S – AV 2884, Port Elizabeth
Generate PDFAvailability status: | Available now in Port Elizabeth |
Race: | White |
Age: | 25 |
Hair colour: | Blonde, brown when I was a child. Progressed more into an ash blonde/ brown colour into adulthood |
Eye colour: | Hazel (Brown/ green) |
Has children: | No |
Proven donor | Yes |
Post matric studies: | No |
Other physical information: | 1.69m., 65kg., athletic build |
Face shape: | Heart |
Other personal information: | South African nationality, O+ blood type. Candidate is a full time B(EMC) student. Her interests include mostly outdoor activities, such as hiking (she has summited Kilimanjaro and plans on summiting many more mountains), kloofing, etc. She also enjoys reading both fiction and non-fiction books about history. Non-smoker. Reason for donating: I believe that I am capable of helping others, so would like to do so. |
Reproduction history: | No children and proven egg donor |
What are your views on religion and spirituality, and practiced religion? | I don't believe we should be close minded to such things, each to their own as long as you respect others and what they believe in (with the exception of Satanism) |
Category: Uncategorized
Additional donor information
Initial information
In which town and province do you live? | Port Elizabeth, Eastern Cape |
Nationality | South African |
Where were you born? | Pretoria |
What language(s) do you speak? | English and Afrikaans |
Year of birth | 1997 |
Age | 25 |
Star sign | Sagittarius |
Blood group (if known) | O+ |
Why do you want to be an egg donor and if you had a message for your recipient what would it be? | I believe that if I am capable of helping others, I should do so |
How do you best describe yourself? | Optimistic, goal oriented, hard working, honest, loves to laugh and joke around, loves being outdoors but from time to time I enjoy alone time. |
Relationship status | Single |
Physical profile
Race | White/ Caucasian |
Skin complexion | Tanned |
Face shape | heart |
Nose shape defined by Wikipedia | Unanswered |
Eye shape | Almond |
Height in metres | 1.69m. |
Weight in kilograms | 65kg. |
What is your usual or ideal weight? | I want to maintain a weight of 65kg, not exceeding it but also not weigh less than 60kg |
Build and body shape | Athletic builds |
Which body part is most sensitive to weight gain or loss? | Thighs are most sensitive to weight gain, stomach most sensitive to weight loss |
Eye colour | Hazel |
Natural hair colour | Brown |
Hair colour as a child | Blonde/ brown |
Hair type | Straight |
Hair texture | medium |
Description of hands and fingers | Air shaped hand |
Any other defining traits such as breast cup, size shoe size, freckles, dimples, etc | 34B bra size, size 5 - 6 shoe depending on the store, beauty spots on face |
Are you left handed or right handed? | Ambidextrous |
With celebrity do you most resemble - physically? | Missy Peregrym |
Siblings physical traits - hair and eye colour, height, weight and build | Brother is lean and very tall, dark hair, tanned skin |
Reproductive information
Are you a virgin? | No |
Ever miscarried? | No |
No. and ages of children (if applicable) | N/a |
Fertility issues | None of which I am aware |
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. | Mild consumption over some weekends (maximum 2 weekends and only 1 day over the weekend) |
Do you wear glasses? | Never |
How would you rate your sight? | 20/20 vision |
Any skin disorders, albinism, ectodermal dysplasia, eczema, acne, etc | Keratosis pilaris |
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? | I used to be anaemic, however since I have had the Mirena device placed, the issue resolved itself |
Have you had any cancer? | No |
Have you had any heart problems? | No |
Please indicate if you have any allergies | None known |
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. | None |
Any physical handicaps or deformaties? If yes, please state. | None |
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? | None |
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. | None |
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. | None |
Any specific diet such as vegan, vegetarian, health conscious, low fat, etc. | None |
How often do you excercise? | A few times a week |
In which exercises or sports do you partake now? | Running, swimming and rescue training as part of my degree which includes but is not limited to vigorous cardio as well as strength exercises. I also rock climb |
Have you excelled in any sports? | Hockey, artistic gymnastics and shotokan karate |
What sports did you play at school? | Hockey, artistic gymnastics and shotokan karate |
Professional and academic information
Occupation | Full time Student |
What is your ideal career/ occupation? | Emergency care practitioner |
What are you doing to get to your desired profession in life? | Currently studying |
Do you have a matric and university exemption? | Matric and Exemption |
Subjects and grades or marks at school | Afrikaans Home language, English home language, Mathematical literacy, Consumer Studies, Life Sciences and Physical Sciences (includes Physics and Chemistry) |
What is the name of any course / degree completed? | Completes Basic ambulance assistant course, then Ambulance emergency assistant course |
Planned studies | Currently studying B(EMC) |
In what aspects do you have a keen interest? | Outdoor activities, reading, living life to the fullest |
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? | Never tested |
Behavioural traits
What is most important in life to you? | To chase the adrenaline rush |
If you had unlimited resources and could save one thing on earth what would it be? | The forests |
What are your views on religion and spirituality, and practiced religion? | I don't believe we should be close minded to such things, each to their own as long as you respect others and what they believe in (with the exception of Satanism) |
Childhood religion? | Christian |
Any specific achievements or aspects of recognition in your family | |
Interests and hobbies | Reading, hiking, rock climbing, improving my skills |
What is your preferred holiday? | |
If you were offered an all-inclusive holiday, what would it be? | |
Which interesting places have you visited? | Kilimanjaro |
What are your feelings on animal welfare? | I feel horrible for the poor animals. I avoid going to animal shelters myself because I want to bring an animal home with me, so whenever I donate either food or blankets, I send it with friends |
Strength and weaknesses | Weaknesses - Sometimes too trusting of people, can be naive, short temper, blunt. Strengths - Honest, will cheer up my friends in any way I can, independent, motivated |
What do others generally think of you? | That I am never serious but I am closed off |
Favourite flower | Daisy, sunflower |
What is your favourite meal? | Home-cooked meat in a clay pot, wheat, pumpkin, green beans with malva pudding as a dessert |
What is your favourite movie? | Only the Brave |
What is your favourite book? | Persómi |
Who is your favourite actor? | Chris Hemsworth |
Who is your favourite actress? | Hayley Atwell |
What is your favourite colour? | Olive green |
What is your favourite colour lipstick? | Burgundy |
What is your favourite perfume? | Red gold |
Who is your favourite person? | My brother |
Are you more introverted or extroverted? | Extroverted |
Would you prefer to go out with friends or stay in with a loved one or book? | Depends on the situation |
Are you musical or played any musical instruments? | I used to sing in thr choir |
Are you more cultural or more adventurous? | More Adventurous |
Do you prefer indoors or outdoors? | Outdoors |
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 | Mom - French ancestry, dad - German/ Dutch ancestry |
Language spoken for mother and father | Afrikaans and English |
Professions for mother and father | Mom - registered nurse working in ICU, dad - fitter and turner |
Achievements on an academic level for mother and father | Mom - registered nurse, dad - technical College for his training |
Race for mother and father | Both white |
Natural hair colour for mother and father | Mom - dark chocolate brown/ black, dad - blonde |
Eye colour for mother and father | Mom - brown, dad - blue/ green |
Height for mother and father | Mom - 1.67m., dad - 1.76m. |
Mother and father build | Mom - broad shoulders and hips, dad - triangle shape with broad shoulders |
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) | Mom - 51, dad - 54 |
Health status | Mom and dad both healthy. Mom takes thyroid medication, dad takes light anti-hyperyensive medication. |
Please indicate if any twins in your family and the relationship to you | Twins on my father's side - his cousins are twins |
Please list any family members who have had cancer including aunts or uncles and on which family side | None |
Any fertility problems in your family | Yes, mom has polycystic ovary syndrome, father has low sperm count |
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 hypothyroidism, POS, and is a type 2 diabetic. Dad has cholesterol and pre-hypertension. Brother has asthma. Maternal grandmother had cardiac and pulmonary issues, paternal grandfather had hemocrematosis. Paternal grandfather has slight hypertension. |
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? | Yes, hemocrematosis is on the maternal side, however my mother has been tested and she is not a carrier of the disease, thus neither my brother nor I can be carriers or have the disease |
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 | Dad has depression |
Any physical deformaties or handicaps? If yes, please state | None |
History of asthma | Not Selected |
Any skin disorders, albinism, ectodermal dyslasia or other in your family – please explain | Father has keratosis pilaris |
Any other comments regaring any health aspects in your family | None |
Alcoholism / substance abuse | No To Both |
Grandmothers still alive? | Only PGM |
If deceased, state cause of death | MGM died from congestive cardiac failure leading to multi system organ failure |
Current age or age of death | MGM - died at 65 |
Grandfathers still alive? | Only PGF |
If deceased, state cause of death | MGF was exposed to organophosphates and died as a result. |
Current age or age at time of death | MGF - died at 55 |
Grandfathers' eye colour (maternal and paternal) | Both blue |
Grandmothers' eye colour (maternal and paternal) | MGM - brown, PGM - blue |
Grandfathers' hair colour (maternal and paternal) | MGF - brown, PGF - dark brown |
Grandmothers' hair colour (maternal and paternal) | MGM - dark brown, PGM - blonde |
Health of grandmothers (maternal and paternal) | Maternal poor, paternal excellent |
Health of grandfathers (maternal and paternal) | Maternal good, paternal good |
Please specify if the race of your grandparents is different to yours. If mixed race, please specify race for maternal and patermal grandparents | Same race as me |
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 | Port Elizabeth |
Towns available in which to donate - travel costs will be covered |
Confirmation
I have only made myself available as an egg donor with baby2mom. | Yes |
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 |