This Anxiety questionnaire is designed for pre-infertility treatment evaluation. Since anxiety can affect pregnancy rate. Those who have moderate to high anxiety level should be adjusted before starting the treatment.
1. Do you worry continually almost every day about both big and small problems, situations, events, and/or activities?
2. Do you have difficulty controlling your worries or anxieties?
3. Do you have trouble keeping your mind on one thing?
Do you feel restless or keyed up or own edge much of the time?
5. Do you have headaches and/or other aches and pains for no apparent reason?
9. Do you sometimes sweat or have hot flashes?
10. Do you sometimes have a lump in your throat when you're worried?
11. Do you sometimes feel like you might throw up when you're worried?
12. Do you feel like you can't concentrate or that your mind goes blank at times?
13. Does your worrying interfere with your normal routines, work or school, and/or social activities?
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