Register

You can easily sign up to participate in Moeders voor Moeders by filling out the form below. First, confirm that you are pregnant. Then, enter either the date of your last period or your estimated due date. If you are less than 12 weeks pregnant, the rest of the sign-up form will automatically appear.

Are you pregnant?

Please fill out the form below:

No Yes

How far are you pregnant?

Can you participate?

Your urine is used to create a medicine. The health authorities overseeing medicines have stipulated that the urine collected by Moeders voor Moeders must meet certain quality standards. Below are the conditions for participating in Moeders voor Moeders.

I do not suffer from hepatitis
I am not HIV positive
I have not spent more than 180 days in the United Kingdom (England, Wales, Northern Ireland, Scotland, the Isle of Man, or the British Channel Islands) between 1980 and 1996
I have never had a blood transfusion
Neither I nor my blood relatives suffer from Creutzfeldt-Jakob disease
I have never received growth hormone treatment
I do not suffer from chronic kidney inflammation
I have never had a corneal transplant
I have never had a meninges transplant
I do not suffer from type 1 or type 2 diabetes (if you have gestational diabetes, you are still eligible to participate)
I am not an excessive alcohol user or intravenous drug user
I declare that I am 18 years or older

I meet these conditions:

Nee Ja

Congratulations, you can donate

First name

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This field can only contain letters

Insert

Last name

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Email address

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Repeat email address

The emailaddresses must be the same

Phone number (10 digits)

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This field can only contain numbers

Your address

Enter your zipcode and housenumber. Your address will appear automatically.

Zipcode

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Housenumber

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Addition

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Street

City

Thank you for your interest

Because you answered the question 'Are you pregnant?' with 'no', you unfortunately cannot participate.

Moeders voor Moeders collects urine from women who are in the early stages of pregnancy. The hCG hormone that is processed into fertility drugs is extracted from this urine.

Do you have any questions? Please contact us by calling 088 - 278 0000 or send an email to info@moedersvoormoeders.nl.