Egg Donor Interview & Screening Process

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Choose clinic *

Personal Data

Street address

Email address *

Phone number *

Physical characteristics and ethnicity

Ethnic group: Finnish/something else, please specify *

About being a donor

Have you donated eggs before? *

I have read the information related to egg donation on Ovumia's website and I am aware that if I am accepted as an egg donor, I will have to visit the clinic 3–4 times during the donation period. *

Menstrual cycle

Age of first menstruation *

Duration of menstrual cycle (in days, from the first day of one period to the first day of the next) *

Is your cycle regular? *

Are you using any form of contraception? *

Genital health

Have you had any genital diseases, such as infections, endometriosis, genital tumors, or other conditions? Please specify.

Pregnancy history

Have you been previously treated for infertility? Where and what kinds of treatments?

State of health

Do you have any illnesses? If yes, which ones? (e.g., diabetes, hypertension, gastrointestinal disorders) *

Have you had any surgeries? *

Medication

Do you take medications regularly? If yes, please specify. *

Stimulants

Do you use nicotine products? If yes, what and how much? If you quit, when? *

Alcohol consumption per week/month (1 unit = 12 cl wine, 33 cl cider/beer, 4 cl spirits) *

Do you use or have you ever used/experimented with drugs? If yes, what and when? *

Illnesses and diseases in your immediate family

Does your family have the following diseases? Specify who: Self / Mother / Father / Sibling / Own Child / Grandparent

Cardiovascular diseases

Diabetes

Gastrointestinal diseases

Other internal organ diseases (liver, kidney)

Rheumatic or connective tissue diseases

Neurological diseases (MS, epilepsy, ALS)y

Mental health conditions (depression, bipolar disorder, schizophrenia)

Neurodevelopmental disorders (ADHD, Asperger, autism)

Congenital abnormalities (clubfoot, cleft lip/palate, scoliosis)

Other hereditary diseases

None of the above

Have you or your close relatives undergone chromosome analysis or testing for hereditary diseases? If yes, who and what was the result?

Where did you learn about egg donation?

Somewhere else:

Other factors that may influence donation of eggs, and possible wishes or comments:

By submitting this form, I consent to the storing of my patient data in Ovumia Oy’s register of patients. *

By submitting this form, I consent to the storing of my patient data in Ovumia Oy’s register of patients. *

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Egg donor interview