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Vegetarian foodVegan food I avoid certain foodstuffs because of food hypersensitivityI avoid certain foodstuffs for religious reasons LCHF-diet (Low carbohydrate, high fat diet) GI-food (You eat food with a low GI i.e. glycemic index) Other diet, describe ______________________________________________________________________
0-2 weeks ago 3-4 weeks ago 1-2 months ago 3-4 months ago 5-6 months ago 7-12 months ago 1-2 years ago 3-4 years ago More than 4 years agoAt least 5 times/week 3 - 4 times/week 1 - 2 times/week 2 - 3 times/month 1 time/month 1 - 6 times/year
0-2 weeks ago 3-4 weeks ago 1-2 months ago 3-4 months ago 5-6 months ago 7-12 months ago 1-2 years ago 3-4 years ago More than 4 years agoAt least 5 times/week3 - 4 times/week 1 - 2 times/week 2 - 3 times/month 1 time/month 1 - 6 times/year
Nose drops Medicines for colds Diuretics Medicine for pain or inflammation relief Relaxants Sleeping pills Medicines for allergies Anti-smoking products (e.g. nicotine chewing gum) Other prescription free drugs Other naturopathic drugs No, I only use prescription drugs No, I use neither medicines nor naturopathic drugs
Less than 1 cup a day 1 cup/d. 2 cups/d. 3 cups/d. 4 cups/d. 5 cups/d. 6 cups/d. 7 cups/d.8 or more cups/d. I don’t drink coffee
Less than 1 glass/w. 1 glass/w. 2 glasses/w. 3 glasses/w. 4 glasses/w. 5 glasses/w. 6 glasses/w. 7 glasses/w.8 or more glasses/w. 0 times 1 time 2 times. 3 times. 4 times. 5 times. 6 times. 7 times. 8 or more times
Fewer than 1 cig/day 1 cig/day 2 - 3 cig/day 4 - 5 cig/day 6 - 9 cig/day 10 - 14 cig/day 15 - 20 cig/day 21 - 30 cig/day 31 or more cig/day
Less than 1 port/day 1 port/day 2 - 3 port/day 4 - 5 port/day 6 - 9 port/day 10 - 14 port/day 15 - 20 port/day 21 - 30 port/day 31 or more port/day
Very dissatisfied Quite dissatisfied Neither satisfied nor dissatisfied Quite satisfied Very satisfied
i. 1.sz. Melléklet - Életmód szűrő kérdőívek
Az Uppsala Egyetem munkatársai által a Swedish Pregnancy Planning (SWEPP) study keretében kidolgozott, kifejezettem az életmód és a fertilitás kapcsolatának feltérképezésére alkalmas kérdőív eredeti kérdései:
Your lifestyle just now
22. What type of food do you eat just now?
(Tick the option which best describes your diet) An all-round diet (You eat most things and do not avoid any specific type of food)
23.a. Do you take folic acid supplements just now?
Yes
No -> Go to question 24
b. If you take folic acid supplements just now, when did you begin taking them?
c. How often have you taken folic acid supplements during this period?
24.a. Do you take multivitamin supplements for women just now?
Yes
No → Go to question 25
b. If you are taking multivitamin supplements for women just now, when did you begin to take them?
(Answer in weeks, months, or years.)
c. How often have you taken the multivitamin supplements for women during this period?
25. Do you use any pharmaceutical products or naturopathic drugs below?
(Tick all relevant options)
26. How much coffee do you drink on average a day (1cup = 1.5dl)?
(Answer in number of cups a day)
The following questions are about your alcohol consumption. In these questions we use the term ”standard glass of alcohol”. A STANDARD GLASS OF ALCOHOL is defined as follows:
50 cl medium strong beer
33 cl strong beer/ strong cider
15 cl wine
8 cl strong wine
4 cl spirit
27.a. Do you drink alcohol at present?
(Tick the option that describes your habits best)
Yes, I drink every week.
Yes, but not every week.
No, I stopped drinking alcohol when I started trying to get pregnant this time
No, I had stopped drinking alcohol before I started trying to get pregnant this time
No, I have never drunk alcohol
b. How many standard glasses of alcohol a week do you drink on average just now?
c. How many times during the last six months have you drunk five standard glasses or more at one sitting?
28.a. Do you smoke just now?
(Tick the option that best describes you)
Yes, I smoke every day.
Yes, but not every day.
No, I have stopped smoking → Go to question 29
No, I have never smoked → Go to question 29
b. How many cigarettes a day do you smoke on average?
29.a. Do you use Swedish snuff tobacco (Sw. ’snus’) at present?
Yes, every day
Yes, but not every day
No, I had stopped using it earlier →Go to question 30
No, I have never used it → Go to question 30
b. How many portions of ’snus’ a day do you use on average just now?
30. Do you use nicotine substitutes (e.g. nicotine chewing gum or nicotine plasters) just now?
Yes
No
31. How many hours sleep per night have you had on average on a normal weekday this last month?
5 or less hrs.
6 hrs.
7 hrs.
8 hrs.
9 hrs.
10 hrs.
11 hrs.
12 hrs.
13 or more hrs.
32. How many hours a week have you spent doing any sort of physical activity this last month?
(Round up or down to the nearest hour.)
0 hrs/w
1 hr/w
2 hrs/w
3 hrs/w
4 hrs/w
5 hrs/w
6 - 10 hrs/w
11 – 20 hrs/w
21 or more hrs/w
33. How many times a week on average do you have vaginal intercourse?
(Round up or down)
Fewer than 1 time/w.
1 time/w.
2 times./w.
3 times./w.
4 times./w.
5 times./w.
6 times./w.
7 times./w.
8 or more times./w.
34. How satisfied or dissatisfied are you with your sex life?
Questions about your health
35. When was the first day of your last period?
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