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 learned about the existence of such donation programs from her husband's relatives, they could not get pregnant and they used the IVF program. They told about their path, about the treatment, about the procedures they went through. This impressed the donor and she decided to help others, to give this opportunity to become parents.
The donor is married, has an 8-year-old son, who is in the 3rd grade of school. The donor spends most of her free time with her son, helps him with his studies, supports his endeavors, they relax and play together. Her son is a sociable, kind, active and inquisitive boy. He likes mathematics, conducting various experiments in physics, studies English in depth. He attends a programming and robotics club.
The donor's parents divorced when she was 6 years old. Her father has another family. They communicate with him, but quite formally and superficially. The donor has a half-brother.
She was raised by her mother, who is a close and dear person to her. Her mother loves nature, animals, takes care of them, lives in the village. She is open and sincere, sociable, loves communication. She always helps everyone, is kind, caring.
The donor herself was an obedient, calm, well-mannered child. She is kind, sociable, respects elders, sensible and intelligent. She studied well, and has been interested in history and ethnography since school years. As a child, she visited the local library to learn more about the past of different peoples, and dreamed of becoming an ethnographer. She was engaged in drawing, and she did it well.
After graduating from school, she entered college to become a hairdresser, but over time she felt that it was not interesting to her and left her studies. After the birth of her son, she worked in a kindergarten that her son attended. Because she wanted to be with him, to be involved in his development and education. She enjoyed working in kindergarten, helping other children and their parents. Her current goal is to enroll in a pedagogical university, she would like to become a speech therapist, to help children develop.
Now she has found herself in floristry. She works as a florist in a flower shop. It is also interesting and creative. It develops her creative abilities, organizational and business.
Donor is a creative person, has an artistic and aesthetic taste. She knows how to see and create beauty. This helps her a lot in her work as a florist. Also, what is important, she is very responsible, decent, conscientious and punctual. Processing orders on time, delivering flowers, this is important for her - therefore it is also a guarantee of peace and joy of her clients. It is important for her not to let down people who are counting on her. If she takes on a job, she will do it qualitatively and on time.
Her peculiarity lies in her intuition. She learns to listen to herself, to act not always logically, but most importantly with her heart. She likes to make plans, this calms her down.
Donor is friendly, sweet, makes a good impression. She is sociable, open, sincere. Positive, friendly, and sensitive. It is important for her to be useful to others, to help people, to understand and hear others.
