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 has repeatedly come across information about oocyte donation programs. She learned about it from an advertisement on a social network. This interested her, she decided to find out more information about it. She has long wanted to do something useful for others, to take part in a charitable cause. The donor believes that donation is one of those good deeds where she can “share with others what she has”.
She is married, has been together with her husband for about 8 years, they have experienced many different life moments, they have a strong, friendly family. She has a 3-year-old daughter who is active, energetic, mobile. She is also a cheerful, sociable and inquisitive girl.
The donor’s mother works as a teacher’s assistant. She is strong, strong-willed, strives to keep everything under control. Ready to help, support, caring, understanding. The donor can talk to her on any topic, she will understand, will not judge.
The father is a miner, hardworking, persistent, courageous. He is balanced, silent, but understanding, reliable, supportive. He is kindred spirit to the donor.
There is an older brother who already has his own family. They have close, warm relationships in the family.
As a child, the donor was calm, balanced, cheerful, friendly, positive. She studied well, was inclined to humanitarian subjects, was interested in chemistry and biology, and even wanted to enter a medical college.
She studied at a music school, was engaged in folk dancing for 11 years. She loved to relax with her family and friends, and at home in peace to watch a movie or listen to her favorite music. She loves to read books.
After the 11th grade, she entered a pedagogical university. She wanted to work with children, help them in their development, in their studies. She has a higher education - a speech therapist. After studying in a kindergarten. Now she is not working, she adapts her child to kindergarten and plans to look for a job.
Her speciality is the ability to adapt to different people, to adjust. She can find a common language with almost anyone.
Her achievement is that she has a positive and optimistic outlook on this life. She dreams of seeing the sea and showing it to her child, traveling abroad, relaxing in peace, quiet and beauty.
Donor loves clarity, planning, order. She approaches any matter meticulously - if she takes on a task, she will see it through to the end. Donor is quite sociable, but calm in communication. She is open, polite, friendly, positive, believes in the best qualities in people. She is intelligent, smart, well-mannered. She is responsible in business, conscientiously fulfills her obligations, and persistently goes towards her goals.
