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 always wanted to be a donor. She is a blood, bone marrow, and liver donor. Her grandfather was also an honorary donor. The main thing is that someone will live, either overcome the disease, or a new life will be born.
She is married, has a 10-month-old daughter, who is an active, healthy, beautiful, and developed child.
Although her parents divorced 5 years ago, their family has warm, friendly relations with everyone. The donor has a younger sister, whom she helped babysit, played with her, and is now an older friend.
Her mother is bright, beautiful, kind, calm, and always helps others. She has a higher education - a rehabilitation specialist.
Dad is a professional football player, has many awards. Handsome, tall, red-haired. He is a leader, strong-willed, emotional, responsible.
She was an obedient child, helped her parents, played with her sister. She studied well, she liked it and succeeded with ease. She played sports - football, boxing. She believes that sports are an important part of an active life. In her free time - friends, active recreation, walks in nature, interesting communication.
After the 11th grade, she entered the university, where she is currently studying in her final year of the specialty "Tour guide, historian". She is inquisitive, conscientious and responsible in her studies. She is a purposeful and ambitious person, inclined to achieve her goals.
Now she works as an administrator in a massage and rehabilitation center, where she met her husband. After six months of dating, they got married, and a month later she found out that she was pregnant.
Family is the most important thing for her, everything she does is for her loved ones. She and her husband are like a single harmonious mechanism, they are partners, have a lot of common interests and time together.
Friends for her are communication, support, trust, mutual assistance.
She dreams of becoming a bone marrow donor. To do this, she submitted documents to National specialized children's hospital «Ohmatdyt». She would like to save someone's life.
She considers her greatest achievement to date to be that she coped well with the beginning of motherhood. Although it was difficult, she was alone with the child outside the city.
She considers her talent to be the ability to find a common ground with any animal, helps them, takes care of them, treats them. Before pregnancy, she was engaged in volunteer work for animals.
The donor has a hobby - she trains her own and other people's dogs, if they contact her.
Those close to the donor say that she is direct, open - she honestly says what she thinks. She is humorous, kind. She can be emotional, even impulsive, but she knows how to forgive and quickly "leave". She believes that she knows how to negotiate and adapt to other people. She will always help others, give a piece of herself. She is sociable, has many friends, loves company, interesting communication, it is difficult for her to sit still.
