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 can't 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 them in whatever way she can - to share what she has. She believes that donation is everyone's business, everyone has their own opinion about it, their own goal.
She is divorced, but on friendly terms with her ex-husband – they have an 8-year-old daughter to raise. The girl is growing up creative, athletic, and active. She is inquisitive, learns new things quickly, and is energetic. She is involved in creativity, drawing, dancing, and gymnastics.
Her parents live nearby, they often communicate, support each other. She values her family, their support and help, is grateful to her parents for their faith in her and support. She protects her parents as best she can, solves her own situations so as not to bother them, so that they are less nervous. The donor has a brother who is 7 years older, he is now a soldier, has his own family, a child. They have a friendly, reliable family, warm and close relationships.
Her mother is emotional, sensitive, joyful, cheerful and optimistic - these traits are also present in her from her mother. It is always warm and pleasant with her mother.
Her father is more serious, collected, strong and solves all problems himself, and in this she is like her father – independent and strong in spirit.
The donor was a calm child. She was responsible, conscientious, active. She was more open with loved ones, she got used to new people gradually. She studied well, with pleasure, was interested in studying history. She was a creative, sporty child. She danced for several years. She participated in various school competitions, performances, quizzes. In her free time, she played active games with her friends, rested in nature, had picnics, and walked.
After the 11th grade, she entered a lyceum. The studies there were more interesting, there were more practical classes, we went to practice at sea. She became more independent, more mature. She dreamed of getting a medical education, but her parents didn't have the financial means for this. Therefore, she decided that it was better not to strain her parents financially. She also likes her current profession. She has a secondary specialized education - Chef-Confectioner. She currently works as a sushi chef and administrator-cashier in a cafe.
She dreams of learning to drive a car and traveling. She is moving towards this goal, gradually everything will be. She considers her speciality to be the ability to find a common ground with every person, the quality of a common interest, curiosity and to build a pleasant conversation. This skill is very useful in life.
She considers her achievement to be that she is raising her daughter herself, that she is now providing for her small family herself.
Her loved ones call her the "soul of the company". It is fun, joyful, cozy with her. That she always listens, supports, understands, helps.
Donor is an active, energetic, sociable person. She is emotional, sensitive, empathetic. In conversation, she is open, talkative, quick in reactions and answers. She is smart, well-mannered, intelligent, answers questions logically, clearly. Very pleasant to communicate with. She is characterized by responsibility, purposefulness, hard work, independence, self-confidence. She strives to be independent.
