The items in the prototype FertiQoL survey were randomly presented and rated on a scale of 0 -4, where higher scores indicated more favorable QoL. The online survey (prototype FertiQoL and Background Information Form) was designed using SurveyTracker software for Training Technologies, inc and the paper version for clinic distribution was designed using InDesign. Webmasters were provided with a hyperlink to the survey. In clinics, FertiQoL coordinators at each site distributed the study pack to consecutive patients who returned completed surveys anonymously in a marked collection box in the patient waiting room.