This donor has passed a rigorous medical examination to ensure absolute safety. Our screening process includes strict testing for infectious diseases (HIV, Hepatitis B/C, STIs), an evaluation of lifestyle habits, and a general physical assessment. We confirm the donor is currently in excellent health and free from transmissible conditions.
Assess your vision without corrective contact lenses
Do you wear contact lenses or have you had corrective surgery?
If yes, describe a problem:
What is the condition of your teeth?
Have you ever had braces?
Do you use nicotine products?
Do you drink alcoholic beverages?
If yes, how much alcohol do you drink?
Describe your diet
Estimate the level of nutrition:
Do you have allergies?
If yes, describe what exactly you are allergic to:
What is your sexual orientation?
How many children do you have?
Age at the time of the first menstruation:
The interval between menstruation is:
Have there been cases of multiple pregnancies in the family:
Please provide information about your biological relatives (indicate only natural hair and eye color):
Relative
Height, cm
Weight, kg
Eye color
Natural hair color
Primary medical history
Mother:
Father:
Complete the table
Family (which relative has the disease)
Age
Cause of death
Disease
The age at which was diagnosed
| Have you ever been diagnosed with or suspected of having any neurological disease (including dementia or degenerative /demyelinating disease of the CNS or other neurological disease of unknown etiology)? | No |
| Have you or any of your sexual partners ever been diagnosed with or suspected of having West Nile Virus (based on symptoms and/or laboratory results or confirmed WNV viremia), experienced symptoms of WNV infection? | No |
| Have you ever been exposed to known or suspected HIV, Hepatitis B, Hepatitis C infected blood or body fluids through skin inoculation, open wounds, non-intact skin or mucous membranes? | No |
| Have you or any of your sexual partners has had sex in the preceding 12 months with a person known to have HIV, clinically active HBV or clinically active HCV? | No |
| Have you or any of your sexual partner(s) ever received, blood, blood components, blood products, or other human tissues that are known to be possible sources of blood-borne pathogens? | No |
| Have you or your sexual partners been diagnosed with Zika virus in the past 6 months? | No |
| Have you travelled to an area with Zika virus transmission? | No |
| Alcoholism | No |
| Drug addiction | No |
| Alzheimer's disease / dementia before age 60 | No |
| Aneurysm | No |
| Fear / panic attacks | No |
| Attention deficit / hyperactivity disorder | No |
| Autism or Asperger's syndrome | No |
| Bipolar disorder | No |
| Blood coagulation disorders / hemophilia | No |
| Blindness before the age of 50 | No |
| Brain tumor / abnormality | No |
| Breast cancer | No |
| Cerebral palsy | No |
| Non-union of the lip or palate | No |
| Colorectal cancer | No |
| Flat feet | No |
| Depression | No |
| Epilepsy or seizures | No |
| Extra or fused fingers or toes | No |
| Genetic disorders | No |
| Hearing disorders / deafness under the age of 50 | No |
| Heart attack before age 50 | No |
| Heart defect | No |
| Huntington's disease | No |
| Immune disorders | No |
| Kidney defect / disorder / cancer | No |
| Intellectual disability / developmental delay | No |
| Melanoma | No |
| Mental retardation | No |
| Obsessive-compulsive disorder | No |
| Ovarian cancer | No |
| Pancreatic cancer | No |
| Parkinson's disease before the age of 60 | No |
| Pituitary disorder | No |
| Prostate cancer before the age of 50 | No |
| Schizophrenia | No |
| Speech disorders / lisping / stuttering | No |
| Split spine | No |
| Stroke under the age of 50 | No |
| Uterine cancer | No |
| Tourette syndrome | No |
| Vision disorders | No |
| Vitiligo / pigmentation disorders | No |
| Death before the age of 50, including childhood | No |
| Other cancer diagnoses before the age of 50 | No |
| Other congenital defects | No |
| Other health disorders | No |
| Diabetes | No |
| Hypertension | No |
| Rheumatoid arthritis | No |
| Pathology of the thyroid gland | No |
| Endometriosis | No |
“Big Five” personality traits of the Donor
1
Extraversion
2
Emotionality
3
Openness to New Experiences
4
Conscientiousness
5
Agreeableness
A
Psychological assessment of the donor:
According to the donor, there are many people who want to become parents, but for various reasons they cannot. She says that she was once mistakenly “given such a diagnosis” and she was very shocked and confused. Therefore, she understands what it is like, sympathizes and wants to help couples and women who dream of parenthood to achieve their dreams.
Now, the family for the donor is her and her daughter. She speaks about her daughter with love and comfort, with tenderness.
The donor is not married. She says that she is open to new relationships, but wants a responsible and serious partner.
The father of her child does not accept participation in raising her daughter. The relationship with him did not work out. She met him at the age of 16, wanted support and protection, because she often ran away from home. Her stepmother insulted her. But her husband did not turn out to be that “support”.
She says about herself that she is punctual and “homely”. That home comfort is important to her, that things are good at home. She wants her child to grow up in love, support, and warmth.
Her mother died when she was 3 years old. Her father took her to raise her in his new family. But the relationship with her stepmother did not work out, who did not love her and abused her.
The donor has an older sister and brother. But after her mother's death, her father limited communication with them. Therefore, the donor missed them in childhood. Now their relationship is gradually becoming closer and more friendly. She also has a brother and a sister by her father. Her stepmother passed away this year. She tries to support and help her father and younger sister as much as she can. But they have different views on life and values, so the relationship does not have that love and closeness.
The donor's maternal grandmother was an ideal and the closest person for the donor. She was kind, bright, never shouted or offended.
She talks about her childhood as quite difficult. She grew up without a mother and without maternal affection and support. There is a feeling of a lack of love, so the donor often sought protection and support from other older women, and wants to give this love to her daughter.
Donor studied for average grades. She was more interested and motivated by creativity. She was artistic and active. She sang in the choir. She was interested in acting. She participated in various performances, competitions, concerts. She liked it - being in public, being in the spotlight.
Donor has a secondary specialized education in agronomy. But she does not work in this specialty. She completed specialized training and is currently working as a master of eyelash extensions.
Donor is a sociable, talkative person. She is pleasant to communicate with, open, sincere. She always sought to get what she wanted, achieve her goals, satisfy her own ambitions. In her work, she shows herself as a conscientious, responsible, and persistent worker.
