S – CM 3205, Cape Town
Generate PDF| Availability status: | Available now in Cape Town |
| Race: | White |
| Age: | 22 |
| Hair colour: | Dark brown |
| Eye colour: | Dark brown |
| Has children: | No |
| Proven donor | No |
| Post matric studies: | Yes |
| Other physical information: | 1.50m., 55kg., thin but very healthy |
| Face shape: | Oval |
| Other personal information: | South African nationality, AB+ blood group, Christian. Candidate has just completed school and would love to help where she can. She describes herself as a loving and caring person. |
| Reproduction history: | No children and no donations as yet. |
| What are your views on religion and spirituality, and practiced religion? | Christian |
Category: Active Donor
Additional donor information
Initial information
| In which town and province do you live? | Cape Town, Western Cape |
| Nationality | South African |
| Where were you born? | Saldanha, Western Cape |
| What language(s) do you speak? | Afrikaans and English |
| Year of birth | 2001 |
| Age | 22 |
| Star sign | Virgo |
| Blood group (if known) | AB+ |
| Why do you want to be an egg donor and if you had a message for your recipient what would it be? | I want to help a woman get a child of her own and it's really sad that there are wome that can't have a child of her own. |
| How do you best describe yourself? | I am a loving and caring person, I have two sisters so I have been taught to share. |
| Relationship status | New relationship |
Physical profile
| Race | White/ Caucasian |
| Skin complexion | Olive |
| Face shape | oval |
| Nose shape defined by Wikipedia | Snub |
| Eye shape | Almond |
| Height in metres | 1.5 |
| Weight in kilograms | 55 |
| What is your usual or ideal weight? | 53kg. |
| Build and body shape | Thin but a little bit curvy |
| Which body part is most sensitive to weight gain or loss? | My bums and legs |
| Eye colour | Brown |
| Natural hair colour | Brown |
| Hair colour as a child | Dark brown |
| Hair type | Curly |
| Hair texture | medium |
| Description of hands and fingers | Big hands Long fingers |
| Any other defining traits such as breast cup, size shoe size, freckles, dimples, etc | Breast cup A, (really small breast), size 6 shoe, no freckles, no dimples. |
| Are you left handed or right handed? | Right handed |
| With celebrity do you most resemble - physically? | Selena Gomez |
| Siblings physical traits - hair and eye colour, height, weight and build | Same hair texture, Height and weight |
Reproductive information
| Are you a virgin? | No |
| Ever miscarried? | No |
| No. and ages of children (if applicable) | None |
| Fertility issues | I have been on the 3 month injection and my menstrual cycle is a mess on the moment |
Health of egg donor
| Are you a twin? | No |
| Are you adopted? | No |
| Current health status lifestyle and/ or current diseases | Healthy with no diseases |
| Smoker | 5 - 10 per day |
| Alcohol consumption per week. | Maybe once a month |
| Do you wear glasses? | Never |
| How would you rate your sight? | Very good |
| Any skin disorders, albinism, ectodermal dysplasia, eczema, acne, etc | None |
| 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 | None |
| 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. | No |
| 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. | None |
| Any specific diet such as vegan, vegetarian, health conscious, low fat, etc. | No |
| How often do you excercise? | A few times a week |
| In which exercises or sports do you partake now? | Cardio, walking dog |
| Have you excelled in any sports? | No |
| What sports did you play at school? | Netbal and hockey |
Professional and academic information
| Occupation | Study |
| What is your ideal career/ occupation? | Managing |
| What are you doing to get to your desired profession in life? | Go for business studies |
| Do you have a matric and university exemption? | Only Matric |
| Subjects and grades or marks at school | Good |
| What is the name of any course / degree completed? | Only matric |
| Planned studies | Business study |
| In what aspects do you have a keen interest? | Business managing |
| 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? | Family |
| If you had unlimited resources and could save one thing on earth what would it be? | Nature and animals |
| What are your views on religion and spirituality, and practiced religion? | Christian |
| Childhood religion? | Christianity |
| Any specific achievements or aspects of recognition in your family | My mother and dad owns a business |
| Interests and hobbies | Beauty, taking photo's. |
| What is your preferred holiday? | |
| If you were offered an all-inclusive holiday, what would it be? | |
| Which interesting places have you visited? | Durban, Springbok, Citrusdal, Robertson, all the places in the western cape |
| What are your feelings on animal welfare? | Animals should be protected and looked after |
| Strength and weaknesses | Strength - knowing what I want in life, weakness - soft heart |
| What do others generally think of you? | Well presented lady |
| Favourite flower | Roses |
| What is your favourite meal? | Sushi |
| What is your favourite movie? | All of them, every movie has a nice story |
| What is your favourite book? | Vaselinetjie |
| Who is your favourite actor? | Adam sandler |
| Who is your favourite actress? | Angelina Jolie |
| What is your favourite colour? | Pastel colours |
| What is your favourite colour lipstick? | Natural |
| What is your favourite perfume? | Alien |
| Who is your favourite person? | My mom and Dad |
| Are you more introverted or extroverted? | Extroverted |
| Would you prefer to go out with friends or stay in with a loved one or book? | Go out with friends |
| Are you musical or played any musical instruments? | No |
| Are you more cultural or more adventurous? | -1 |
| 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 Africa |
| Country of origin and ancestry for mother and father | Both South african |
| Language spoken for mother and father | Both afrikaans but my father grew up english |
| Professions for mother and father | Mom - business owner, dad - supervisor |
| Achievements on an academic level for mother and father | Mom - matric, dad - N4 |
| Race for mother and father | Both white |
| Natural hair colour for mother and father | Mom - dark brown, dad - light brown and blonde |
| Eye colour for mother and father | Mom - hazel brown, dad - blue |
| Height for mother and father | Mom - 1.72m., dad - 1.7m. |
| Mother and father build | Healthy |
| 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 - 41, dad - 47 |
| Health status | Excellent |
| 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 |
| 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? | Unsure |
| 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 | None |
| History of asthma | Only my mother |
| Any skin disorders, albinism, ectodermal dyslasia or other in your family – please explain | No |
| Any other comments regaring any health aspects in your family | No |
| Alcoholism / substance abuse | No To Both |
| Grandmothers still alive? | Only MGM |
| If deceased, state cause of death | Cancer |
| Current age or age of death | 67 |
| Grandfathers still alive? | Only MGF |
| If deceased, state cause of death | Heart attack |
| Current age or age at time of death | 55 |
| Grandfathers' eye colour (maternal and paternal) | Blue and green |
| Grandmothers' eye colour (maternal and paternal) | Blue and brown |
| Grandfathers' hair colour (maternal and paternal) | Dark brown and light brown |
| Grandmothers' hair colour (maternal and paternal) | Ash blonde and light brown |
| Health of grandmothers (maternal and paternal) | Unsure |
| Health of grandfathers (maternal and paternal) | Unsure |
| Please specify if the race of your grandparents is different to yours. If mixed race, please specify race for maternal and patermal grandparents | None only white |
| 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 |
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 |
