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Q1. How old are you?

Select one

18-24 years
25-30 years
30-34 years
35-39 years
40-45 years
Above 45 years

Q2. Which stage of life best describes you?

Select one

Single and focused on career
In a relationship
Newly married (0–2 years)
Married (2–10 years)
Married with children
Trying to conceive
Empty nest / older children

Q3. Which best describes your profession?

Select one

IT / Software
Business Owner
Sales / Marketing
Government Employee
Healthcare Professional
Teacher
Self-employed
Skilled Worker
Student
Other

Q4. Approximately what is your monthly household income?

Select one

Less than ₹50,000
₹50,000 – ₹1 lakh
₹1–2 lakhs
₹2–5 lakhs
More than ₹5 lakhs
Prefer not to say

Q5. Which language are you most comfortable consuming health content in?

(Select all that apply)

English
Hindi
Telugu
Tamil
Kannada
Malayalam
Marathi
Bengali
Gujarati
Punjabi
Other

Do you experience any of these?

Acne
Excess hair
Weight gain
Fatigue

Have you been diagnosed with PCOS / PCOD?

Yes
Borderline
No
Not tested

What do doctors usually say about your reports?

Everything looks normal
PCOS / PCOD diagnosed
Low AMH
Endometriosis
No clear explanation

Have you ever been told you have “unexplained infertility”?

Yes
No
Not Sure

Have you been told about any of the following?

Select all that apply

Poor egg quality
Low AMH
Thin uterine lining
Implantation failure
None / Not discussed

Have you had miscarriages or chemical pregnancies?

No
Yes, once
Yes, more than once

How would you describe your stress levels?

Low
Moderate
High
Extremely high

Do you experience digestion or absorption issues?

Bloating
Constipation
Fatigue despite supplements
I take medicines but don’t feel results

Physical activity

Regular exercise
Occasional
Sedentary

Diet type

Balanced
Vegetarian
High junk / processed food
Irregular meals

How does your fertility journey make you feel today?

Hopeful
Confused
Emotionally exhausted
Anxious / scared of IVF

What are you most looking for right now?

Clarity on why it’s not happening
Natural support before IVF
Improve egg quality & hormones
Prepare body for healthy pregnancy