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 treats the donation as a charitable cause. He believes that such programs benefit both the donor and potential future parents - everyone gets what they need and want. For others, this program is an opportunity to become parents, and for the donor - an opportunity to support the start of their own business with the help of financial rewards.
Her husband knows about her participation in the program. Her husband respects her decision, but is worried that it will not have a negative impact on her health.
The donor has been married for 3 years, but she and her husband have been together for 7 years. They have a son, who is now 1 year and 2 months old. The donor talks about her son with a warm smile, saying that he is a healthy, active, inquisitive baby. He is developing and actively learning about the world.
The donor talks with sadness about her father, who died 5 years ago. In her memories, he is always very balanced, calm, kind, without a hint of aggression and conflict. He was caring, open, sincere, loving - just like her husband.
She and her mother are similar, in her opinion. Mom is a strong-willed woman, confident in herself. She is a leader, with a strong character, if she decides something, it is almost impossible to change it. She strives to be the first in everything.
Donor was active as a child, inquisitive, mobile, energetic. Everything was interesting to her, she sought to organize people around her, showed leadership qualities. She was stubborn, insisted on her own opinion, her desires. She was always surrounded by a circle of friends. Since childhood, it is important for a donor to be in the spotlight, to be surrounded by loved ones, to communicate, to feel needed, loved.
She studied well at school. She was fond of biology, chemistry, physics. She has a talent for creativity, artistic and musical abilities - she studied at a music school, attended a beadwork circle. She dreamed of becoming a psychologist or a pediatrician, but her parents' financial situation did not give her such an opportunity.
After the 9th grade, she entered college. The choice of profession was to some extent influenced by her mother's opinion. Therefore, studying at college was felt by her more as a duty and necessity. She had no interest or motivation for this profession.
The donor has a secondary education - veterinary medicine. But she does not work and does not plan to work after her education.
The donor is currently unemployed, she is on maternity leave. She intends and wants to develop her own small business - she wants to open a children's clothing store.
The donor feels like a person who craves tenderness, love, care, she needs attention, support. At the same time, she is a self-confident person, likes to manage the situation, to be in a leadership position. She is friendly, sincere, open. She loves animals, believes in the best qualities in people, takes care of her loved ones, loves to make pleasant surprises and gifts.
The donor is talkative, friendly in communication, sociable. She takes on any business without fear. She is not afraid of change. She strives for self-realization and development. She is responsible, punctual, polite. The donor is emotional, vulnerable, sensitive. Purposeful and ambitious.
She understands the content and obligations of the donation program, understands the responsibility and medical risks associated with the program. She leads a healthy lifestyle, is optimistic about completing the program, follows the doctor's recommendations. She sees no obstacles in the way of fulfilling the donor's obligations. There is no financial, emotional or other coercion from other persons to participate in the donor program. According to the donor, there is no family history of mental illness, substance abuse, etc. Considering the above, this candidate can be recommended as an oocyte donor.
