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:
The donor was told about this program by her mother, who, when she was young, was thinking about participating in such a program. This also interested the donor. Because among her circle there are people who are unable to become parents, so she understands how difficult it is. In addition, the financial reward in the program will be a nice bonus for her, for her family.
The donor is married, she is the mother of a daughter who is now 6 years old and is preparing for school. She is an active, energetic and inquisitive girl. She loves to sing and dance. She is kind and sociable. She learns new things quickly, wants to go to school as soon as possible.
Her parents divorced when she was 14 years old. She has a younger brother. She hardly communicates with her father. She supports her mother more and has a warm relationship with her. Her mother is currently serving in the army as a cook. She is a brave, optimistic, strong woman. She is independent and self-sufficient, she can do anything if she wants. Her strength and confidence are an example to follow.
As a child, she was obedient, non-conflicting, well-mannered. She was active, inquisitive, and smart. She studied well, and she was more interested in humanitarian subjects. She was responsible for her studies and was a conscientious student.
She was engaged in needlework - she sewed, embroidered, tried various crafts. She liked drawing, everything was interesting, she wanted to try everything. She loved to spend her free time with friends, in an interesting company, talking, walking.
She remembers how in childhood she and her friends baked potatoes, swaddled cats, as children and leaves from trees were for them instead of money. She spent the summer in the village, in nature, with friends and relatives.
After the 11th grade, she entered a medical college, where she received a secondary medical education - Medical laboratory assistant. Now she works in a private clinic as a laboratory assistant in a laboratory. She likes medicine, she is interested in developing in this field. She would like to become a doctor in the future.
She considers her speciality to be the ability to tell the truth to the face, it is better to tell it as it is than to deceive herself and the interlocutor. This is better than gossiping or betraying yourself.
Her achievements are her family, she is happy to have a child, a wonderful husband and loved ones.
She dreams of traveling, seeing this diverse world, different countries, getting to know interesting cultures, architecture, etc.
During communication, the donor behaves openly, friendly, confident. It is easy to have a conversation with her, she is sincere, direct, and ready for contact. She answers questions judiciously and frankly. She shows herself as a caring and attentive mother. She is strong in spirit, self-confident, active, responsible, purposeful, emotional and sensitive.
Donor tested for up to 100 genes.