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 | Yes |
| 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 decided to participate in the donation program after much thought and hesitation. She saw an advertisement on social networks, began to learn more about the donation program. Realizing that this program benefits people who want to have children, but cannot do so without outside help, she decided to make a possible contribution.
The donor and her husband have been married for two years, raising a 1-year-old son, who is an active, healthy, lively, inquisitive baby.
The donor's father did not participate in her upbringing, so she almost does not remember him.
The mother raised the donor and her older brother alone. For the donor, a mother is a dear and close person who has always shown her care, love, and concern. She is a kind, calm, non-conflict person who conscientiously and persistently works for herself and her family.
The donor has been energetic, active since childhood, knows how to stand up for herself and have her own opinion. As a child, she spent most of her time in the company of boys, so she was a mischievous, bold, strong-willed girl. She studied well, the humanities were more interesting to her, she also liked chemistry and physics. She drew well - she attended art school. Free time for her is walks, active recreation, reading books, interesting communication.
After the 9th grade, she continued her studies at school. Where life was already more saturated with interesting acquaintances, new knowledge. She felt like an independent and responsible student - living in a dormitory, away from her family, she had her first part-time job. She liked doing internships, getting direct work experience.
Donor has a secondary specialized education as a Cook. After studying, she worked in her specialty, and also abroad. Until she became pregnant and started a family.
For her, family is her protection, her peace, reliability and support, the most valuable and dearest people.
Now Donor does not work, she is on maternity leave.
She calls her speciality - the desire for justice. She is ready to defend justice in all possible ways, both in relation to herself and to stand up for other people.
Her main achievement today is her motherhood. She is happy to be a mother, raise a child, share her love, warmth.
She dreams of a big happy family, where mutual respect, trust, love, support and care are important.
The donor manifests herself as a sociable, simple, open and sincere person in communication. She is friendly, welcoming and sweet. She is characterized by responsibility, punctuality and accuracy. She values and respects others and expects a sincere attitude towards herself in return. It is characteristic of her to take care of her loved ones first, and only then of herself.
