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 an older brother and sister. She was raised by her mother. Due to the fact that her mother worked for a long time, in her childhood the donor had to organize her life independently and take responsibility for herself and everyday affairs early. At the same time, she describes her relationship with her mother today as close and good. Her mother takes an active part in her life, helps with the child and supports the donor.
She remembers her childhood mostly positively. According to the donor, she was smart from an early age, started talking early, studied well and easily learned new material. During her school years she had good relations with her peers, was the class president, was engaged in singing and dancing. She describes herself as an active and sociable child. At the same time, the family had a large household, so from childhood she had a significant amount of household duties and helped her parents. Despite this, she had the opportunity to communicate with her peers, go for walks and lead an active social life.
After the ninth grade, she continued her studies and received an education. She did not work in her specialty. She has experience working in a store and as a hairdresser. At the time of the psychological assessment, the donor is on maternity leave and is raising her little son on her own. Since the child was born, she has been constantly with him, actively involved in his upbringing. She describes her relationship with her son as close and warm. She receives significant support in raising the child from her mother. In the near future, she plans to send the child to kindergarten and gradually return to professional activity. She has quite specific life plans related to professional and financial development. She plans to develop in the restaurant business, strives to have a stable income, become financially independent and provide the child with proper living conditions. Among her personal goals, she names obtaining a driver's license, purchasing a car, her own home and achieving stability. Her life plans are realistic and aimed at independence and improving the quality of life.
The donor learned about the possibility of participating in the oocyte donation program via the Internet. According to her, she had been thinking about donating even before the child was born. The decision to participate is her own and made without external pressure. The main motivation is the desire to help people who have difficulties with having a child. She sees the financial reward as an additional motivation and an opportunity to create a financial cushion for herself and the child. Thus, the motivation to participate is conscious and mixed, with the altruistic component being significant for her.
The donor’s attitude towards reproductive assistance was to some extent influenced by her own unpleasant medical experience related to a mistaken diagnosis of infertility. Later it turned out that the diagnosis was wrong. The donor is aware of the importance of having a child and perceives her participation in the program as an opportunity to help another family.
She has a good relationship with her brother and sister. Her brother is currently participating in hostilities, which is a factor of concern for the donor for a loved one. Her mother and sister are aware of her decision to donate. At first, they were worried about the possible impact of the procedure on her health, but generally supported her decision.
