General and biometric information |
| Year of birth |
1989 |
| Height, cm |
182 |
| Height, foot |
6'0" |
| Weight, kg |
75 |
| Religion |
Christian |
| City of residence |
St.Petersburg |
| Eye colour |
Greyish-green |
| Hair color |
Middle blond hair |
| Hair specific |
Straight |
| Hair colour in your childhood |
Blond hair |
| Do you have grey hair? (from what age) |
No |
| Hair density |
Thick hair |
| Body frame |
slim |
| Skin complexion |
Fair (skin will tan lightly on sun exposure) |
| Freckles |
Some freckles on face in spring-summer time |
| Race |
European (Caucasian) |
Nationality of grandparents
|
| Father`s mother |
Russian |
| Father`s father |
Russian |
| Mother`s father |
Russian |
| Mother`s mother |
Russian |
Personality
|
| Why I became an egg donor |
Being an egg donor adds a positive meaning to my life. Happiness is not only a career, health… but also giving the gift of a life to another human. |
| Right handed/ Left handed/ Ambidexter |
Right handed |
| Marital status |
Married |
| If married, how many years? |
1,5 years |
| Occupation |
The main occupation at the moment - A mother and a housewife |
| Hobbies/interests |
Chemistry, mathematics, swimming, childcare and upbringing |
| Current and future personal goals |
To make a career as an engineer, to be a good mother and a wife |
| Add something about yourself |
I like order, I am goal-oriented, thoughtful and rational |
| Main character traits |
Responsive, Sociable, Neat, Polite, Strict, Careful, Reliable, Faithful, Straightforward, Goal-oriented, Caring |
Medical and genetical information |
| Blood group and Rh factor |
A+ |
| Are you adopted? |
No |
| How many full siblings do you have? |
1 sister |
| Contraception |
birth control pills |
| Do you regularly visit gynecologyst? |
3 months ago |
| Do you have/Did you have any gynecological diseases/surgeries? |
No |
| Do you wear hearing aids? Have any problems with hearing? |
No |
| Do you wear contact lenses/ glasses? Have any problems with eyesight? |
Myopia, -2,5 |
| Have you had corrective eye surgery? For what problems (nearsighted, farsighted, other?) |
No |
| Please rate the health of your teeth |
Good |
| Have you ever had braces on your teeth? |
Yes |
| Do you smoke? |
No |
| How much alcohol do you consume per week/ month? |
None |
| Describe your type of diet |
Non vegetarian |
| Do you have any allergies? |
None |
| Do you exercise regularly? |
Daily walks in a park with my baby |
| Do you take any prohibited drugs? |
No |
| Have you had a blood transfusion? |
No |
| Have you had been hospitalized for psychical reasons? |
No |
| Are there any triplets or twins in your genetic family? |
No |
| Have you had any stillbirths, miscarriages, abortions? |
No |
| Are you breastfeeding at the moment? |
No |
| Do you have any medical conditions? |
No |
| Do you have any chronic diseases? |
No |
| Do you take any medications (prescribed or not)? |
No |
| Have you had any hospitalizations/ surgeries? |
No |
| History of STD (HIV, Syphillis, Gonorrhea, Chlamydia, Herpes, Viral Hepatitis B or C, CMV), specify the dates and treatments, if were any |
No |
| Do you have/Have you ever had these infections: chlamydia, gonorrhea, trichomoniasis, genital herpes? |
No |
Health condition of donor`s genetical family
|
| Migraines |
No |
| Mental illness or disabilities |
No |
| Epilepsy |
No |
| Muscular dystrophy |
No |
| Hearing problems, deafness |
No |
| Colour blindness, blindness |
No |
| Wearing glasses/ contact lenses, Farsighted/ Nearsighted |
Mother farsighted in her 47 and sister nearsighted after an accident |
| Glaucoma |
No |
| Schizophrenia |
No |
| Frequent depressions |
No |
| Serious congenital malformation |
No |
| Clubfoot |
No |
| Dwarfism |
No |
| Cardiovascular diseases |
No |
| More than two miscarriages |
No |
| dermatodyschromia, rash |
No |
| Dermatomelasma, Neurodermatitis, Psoriasis |
No |
| Baldness (if yes, specify the age) |
No |
| Cancer (specify the type) |
No |
| Haemophilia |
No |
| Stroke |
No |
| Ulcer |
No |
| Ovarian cycts |
No |
| Ovarian tumor |
No |
| Fibroma uteri |
No |
| Uterine (Myoma) fibroids |
No |
| Alcoholism |
No |
| Drug addiction |
No |
| Diabetes before age of 55 |
No |
| Autism |
No |
Social information and abilities |
| Education level |
Higher education, University degree in Chemical Engineering |
| What languages do you speak, read or write? |
English |
| What musical instruments do you play? |
None |
| What were/are your athletic skills/favourite sports? |
Basketball |
| What are your plans for future education? |
Professional training |
| List 3 last jobs you have had (job title, duties, full-time or part-time job) |
Cashier (full time) |
| Your philosophy is |
To achieve everything myself and don`t rely on anybody except myself |
| If you could pass on a message to the recipient(s), what would that message be? |
Take care of your health since your youth |
Temper and preferences |
| Favourite food |
Meat, potatoes, vegetables |
| Favourite colour |
Green, grey |
| Favourite season |
Summer |
| Favourite holiday |
New Year |
| Favourite music style |
Popular |
| Favourite movies |
Family movies, Movies without cruelty |
| Do you believe in miracles? |
No |
| Do you follow the news? |
Yes |
| Do you believe in astrology? |
Yes |
| Do you pray? |
Sometimes |
| Do you have any pets? |
Yes |
| Do you speak with strangers while traveling? |
Sometimes |
| Do you make a wish after falling star? |
Yes |
Learning and cognitive abilities
|
| How well can you acquire knowledge, learning new skills? Do you enjoy it? |
Easy-educated. I like acquiring knowledge and I always improve my knowledge in free ( if I have the time ). |
Analysing abilities
|
| How well can you analyze information, extract important and useful details? Do you enjoy it? |
Well. I make the conclusions from all situations. I do it automatically. |
Logic abilities
|
| How well can you discuss things in a right and reasonable way, make conclusions? Do you enjoy it? |
I find this very easy. I always make the conclusions, but I don't know how well. |
Poetry abilities
|
| How well can you write poems, set forth your thoughts in poems in a right and nice way? Do you enjoy it? |
Badly. I used to write poems constrainedly at school. There is a rhyme, but not a sense. |
Narration and oratory abilities, elocutionary gift
|
| How well can you retell stories, speak interesting and well in a nice manner? Do you enjoy it? |
I retell stories well, but not word for word. It's necessary to speak in a nice manner and to expound the thoughts and I try to do it without hesitation. |
Linguistic abillities
|
| How well can you learn and use languages (not only foreign languages, but also your native language)? Do you enjoy it? |
Well. I try to keep at a level my native language. The foreign languages are not my things. |
Communicative abilities
|
| How well can you communicate, make new acquaintances, hand over information and receive information? Do you enjoy it? |
I easily make new acquaintances if people don't make me feel some negative emotions. I really enjoy this, but It happens seldom and mainly during my work. |
Sport abilities, Having a skilled body
|
| How well can you do sports, for instance: swimming, skiing, skating, playing volleyball and other physical activities? Do you enjoy it? |
I like playing volleyball and basketball, the other kinds of sport are only for company. I don't like any water sports. I like doing sports if I have free time, for example, kicking a ball with my child. |
Dancing abilities, choreographic abilities and one’s body plasticity
|
| How well can you dance, move in rhythm with music, make dancing movements? Do you enjoy it? |
Middle. I can't dance to classical music, but I always moving at the disco. I like going to the disco and I like watching some classic dances on TV. |
Imagination abilities
|
| How well can you generate ideas, express your thoughts and ideas in a creative way? Do you enjoy it? |
Badly. I do it seldom and if it's really necessary. I don't draw and don't model, but I do articles and inside repair. That's a creation too! |
Drawing abilities
|
| How well can you draw or paint? Do you enjoy it? |
Badly. At a level of a primary school. A drafting proves better. This is not one of my strengths so I do not really enjoy it! I draw with my child without thinking. |
Singing abilities, Having a good ear
|
| How well can you sing, sing along, sing with karaoke, sing in a bathroom? Do you enjoy it? |
I have no talent, but I sing with radio and TV. I like joining in the process of singing. |
Acting abilities
|
| How well can you act as an actress: to enter into some role, to play up to somebody’s play? Do you enjoy it? |
Easily. There was a school theatre, plays with my friends and now I play with my child. This is not one of my strengths so I do not really enjoy it before the birth of my child. Now I play for my child and do it well. |
