If you think you do, see your physician sooner rather than later. Your chance for a healthy pregnancy may be much more successful if begun early.
| ___ | You or your partner had infertility with other partners. |
| ___ | You and your partner have been unable to conceive despite unprotected intercourse for a year. |
| ___ | You or your partner had a sexually transmitted disease. |
| ___ | You have irregular menstrual cycles with periods further apart than every 35 days. |
| ___ | You have had two or more miscarriages. |
| ___ | You have a systemic illness such as diabetes or thyroid disease. |
| ___ | You are taking certain chronic condition medications, such as ACE inhibitors to lower cholesterol, or medications to treat ovarian cysts or endometriosis. |
| ___ | You are over 35 years old. |
| ___ | You have had pelvic inflammatory disease. |
| ___ | Your partner has had an inguinal hernia or a varicocele. |
| ___ | You or your partner has had chemotherapy or radiation therapy. |
| ___ | You have had any pelvic or abdominal surgeries. |
| ___ | Your mother or your partner’s mother was given DES during her pregnancy. |
| ___ | You have a history of very painful periods. |
| ___ | A doctor has ever told you that you might have trouble getting pregnant. |