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 believes that she is doing a good deed - helping couples who cannot have children, but want to. She can be useful to them, and also receive financial compensation as support for her and her family.
The donor is divorced, raising a 4-year-old daughter alone. She is an active, restless, energetic, inquisitive and smart girl. She has a talent for drawing, dances. She loves animals, is open, communicative and playful.
The donor's mother is a nurse, has worked in a hospital all her life, helping people. She is kind, caring, loving, understanding.
The father is more strict, serious, reliable, businesslike, responsible and purposeful, has her own business,
The donor's younger sister, 1.5 years old, already has her own family, is waiting for a child.
Family for the donor is trust, support, mutual understanding, close ties.
The donor was active, fast, mobile, but balanced in childhood. She had many friends with whom she loved to walk, play, communicate, have fun and have fun. She studied well, was more inclined to the humanities, was fond of literature. She was also interested in biology, natural sciences. She was engaged in music, vocals, attended various creative circles.
After the 11th grade, she entered medical school. She had dreamed of getting a medical education since childhood, so studying there was interesting, exciting, although quite difficult. The donor has a secondary medical education - a nurse. She worked in the neurological department, is now on maternity leave. She believes that medicine is her field. In the future, the donor wants to develop and improve her skills, abilities, and knowledge.
Her talent is the ability to sing beautifully. Singing is also her hobby.
She considers the birth and upbringing of her daughter to be her achievement, she is proud of her.
She dreams of coming out of maternity leave to her favorite job, continuing to self-realize, grow professionally, and improve. She also dreams of developing in the field of cosmetology.
Her loved ones see her as sincere, kind, and open. Also punctual and obligatory.
Donor is friendly, welcoming, and sociable. In some life situations, she manifests herself as a leader, organizer. But she can also be a good performer, a team player. Modest, well-mannered, and polite. She is an active person, hardworking, responsible, and persistent. Prudent and intelligent. She is emotional, sensitive, vulnerable, and sensual. She cannot stay away when a person needs help, it is important for her to be useful, to be needed. Also wants to receive support and care in return.
