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 | |
| 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 decided to participate in the program because her friend had problems giving birth to a child. She knows what she feels and how a woman copes in such situations. Therefore, she understands and wants to support other women. In addition, there is a war in the country, she would like to make her possible contribution to the birth of a new life and the continuation of her gene pool. The donor is married, she and her husband are raising a 2-year-old girl. Her daughter is active, stubborn, insists on her own, inquisitive, energetic. She loves to draw, play with children, go for walks.
The donor's father died when she was a year old, so she only knows about him from her mother's stories. Her mother loved her father very much, she still misses him and remembers him. Her mother has a strong-willed character, cheerful, energetic. She thinks that she looks more like her mother in appearance. Well, and self-respect. If someone offends, treats her badly, we will not tolerate it, we will leave such communication. Also, since my mother is straightforward and honest, it is better to tell the truth to her face than behind her back.
The donor has an older brother on her mother's side and a younger sister.
The donor was an active child, strong-willed, courageous. She studied normally, but she was more interested in sports and creativity. She loved to draw, she did well. She played sports, danced.
After the 9th grade, she entered college, where she made a best friend, new acquaintances, and an interesting company. Studying was more motivating, exciting, and a more independent and responsible student life began. She received a secondary specialized education - Sales Consultant and Cook.
During her studies, she met her husband, got married, and had a daughter. For her, family is her support, the best thing in her life. They have a calm, non-conflict family, they find a compromise and appreciate each other.
Now the donor works as an administrator and sales consultant in a household goods store. To this day, she has a hobby - drawing, it calms her down and restores her. Unfortunately, she doesn’t have much time for it, because she has a family, a child, and a job.
Her achievement today is that she worked as a store manager, she went through a difficult path to get this position. A family for the donor is also an achievement, because she is young - 20 years old, and already has her own family.
She dreams of learning to drive a car, wants to buy a car, get a driver's license and be a skilled driver.
Her loved ones believe that she is cheerful, active, responsible. Her best friend jokingly says that she is desperate - she isn't afraid to change her life, develop, move forward.
The donor appears as a punctual, responsible, conscientious person. She has her own ambitions, strives for self-development, improvement. She is collected, serious, prudent and independent. At the same time, she is sweet, kind, friendly and emotional.
