A – SP 2979, Johannesburg
Generate PDFAvailability status: | Available now at Medfem and Pretoria, coastal regions - travel costs |
Race: | Indian |
Age: | 25 |
Hair colour: | Black |
Eye colour: | Brown |
Has children: | No |
Proven donor | Yes |
Post matric studies: | Yes |
Other physical information: | 1.59m., 56kg., fair skin complexion, size 4 shoe |
Face shape: | Round |
Other personal information: | South African nationality. Candidate is doing a degree in internet communication. She enjoys baking, decorating, reading, computers and watching TV. She is a very academic person and strives to do her best. She is creative, helpful, diligent, co-operative and responsible. Non-smoker. Reason for donating: I am a healthy young women that feels that I should do good for others because if I were in the shoes of the recipients I would want someone to help me so I should do it now while I am able to because if the tables were turned I would hope for a donor. |
Reproduction history: | No children and proven egg donor resulting in a pregnancy. |
What are your views on religion and spirituality, and practiced religion? | I believe God is a very important part of anyone's life and should not ever be forgotten. |
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Category: Uncategorized
Additional donor information
Initial information
In which town and province do you live? | Johannesburg, Gauteng |
Nationality | South African |
Where were you born? | Johannesburg, South Africa |
What language(s) do you speak? | English |
Year of birth | 1996 |
Age | 25 |
Star sign | Pisces |
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 am a healthy young women that feels that I should do good for others because if I were in the shoes of the recipients I would want someone to help me so I should do it now while I am able to because if the tables were turned I would hope for a donor. |
How do you best describe yourself? | I'm friendly, hardworking, responsible, healthy, intelligent, efficient, determined, coorperate, academic and fun. |
Relationship status | Serious relationship |
Physical profile
Race | Indian |
Skin complexion | Fair |
Face shape | round |
Nose shape defined by Wikipedia | Greek - perfect straight nose |
Eye shape | Round Almond |
Height in metres | 1.59m. |
Weight in kilograms | 56kg. |
What is your usual or ideal weight? | 60kg. |
Build and body shape | I'm not skinny or plumpy. I'm regular proportioned in weight and shape. I'm fit. |
Which body part is most sensitive to weight gain or loss? | My thighs |
Eye colour | Brown |
Natural hair colour | Black |
Hair colour as a child | Black |
Hair type | Straight |
Hair texture | Thick |
Description of hands and fingers | I have normal size hands, my fingers are not long, they are a good length and normal fatness, not very fat or stumpy fingers. |
Any other defining traits such as breast cup, size shoe size, freckles, dimples, etc | Size 4/ 5 shoe |
Are you left handed or right handed? | Right handed |
With celebrity do you most resemble - physically? | |
How many siblings do you have? |
Reproductive information
Are you a virgin? | No |
Ever miscarried? | No |
No. of children | |
Fertility issues | None |
Health of egg donor
Are you a twin? | No |
Are you adopted? | No |
Current health status lifestyle and/ or current diseases | Healthy |
Smoker | never smoked |
Alcohol consumption per week. | Nil |
Do you wear glasses? | Never |
How would you rate your sight? | Excellent |
Any skin disorders, albinism, ectodermal dysplasia, eczema, acne, etc | Acne |
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 | Hayfever |
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. | No |
Details of any operations? | None |
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? | |
Have you excelled in any sports? | No |
What sports did you play at school? | Netball |
Professional and academic information
Occupation | Fulltime student |
What is your ideal career/ occupation? | Web designer |
What are you doing to get to your desired profession in life? | Studying |
Do you have a matric and university exemption? | Matric and Exemption |
Subjects and grades or marks at school | |
What is the name of any course / degree completed? | Bsc internet communication |
Planned studies | Short courses with unisa |
In what aspects do you have a keen interest? | Computers and beauty |
What type of books do you like to read? | |
Would you prefer to read the book or watch the movie? | Both |
Do you know if your IQ was ever tested and the score please? | No |
Behavioural traits
What is most important in life to you? | God and living your life in a non harmful way to others |
If you had unlimited resources and could save one thing on earth what would it be? | All the animals. I have a great passion for animals, to care for them, comfort and love them as are at our mercy. I love dogs. |
What are your views on religion and spirituality, and practiced religion? | I believe God is a very important part of anyone's life and should not ever be forgotten. |
Childhood religion? | |
Any specific achievements or aspects of recognition in your family | |
Interests and hobbies | Reading, baking, beauty treatments, studying and furthering my knowledge |
What is your preferred holiday? | |
If you were offered an all-inclusive holiday, what would it be? | |
Which interesting places have you visited? | God;s Window in Mpumalanga and the Cradle of Humankind |
What are your feelings on animal welfare? | Very strong, they should always be cared for |
Strength and weaknesses | |
What do others generally think of you? | |
Favourite flower | |
What is your favourite meal? | Pizza |
What is your favourite movie? | Nothing at the moment |
What is your favourite book? | The great gatsby |
Who is your favourite actor? | |
Who is your favourite actress? | |
What is your favourite colour? | Silver |
What is your favourite colour lipstick? | I like a purple with a hint of red or pink in it and not too dark |
What is your favourite perfume? | |
Who is your favourite person? | |
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 musical or played any musical instruments? | No |
Are you more cultural or more adventurous? | Bit of Both - depending on Situation |
Do you prefer indoors or outdoors? | Depending on the Situation |
Which weather do you prefer? | |
Are you more creative or analytical? |
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 | Both english |
Professions for mother and father | Mom - housewife, dad - manager |
Achievements on an academic level for mother and father | college |
Race for mother and father | Both indian |
Natural hair colour for mother and father | Both black |
Eye colour for mother and father | Both brown |
Height for mother and father | 1.8 |
Mother and father build | Both average |
Any specific defining traits for both parents | None |
Are your parents still alive? | Yes to Both |
If deceased, cause of death | Not applicable |
Age (if living, or age deceased) | 62 and 64 |
Health status | Both good |
Please indicate if any twins in your family and the relationship to you | None |
Please list any family members who have had cancer including aunts or uncles and on which family side | PGM and MGF |
Any fertility problems in your family | None |
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? | Mom has high blood pressure |
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? | None |
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 | None |
Any physical deformaties or handicaps? If yes, please state | None |
History of asthma | No to Both |
Any skin disorders, albinism, ectodermal dyslasia or other in your family – please explain | Only acne |
Any other comments regaring any health aspects in your family | None |
Alcoholism / substance abuse | No To Both |
Grandmothers still alive? | No to Both |
If deceased, state cause of death | MGM - heart attack, PGM - womb cancer |
Current age or age of death | 55 and 74 |
Grandfathers still alive? | No to Both |
If deceased, state cause of death | MGF - throat cancer (was a smoker), PGF - old age |
Current age or age at time of death | 76 and 83 |
Grandfathers' eye colour (maternal and paternal) | Both brown |
Grandmothers' eye colour (maternal and paternal) | Both brown |
Grandfathers' hair colour (maternal and paternal) | Both lack |
Grandmothers' hair colour (maternal and paternal) | Both black |
Health of grandmothers (maternal and paternal) | Both good |
Health of grandfathers (maternal and paternal) | Both good |
Please specify if the race of your grandparents is different to yours. If mixed race, please specify race for maternal and patermal grandparents | All Indian |
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 | None |
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 |
Confirmation
I have only made myself available as an egg donor with baby2mom. | No |
Please advise any specific donation criteria other than those mentioned | None |
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 |