S – EM 5793, Centurion
Generate PDF| Availability status: | Available now in Johannesburg and Pretoria |
| Race: | Black/African |
| Age: | 31 |
| Hair colour: | Black |
| Eye colour: | Brown |
| Has children: | Yes |
| Proven donor | No |
| Post matric studies: | Yes |
| Other physical information: | 1.73m., 69kg., fair skin |
| Face shape: | Round |
| Other personal information: | South African nationality. Candidate has studied geological engineering. Non-smoker. Reason for donating: i just realized that its very painful for not being able to bear your own children but by helping each other were we can its absolutely nice. |
| Reproduction history: | One child and no donations as yet. |
| What are your views on religion and spirituality, and practiced religion? | Spiritually is were we connecting with our elders our ancestors and their existence |
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Category: Active Donor
Additional donor information
Initial information
| In which town do you live? | Centurion |
| In which province do you live? | Gauteng |
| Nationality | South African |
| Where were you born? | Gauteng |
| What language(s) do you speak? | Zulu Sotho Pedi Xhosa Tswana English and Venda |
| Year of birth | 1994 |
| Age | 31 |
| Star sign | Aries |
| Blood group (if known) | Unknown |
| Why do you want to be an egg donor and if you had a message for your recipient what would it be? | i just realized that its very painful for not being able to bear your own children but by helping each other were we can its absolutely nice. |
| How do you best describe yourself? | I am a hard worker and a fast learner, I enjoy my space even being around people. |
| Relationship status | Serious relationship |
| Have you donated eggs before? | No |
Physical profile
| Race | Black/African |
| Skin complexion | Fair |
| Face shape | Round |
| Nose shape defined by Wikipedia | Jewish/ Hawk - Thin and sharp |
| Eye shape | Round |
| Height in metres | 1.73 |
| Weight in kilograms | 69 |
| What is your usual or ideal weight? | 62 |
| Build and body shape | Tall and slender |
| Which body part is most sensitive to weight gain or loss? | Stomach |
| Eye colour | Brown |
| Natural hair colour | Black |
| Hair colour as a child | Brown |
| Hair type | Afro |
| Hair texture | Fine |
| Description of hands and fingers | Long slender fingers |
| Any other defining traits such as breast cup, size shoe size, freckles, dimples, etc | Dimples |
| Cup size | 34D |
| Shoe size | 3 |
| Are you left handed or right handed? | Right handed |
| With celebrity do you most resemble - physically? | Thabile from uzalo |
| How many siblings do you have? | 3 |
| Sibling 1 Hair Colour | Black |
| Sibling 1 Eye Colour | Black |
| Sibling 1 Build | Strong and tall and fat |
| Sibling 2 Hair Colour | Black |
| Sibling 2 Eye Colour | Black |
| Sibling 2 Build | Short and slim |
| Sibling 3 Hair Colour | Blonde |
| Sibling 3 Eye Colour | Brown |
| Sibling 3 Build | Short and slender |
Reproductive information
| Are you a virgin? | No |
| Ever miscarried? | No |
| No. of children | 1 |
| Child 1 Date of Birth | 20/09/2017 |
| Fertility issues | None |
Health of egg donor
| Are you a twin? | No |
| Are you adopted? | No |
| Would you consider your lifestyle | Healthy |
| Any current diseases? | No |
| Current health status lifestyle and/ or current diseases | Healthy |
| Smoker | never smoked |
| Alcohol consumption per week. | 0_drinks |
| Do you wear glasses? | Never |
| How would you rate your sight? | 9 |
| Any skin disorders, albinism, ectodermal dysplasia, eczema, acne, etc | No |
| Have you suffered from/ currently have any health concerns/ diseases including but not limited to diabetes, cholesterol, blood pressure, thyroid, haemophilia, blood clotting, paralysis, porphyria? | No |
| Have you had any cancer? | No |
| Have you had any heart problems? | No |
| Please indicate if you have any allergies | No |
| Any mental or psychological diseases/ learning disorders including but not limited to genetic depression, bi polar, psychiatric illness etc. Please elaborate and indicate if genetic. | No |
| Any physical handicaps or deformaties? If yes, please state. | No |
| Do you have any genetic diseases or are a carrier of any genetic concerns including but not limited to thalassemia, cystic fibrosis and sickle cell? | No |
| History of asthma | No |
| Indicate any medication you are taking and reason for it. | None |
| Have you ever been addicted to any substances? | No |
| Have you partaken in any recreational drugs had tattoos or piercings in the last six months? Please explain. | Yes |
| Please list | Tattoo of my son name and date of birth |
| Details of any operations? | No |
| Are there any health issues of which you are aware that may be of concern for you to become an egg donor? If yes, please state. | No |
| Any specific diet such as vegan, vegetarian, health conscious, low fat, etc. | No |
| How often do you excercise? | Never |
| In which exercises or sports do you partake now? | Athletic |
| Have you excelled in any sports? | yes |
| What sports did you play at school? | Long jump and netball |
Professional and academic information
| Occupation | Unemployed |
| What is your ideal career/ occupation? | Mine health and safety officer |
| What are you doing to get to your desired profession in life? | Trying to apply with my qualifications for a better job |
| Do you have a matric and university exemption? | Matric and Exemption |
| Subjects and grades or marks at school | Sesotho 64% English 50% Mathematics 45% lLfe Orientation 61% Geography 59% Life Sciences 55% Physical Sciences 47% |
| What is the name of any course / degree completed? | mining engineering scaffold inspection scaffold erecting mine health and safety and regulations emergency care level one boiler making computer literal |
| Planned studies | Mining engineering Geology |
| In what aspects do you have a keen interest? | Teaching |
| What type of books do you like to read? | fiction |
| Would you prefer to read the book or watch the movie? | Read the Book |
| Do you know if your IQ was ever tested and the score please? | No |
Behavioural traits
| What is most important in life to you? | My son |
| If you had unlimited resources and could save one thing on earth what would it be? | People's lives |
| What are your views on religion and spirituality, and practiced religion? | Spiritually is were we connecting with our elders our ancestors and their existence |
| Childhood religion? | Christian |
| Any specific achievements or aspects of recognition in your family | We believe in dreams |
| Interests and hobbies | Reading books |
| What is your preferred holiday? | Stay at home |
| If you were offered an all-inclusive holiday, what would it be? | To go and visit the orphans |
| Which interesting places have you visited? | Mpumalanga because of firms |
| What are your feelings on animal welfare? | I hate wild animals with all my heart actually I fear them |
| Strength and weaknesses | Strength - reading books and working Weakness - shy and even when a person is wrong, I cant confront them |
| What do others generally think of you? | I am talkative |
| Favourite flower | Rose |
| What is your favourite meal? | Pap and beef stew |
| What is your favourite movie? | Titanic |
| What is your favourite book? | Comfort |
| Who is your favourite actor? | Steven Segal |
| Who is your favourite actress? | Jennifer Lopez |
| What is your favourite colour? | Beige |
| What is your favourite colour lipstick? | Burgundy |
| What is your favourite perfume? | Lady in million |
| Who is your favourite person? | My son |
| Are you more introverted or extroverted? | Introverted |
| Would you prefer to go out with friends or stay in with a loved one or book? | Stay in with a loved one or book |
| Are you more cultural or more adventurous? | More Cultural |
| Do you prefer indoors or outdoors? | Indoors |
| Which weather do you prefer? | cold |
| Are you more creative or analytical? | creative |
Family information of genetic parents
| Nationality for mother and father | Both South African |
| Country of origin and ancestry for mother and father | Both South Africa |
| Language spoken for mother and father | Sotho and zulu |
| Professions for mother and father | Chef and driver |
| Achievements on an academic level for mother and father | Singing and soccer player |
| Race for mother and father | Both black |
| Natural hair colour for mother and father | Brown and black |
| Eye colour for mother and father | Brown and black |
| Height for mother and father | 1.85 and 2.05m. |
| Mother and father build | slim and tall tall and fat |
| Are your parents still alive? | Yes to Both |
| Age (if living, or age deceased) | 63 and 62 |
| Health status | Both healthy |
| Please indicate if any twins in your family | No |
| Any family members who have had cancer including aunts or uncles? | No |
| Any fertility problems in your family | No |
| In your family, has anyone suffered from/ currently have any health concerns/ diseases including but not limited to diabetes, cholesterol, blood pressure, thyroid, haemophilia, blood clotting, paralysis, porphyria, heart problems? | No |
| In your family, does anyone have any genetic diseases or are a carrier of any genetic concerns including but not limited to thalassemia, cystic fibrosis, sickle cell, tay sachs? | No |
| Any mental or psychological disease or learning disability or learning disorders including genetic depression, bi polar, psychiatric illness in siblings or family? If yes, please state | No |
| Any physical deformaties or handicaps? If yes, please state | No |
| History of asthma | No To Both |
| Any skin disorders, albinism, ectodermal dyslasia or other in your family – please explain | No |
| Any other comments regaring any health aspects in your family | All healthy |
| Alcoholism / substance abuse | No To Both |
| Grandmothers still alive? | Only MGM |
| If deceased, state cause of death | MGM - murdered |
| Current age or age of death | MGM - murdered at age 55 |
| Grandfathers still alive? | No to Both |
| If deceased, state cause of death | Food poison and car accident |
| Current age or age at time of death | 88 and 65 |
| Grandfathers' eye colour (maternal and paternal) | Both black |
| Grandmothers' eye colour (maternal and paternal) | Brown and black |
| Grandfathers' hair colour (maternal and paternal) | Both black |
| Grandmothers' hair colour (maternal and paternal) | Brown and black |
| Health of grandmothers (maternal and paternal) | One healthy |
| Health of grandfathers (maternal and paternal) | Both healthy before dying |
| Please specify if the race of your grandparents is different to yours. If mixed race, please specify race for maternal and patermal grandparents | MGM - coloured all others black |
| Any genetic health or psychological concerns worth noting regarding your grandparents | None |
| Any notes/ comments re family of family health aspects - genetic ito psychological, physical, deformaties, diseases, concerns | All physically strong |
Egg donation stipulations
| Please indicate if you have any donation conditions or criteria such as persons to whom you prefer not to donate | None |
| Preferred town to donate | Johannesburg |
| Towns available in which to donate - travel costs will be covered | Johannesburg, Pretoria |
Confirmation
| I have only made myself available as an egg donor with baby2mom. | Yes |
| Please advise any specific donation criteria other than those mentioned | No |
| All information provided is correct and pictures are all of me. I agree to keep baby2mom updated with the donor programe (screening, blood tests, scans, egg retrieval. I will keep baby2mom updated wrt my availability and wrt egg donation pregnancies achieved. I consent to participate in the baby2mom egg donor program and participate as required and understand the concept of anonymous egg donation and claim no further rights over any child(ren) conceived of egg donation. I agree that I will be prescribed medication to potentially synchronise my menstrual cycle with that of the recipients and will be given hormones in a controlled environment by professional fertility specialists to stimulate donor egg developement. I agree to find more information pertaining to egg donation on the baby2mom egg donor site or ask if I have any further questions about being an egg donor. I agree to participate as required as people often travel from international destinations to participate in a South African egg donation program and have incurred considerable financial and emotional costs | Yes |
