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 knows that there are couples who cannot have children naturally. She was interested in this problem, what these people are going through, how they strive for it. Therefore, she decided to help in any way she could.
The donor is married, her husband is a military man, so he is rarely at home and most of the family worries fall on her. The donor has a 10-year-old daughter from her first marriage and a 2-year-old son from this marriage. She says about her daughter that she is a beautiful, intelligent, active, sociable and open girl. She studies well, studies English in depth, is fond of creativity. The son is an energetic, mobile, inquisitive and playful baby.
The donor's parents are always nearby, now they live in the next house. The donor's family is associated with home comfort, peace, mutual understanding, warmth and support.
The donor's mother is a chemistry and biology teacher. She is strict, but fair. Discipline and politeness are important to her, so that everything is done correctly and under control. She values order, comfort, and accuracy. That is why the donor feels that this has brought up the “excellent student syndrome” in her.
The donor's father is a builder. He is a calm, non-conflict, silent person, but at the same time he is kind, caring, and reliable.
The donor has a younger brother who is already an adult, has graduated, and works as a court security guard.
The donor says about her childhood that she was a well-mannered, obedient, calm, and problem-free child. She was open, sincere, and kind - she always helped her parents with the household, supported her brother, and was also an assistant to her grandparents. She was an excellent student in her studies, as she was responsible, persistent, and hardworking. She was engaged in vocals and drawing. She participated in school olympiads, contests, and competitions. She sang, was a presenter and organizer of school events. The donor has a talent for creativity - she graduated from art school, took various master classes and additional classes from professional artists. She even dreamed of getting a higher art education. Needlework for her is still a hobby, recreation and inspiration – she was engaged in clay modeling, knitting, sewing clothes.
After school, she entered a technical school. Where she also showed herself actively and persistently in student life – participating in amateur performances, leading celebrations, etc. And she also had no difficulties in studying, she studied well and with enthusiasm.
As a result, the donor received a secondary economic education - Accounting. Then she continued her studies at the university and received a higher education in this direction.
Now the donor has her own business - a coffee shop and works as a manicurist.
Her specialty is the ability to go to the goal. She does not give up in a difficult situation, strives for financial independence. Continuous development and self-improvement are important to her.
Her main achievement is organizing her own business from scratch, developing and improving her work.
She dreams of a vacation by the sea with her whole family. Because time together is the most valuable thing they have, and the most scarce in modern conditions.
It is fun, joyful, cozy with her. She always listens, supports, understands, helps. The donor is a kind, gentle person, it is difficult for her to refuse people. She is emotional, responsive, empathetic. In conversation, she is open, friendly, sincere. She is smart, well-mannered, intelligent, answers questions logically and clearly. She is responsible, purposeful, hardworking, and self-confident. She strives to be independent, develop, and realize herself.
