S – CL 6018, Port Elizabeth
Generate PDF| Availability status: | Available now in Port Elizabeth, other regions - travel costs |
| Race: | White/ Caucasian |
| Age: | 25 |
| Hair colour: | Brown |
| Eye colour: | Hazel |
| Has children: | No |
| Proven donor | Yes |
| Post matric studies: | Yes |
| Other physical information: | 1.52m. 51kg. |
| Face shape: | Round |
| Other personal information: | South African nationality. B+ blood group. Candidate is employed as a cashier. She aspires to be an online English teacher and a game ranger. Light to non-smoker. Reason for donating: I would love to make a big impact in someone's life. I would want them to be happy and have the same natural birth experience as many other moms. |
| Reproduction history: | No children and proven donor. |
| What are your views on religion and spirituality, and practiced religion? | I am religious due to certain experience with God. |
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Category: Active Donor
Additional donor information
Initial information
| In which town do you live? | Port Elizabeth |
| In which province do you live? | Eastern Cape |
| Nationality | South African |
| Where were you born? | South Africa. PE |
| What language(s) do you speak? | English Afrikaans |
| Year of birth | 2000 |
| Age | 25 |
| Star sign | Taurus |
| Blood group (if known) | B+ |
| Why do you want to be an egg donor and if you had a message for your recipient what would it be? | I would love to make a big impact in someones life. I would want them to be happy and have the same natural birth experience as many other moms. |
| How do you best describe yourself? | Outgoing and friendly People's person Active Non-judgemental |
| Relationship status | Single |
| Have you donated eggs before? | Yes |
| If yes, please advise whether you donated through an egg donor agency? | Yes |
| If yes, with which clinic did you donate? | Fembryo |
| How many eggs were produced and do you know the result? | 15. no |
| Were your eggs confirmed good to donate again? | Yes |
| Any comments around your previous donation if applicable | . |
Physical profile
| Race | White/ Caucasian |
| Skin complexion | Fair |
| Face shape | Round |
| Nose shape defined by Wikipedia | Greek - perfect straight nose |
| Eye shape | Thin Almond |
| Height in metres | 1.52 |
| Weight in kilograms | 51 |
| What is your usual or ideal weight? | 49 |
| Build and body shape | Short semi muscular |
| Which body part is most sensitive to weight gain or loss? | Legs |
| Eye colour | Hazel |
| Natural hair colour | Brown |
| Hair colour as a child | Brown |
| Hair type | Straight |
| Hair texture | Thick |
| Description of hands and fingers | Small stubby cute hands i would say. |
| Any other defining traits such as breast cup, size shoe size, freckles, dimples, etc | Slight freckles, smile lines if I smile really hard. |
| Cup size | Between B and C |
| Shoe size | 4-5 |
| Are you left handed or right handed? | Ambidextrous |
| With celebrity do you most resemble - physically? | Dua Lipa Demi Lovato |
| How many siblings do you have? | 1 |
| Sibling 1 Hair Colour | Brown |
| Sibling 1 Eye Colour | Brown |
| Sibling 1 Build | Short and muscular/ athletic |
Reproductive information
| Are you a virgin? | No |
| Ever miscarried? | No |
| No. of children | 0 |
| 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 |
| Please list | Slight psoriasis |
| Smoker | 0 - 5 per day |
| 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 | Yes |
| 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? | Yes |
| Please list | Low blood pressure |
| Have you had any cancer? | No |
| Have you had any heart problems? | No |
| Please indicate if you have any allergies | Yes |
| Please list | Cats and dust |
| 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. | Yes |
| Please list | Slight ADHD |
| 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? | Yes |
| Please explain | Nicotene Cannabis |
| Have you partaken in any recreational drugs had tattoos or piercings in the last six months? Please explain. | Yes |
| Please list | Piercings and tattoos |
| 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? | Daily |
| In which exercises or sports do you partake now? | Body building |
| Have you excelled in any sports? | No |
| What sports did you play at school? | Walking and chess |
Professional and academic information
| Occupation | Cashier |
| What is your ideal career/ occupation? | Online English teaching |
| What are you doing to get to your desired profession in life? | I want to be a game ranger. I am saving up to study |
| Do you have a matric and university exemption? | Only Matric |
| Subjects and grades or marks at school | English 58% Afrikaans 80% Maths lit 85% |
| What is the name of any course / degree completed? | 120 hour TEFL course |
| Planned studies | Biology |
| In what aspects do you have a keen interest? | Nature Photography |
| What type of books do you like to read? | fiction |
| 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? | Yes |
| What was the score? | 138 |
Behavioural traits
| What is most important in life to you? | Looking after the people close to me |
| If you had unlimited resources and could save one thing on earth what would it be? | Conserve nature |
| What are your views on religion and spirituality, and practiced religion? | I am religious due to certain experience with God. |
| Childhood religion? | Christianity |
| Any specific achievements or aspects of recognition in your family | No |
| Interests and hobbies | Walking Art Drawing Handy work Darts Swimming Photography |
| What is your preferred holiday? | Bush |
| If you were offered an all-inclusive holiday, what would it be? | Explore Egypt and the historical religious sites |
| Which interesting places have you visited? | Knysna and Plettenberg Bay |
| What are your feelings on animal welfare? | I would save all of them if I really could. |
| Strength and weaknesses | Strengths - artwork, Maths, people especially making friends with strangers |
| What do others generally think of you? | Bubbly and funny sense of humour |
| Favourite flower | Lily |
| What is your favourite meal? | Lasagne |
| What is your favourite movie? | Cat in the hat |
| What is your favourite book? | Gossip girls series |
| Who is your favourite actor? | Chris Hemsworth |
| Who is your favourite actress? | Megan Fox |
| What is your favourite colour? | Baby blue |
| What is your favourite colour lipstick? | Nude |
| What is your favourite perfume? | Barakat |
| Who is your favourite person? | My sister |
| 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 write music or lyrics |
| Are you more cultural or more adventurous? | Bit of Both - depending on Situation |
| Do you prefer indoors or outdoors? | Outdoors |
| Which weather do you prefer? | hot |
| Are you more creative or analytical? | analytical |
Family information of genetic parents
| Nationality for mother and father | Both South African |
| Country of origin and ancestry for mother and father | Mom - South Africa Dad - England |
| Language spoken for mother and father | Mom - english and afrikaans Dad - english and afrikaans |
| Professions for mother and father | Mom - advanced admin Dad - computer tutor |
| Achievements on an academic level for mother and father | Mom - typing Dad - technical |
| Race for mother and father | Both white |
| Natural hair colour for mother and father | Mom - dark brown Dad - black |
| Eye colour for mother and father | Mom - brown Dad - blue |
| Height for mother and father | mom - 1.52m dad - 1.73m |
| Mother and father build | Mom - slender to medium Dad - chubby |
| Are your parents still alive? | Yes to Both |
| Age (if living, or age deceased) | Mom - 57 Dad - 60 |
| Health status | Both healthy |
| Please indicate if any twins in your family | No |
| Any family members who have had cancer including aunts or uncles? | Yes |
| Please provide details about cancer in your family | Aunt - breast cancer |
| 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? | Yes |
| Please provide details of health concerns in your family | Mom - high blood pressure Dad - none |
| 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 | Yes |
| Please provide details of skin disorders in your family | Psoriasis |
| Any other comments regaring any health aspects in your family | None |
| Alcoholism / substance abuse | Only my father |
| Grandmothers still alive? | No to Both |
| If deceased, state cause of death | MGM - dementia (organ failure) MGF - heart attack PGM - lung collapse due to kidney failure |
| Current age or age of death | MGM - 72 deceased PGM - 86 deceased |
| Grandfathers still alive? | Only PGF |
| If deceased, state cause of death | MGF - heart attack |
| Current age or age at time of death | MGF - 76 deceased PGF - living, aged 78 |
| Grandfathers' eye colour (maternal and paternal) | Both blue |
| Grandmothers' eye colour (maternal and paternal) | Both blue |
| Grandfathers' hair colour (maternal and paternal) | MGF - light brown PGF - brown |
| Grandmothers' hair colour (maternal and paternal) | MGM - blonde PGM - black |
| Health of grandmothers (maternal and paternal) | Both healthy |
| Health of grandfathers (maternal and paternal) | Both healthy |
| Please specify if the race of your grandparents is different to yours. If mixed race, please specify race for maternal and patermal grandparents | None |
| 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 | Cape Town |
| Towns available in which to donate - travel costs will be covered | Cape Town, Stellenbosch, Johannesburg, Pretoria, Port Elizabeth, Durban, Nelspruit, Bloemfontein |
Confirmation
| I have only made myself available as an egg donor with baby2mom. | No |
| 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 |
