This field is required.
Acne
Bloating
Low libido
Migraines
Sensitivity to cold
Weight gain
Constipation
None
11
Have you been diagnosed with any of the following conditions?* This field is required.
Pre-diabetes or diabetes
Hypertension
None
12
Do you have any of the following symptoms?* This field is required.
Severe headaches
Lightheadedness / fainting
Fatigue, especially after eating
Increased thirst and/or frequent urination
None
13
Image Field
14
Have you been diagnosed with any of the following?* This field is required.
Vitamin D deficiency
B Vitamin deficiency (e.g., folate, B12)
None
15
Do you have any of the following symptoms?* This field is required.
Fatigue
Headaches
Pale or yellow skin
Poor memory
Burning / pins-and-needles sensation in hands and feet
Dry skin
Mood swings or depression
Pain / inflammation of the mouth and tongue
None
16
How often do you have the following foods? * This field is required.
Never
Occasionally
Frequently
Daily
Coffee
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Packaged beverages (e.g. juice, soda, energy drinks)
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
Packaged snacks, including sweet (e.g. cakes, cookies, candies) and savory (e.g. chips, pretzels)
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
Fast food
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
Alcohol
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Row 4, Column 3
Sugar in any processed form (e.g. agave, brown rice syrup, candy, fruit juice concentrate, high fructose corn syrup)
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Row 5, Column 3
Leafy green vegetables
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Row 6, Column 3
Coffee
Packaged beverages (e.g. juice, soda, energy drinks)
Packaged snacks, including sweet (e.g. cakes, cookies, candies) and savory (e.g. chips, pretzels)
Fast food
Alcohol
Sugar in any processed form (e.g. agave, brown rice syrup, candy, fruit juice concentrate, high fructose corn syrup)
Leafy green vegetables
Never
Row 0, Column 0
Occasionally
Row 0, Column 1
Frequently
Row 0, Column 2
Daily
Row 0, Column 3
Never
Row 1, Column 0
Occasionally
Row 1, Column 1
Frequently
Row 1, Column 2
Daily
Row 1, Column 3
Never
Row 2, Column 0
Occasionally
Row 2, Column 1
Frequently
Row 2, Column 2
Daily
Row 2, Column 3
Never
Row 3, Column 0
Occasionally
Row 3, Column 1
Frequently
Row 3, Column 2
Daily
Row 3, Column 3
Never
Row 4, Column 0
Occasionally
Row 4, Column 1
Frequently
Row 4, Column 2
Daily
Row 4, Column 3
Never
Row 5, Column 0
Occasionally
Row 5, Column 1
Frequently
Row 5, Column 2
Daily
Row 5, Column 3
Never
Row 6, Column 0
Occasionally
Row 6, Column 1
Frequently
Row 6, Column 2
Daily
Row 6, Column 3
1 of 7
17
Are you currently taking a multivitamin?* This field is required.
YESNO
18
Do you follow a vegan or vegetarian diet?* This field is required.
YESNO
19
Image Field
20
Did you know...?

Vegetarians tend to have lower hormone levels than their meat-eating counterparts.

Why is this?

1. You need cholesterol to make hormones.

One of the raw materials necessary to make your sex hormones is cholesterol. Unfortunuately, plant sterols (the “cholesterol” equivalent from plants) aren't as effectively used by our bodies as cholesterol from animal products. Interestingly, your body does make its own cholesterol, but we often need to supplement with cholesterol from our diet as well to reach optimal levels.

2. You need protein to make hormones.

Protein from animal products tends to be more bioavailable than protein from plant products. There are plenty of sources of protein in a vegetarian diet (e.g., quinoa, rice and beans, lentils). However, it’s just not as quickly and easily digested and assimilated as animal protein.

3. Certain nutrients are only available in animal products, such as vitamin A (retinoids specifically), vitamin D (except maybe mushrooms!) and vitamin B12 (unless foods are fortified with these nutrients). Beyond this, the bioavailability of certain nutrients is better from animal sources than plant sources.

For example, the conversion from ALA (from plant sources) to DHA is quite poor; it’s better to get DHA directly from oily fish. Also, heme iron (from animals) is more bioavailable than nonheme iron (from plants). Zinc levels are also is also lower on vegetarian diets.
21
BMI CalculatorPlease enter your weight and height
22
Have you been diagnosed with any of the following conditions?* This field is required.
Depression
Anxiety
Other mood disorder
None
23
How old are you?* This field is required.
Please Select
Please Select
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-55
55+
24
How many prescription medications do you take?* This field is required.
Please Select
Please Select
0
1
2
3
4+
25
Which best describes your current estimate of when you and your partner would like to get pregnant?* This field is required.
Please Select
Please Select
Currently trying (naturally)
Currently trying (assisted reproductive technology - IUI or IVF)
In the next 3 months
In the next 6 months
In the next 1 year
In the next couple of years
Further in the future, not sure when
Not interested in getting pregnant, just curious
26
On a scale from 1-10, how anxious are you about you and your partner's ability to conceive when you're ready to (1 - not at all, 10 - extremely anxious)?* This field is required.
Please Select
Please Select
1
2
3
4
5
6
7
8
9
10
27
First Name* This field is required.
28
Email* This field is required.By providing your email, you are opting in to view your baby-readiness zone and to receive emails from 9 Months Is Not Enough
example@example.com
29
Score Calculation
Should be Empty: