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 is participating in the oocyte donation program for the first time, she learned about this opportunity from an advertisement on a social network. This interested her, she found more information about the program, its purpose and possible consequences and decided to try to become a donor. She considers it a good deed, maybe she will help someone become a mother.
The donor is married, has a 6-year-old daughter. Her husband served in the army for 2 years, now after being injured at home, with his family. Her daughter is tall, beautiful, active. She is a developed, cheerful, energetic child. She is preparing for 1st grade, inquisitive, sociable and open.
The donor comes from an ordinary, kind and sincere family. She has an older sister. The donor’s mother is an entrepreneur, she is strict, disciplined, has a mathematical mindset, she is honest and straightforward. The father, on the contrary, is cheerful, the soul of the company. He is kind, sincere, gentle and caring. He never even raised his voice at home. She is “daddy’s daughter”, they are close. The family for the donor is the most valuable thing she has.
The donor was an active, developed, inquisitive child. She has a strong-willed and stubborn character. She showed interest in various activities – she went in for sports, dances, learned to play the violin. She attended the theater, cinema, interesting events with her friends. She is sociable, she aspired to be an organizer and leader in the company. She read a lot, was creative. She was interested in chemistry, mathematics and physics. She has always been more friendly with boys, she finds a common ground with them better, they are more understandable and reliable to her.
After the 11th grade, she entered college, where she received secondary education in accounting and programming. She now works as a developer of the SRM system.
She has a hobby-inspiration - she writes music. Unfortunately, she doesn’t have much time for it now. She bought a drum machine and a remote control - she is interested in DJing with an electronic remote control.
She considers the birth of a child and her motherhood to be her achievements for now. And in the professional sphere - this is fulfilling the plan and receiving an additional quarterly bonus - she did it, she is a great person. She believes that work should be enjoyable and financially motivated in order to strive for development and realization.
She dreams of earning enough to be able to move abroad with her child, educate her there, and give her a good future.
Her relatives say that she is cheerful, hot-tempered, and energetic. She is sociable, open in communication, direct, with a sense of humor, and a smile. She is responsible, purposeful, and persistent in work and study. She strives for self-realization and improvement. She is creative, has mathematical and logical thinking. Communication with her is easy and pleasant.
