90 Days Fertility Detox Program
Transform your Fertility Naturally in just 90 days.
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Name
Age
Height
Weight
City
Contact phone
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13%
Which of the below problems you are facing right now?*
Weight Management
Thyroid
PCOD / PCOS
Diabetes / Insulin resistance / Hba1c
Hormonal Imbalance
Cholesterol / Triglycerides
Poor Egg Quality / Sperm Quality
Sleep Disorder / Insomnia
Nutritional Deficiency
Inflammation / Infection
Gut Health
Liver Health
Total Detoxification
Stress Management
Ovarian Cyst
Endometriosis
Irregular Periods
Depression, Anxiety, Mood Swings
Peri-menopause
Auto-Immune Conditions
Eczema / Psoriasis / Rosacea
Unexplained Infertility
I don't know about my problems exactly, but would like to Improve my Overall Health.
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15%
How long have you been trying to conceive?
Less than 6 Months
6 month to 12 months
1-2 year
More than 2 years
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17%
Which of the following best describes your current situation?
Trying to conceive (TTC), had a miscarriage / abortion before
TTC never conceived before
Planning for second child
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19%
What type of treatment have you taken? Or are you planning to take?
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21%
Are you currently taking any Medications / Supplements? If yes, please specify name and doses (e.g., Thyronorm - 50mcg)
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24%
Have you experienced any sudden or unexplained changes in your weight in the last 6 months?
My weight has remained stable
I have gained weight (up to 5 kg)
I have gained significant weight (more than 5 kg)
I have lost weight (up to 5 kg)
I have lost significant weight (more than 5 kg)
I am not sure about any changes
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26%
28
How would you describe your overall energy levels throughout the day?
I have consistent high energy throughout the day
I experience some dips in energy but manage well
I often feel fatigued but can push through
I frequently feel exhausted and struggle to stay energized
My energy levels fluctuate significantly day by day
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28%
Do you experience fatigue or tiredness even after a full night's sleep?
I wake up feeling refreshed and rested
I sometimes feel tired, but not every day
I often feel tired after a full night’s sleep
I always feel fatigued, no matter how much I sleep
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30%
Do you experience recurring symptoms like headaches, joint pain, or muscle aches?
No, I rarely experience these symptoms
I experience mild symptoms occasionally
I frequently experience moderate symptoms
I experience severe symptoms almost daily
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32%
Are your menstrual cycles regular (every 28-32 days)?
Yes, my cycles are always regular
My cycles are mostly regular but vary slightly (by a few days)
My cycles are often irregular, varying by more than a week
My cycles are very irregular, or I have missed periods
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33%
How long is your typical menstrual cycle?
24-26 days
27-29 days
30-32 days
More than 32 days
Less than 24 days
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35%
How many days does your period last?
2-3 days
4-5 days
6-7 days
More than 7 days
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37%
Do you experience painful periods (cramps, heavy bleeding, clotting, etc.)?
No, my periods are pain-free
I experience mild discomfort that does not require medication
I experience moderate pain, which sometimes requires over-the-counter medication
I experience severe pain, which impacts my daily activities and requires medication
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39%
Do you experience spotting between periods?
No, I do not experience spotting
Rarely, I spot once or twice a year
Occasionally, I spot every few months
Frequently, I spot between most cycles
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40%
Do you experience mood swings, anxiety, or depression around your menstrual cycle?
No, my mood remains stable
I occasionally experience mild mood swings
I frequently experience moderate mood swings or anxiety
I experience severe mood swings, anxiety, or depression that impacts my daily life
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43%
Do you experience breast tenderness or swelling before or during your period?
No, I do not experience breast tenderness
I experience mild tenderness occasionally
I experience moderate tenderness frequently
I experience severe tenderness or swelling regularly
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45%
Do you experience hot flashes, night sweats, or difficulty sleeping?
No, I do not experience any of these symptoms
I occasionally experience one or two symptoms
I frequently experience moderate discomfort
I experience severe symptoms that disturb my sleep regularly
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47%
How would you describe your stress levels on a typical day?
I experience little to no stress
I experience moderate stress but manage it well
I frequently feel stressed and it affects my mood
I feel very stressed, and it impacts my daily activities
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49%
How do you manage stress?
I engage in relaxation techniques like yoga, meditation, or mindfulness
I use physical activity or exercise to manage stress
I talk to friends, family, or a therapist for support
I do not actively manage my stress
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51%
Do you sleep well at night?
Yes, I sleep 7-9 hours and feel rested
I sleep 5-7 hours but sometimes feel tired
I have difficulty falling or staying asleep frequently
I have insomnia or regularly wake up during the night
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54%
Do you smoke?
No, I don’t smoke
I smoke occasionally, socially
I smoke regularly, several times a week
I smoke heavily on a daily basis
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56%
Do you consume alcohol?
No, I don’t drink alcohol
I drink occasionally, socially
I drink regularly, several times a week
I drink heavily on a daily basis
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58%
How often do you engage in physical activity?
Daily or almost daily, I exercise regularly
A few times a week
Once a week or less
I do not exercise regularly
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60%
How would you describe your diet?
I eat a well-balanced diet with whole foods
I eat mostly healthy but indulge occasionally
I eat processed or fast foods often
My diet is poor, and I struggle to make healthy choices
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62%
Do you experience frequent bloating, gas, or constipation?
No, my digestion is regular and without discomfort
I occasionally experience mild digestive discomfort
I frequently experience moderate digestive issues
I regularly experience severe bloating, gas, or constipation
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65%
Do you often crave sugar, salt, or carbohydrates?
No, I rarely have cravings
I occasionally crave specific foods, but it’s manageable
I frequently have moderate cravings
I have intense cravings daily, especially for sugar or carbs
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67%
How much water do you drink daily?
More than 2.5 liters daily
1.5-2 liters daily
1-1.5 liters daily
Less than 1 liter daily
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69%
Have you ever experienced a miscarriage?
No, I’ve never had a miscarriage
Yes, I’ve had one miscarriage
Yes, I’ve had two miscarriages
Yes, I’ve had three or more miscarriages
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71%
Have you undergone fertility treatments (e.g., IVF, IUI)?
No, I have not undergone any fertility treatments
Yes, I’ve had one round of treatment
Yes, I’ve had multiple rounds of treatment
Yes, I am currently undergoing treatment
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73%
Are you frequently exposed to environmental toxins or chemicals?
No, I’m not exposed to toxins or chemicals
Yes, I’m occasionally exposed to environmental chemicals (e.g., at work)
Yes, I am regularly exposed to chemicals at work or in my home environment
I’m not sure about my level of exposure
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76%
Do you use personal care products that contain chemicals (e.g., parabens, sulfates)?
No, I use mostly natural products
Yes, but I use a mix of natural and chemical products
Yes, I regularly use products containing chemicals
I’m not sure about the ingredients in my personal care products
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78%
Have you taken any blood test in the last 12 months?
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80%
What is your daily routine? (How many meals a day do you have?)
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82%
What is your dietary preference?
Vegetarian
Vegetarian + Eggs
Non-Vegetarian
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84%
What food items do you have in Breakfast regularly? At what time?
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90%
What food items do you have in Lunch regularly? At what time?
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93%
What food items do you have in Dinner regularly? At what time?
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97%
Are you a tea or coffee addict? How many cups in a day? Can you avoid it?
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100%
Mention periods date of last 6 months
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