A – LS 4571, Potchefstroom
Generate PDFAvailability status: | Available now in Johannesburg |
Race: | White |
Age: | 19 |
Hair colour: | Light brown, soft, curls at the ends |
Eye colour: | Blue/ grey |
Has children: | No |
Proven donor | Yes |
Post matric studies: | No |
Other physical information: | 1.7m., 61kg. |
Face shape: | Oblong |
Other personal information: | South African nationality, O+ blood group. Candidate is an interior designer student. She is very creative and has a deep passion for music. She enjoys singing and playing piano among other instruments. She is a very caring person and often find herself putting others above herself. Non-smoker. Reason for donating: I have seen what effect infertility has had on my stepsisters and friends and have decided to make a difference in others' lives who struggle with the same thing. I want to enable families to have the joy they deserve. |
Reproduction history: | No children and proven donor. |
What are your views on religion and spirituality, and practiced religion? | I am very religious and believe in Christianity, but respect other religions. |
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Category: Active Donor
Additional donor information
Initial information
In which town and province do you live? | Potchefstroom, North West |
Nationality | South African |
Where were you born? | South Africa |
What language(s) do you speak? | Afrikaans, English |
Year of birth | 2004 |
Age | 19 |
Star sign | Capricorn |
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 have seen what effect infertility has had on my stepsisters and friends and have decided to make a difference in others' lives who struggle with the same thing. I want to enable families to have the joy they deserve. |
How do you best describe yourself? | Passionate, energetic, creative, hardworking, empathetic and loving. |
Relationship status | New relationship |
Physical profile
Race | White/ Caucasian |
Skin complexion | Medium |
Face shape | oblong |
Nose shape defined by Wikipedia | Turned up |
Eye shape | Round Almond |
Height in metres | 1.7 |
Weight in kilograms | 61 |
What is your usual or ideal weight? | |
Build and body shape | Tall, thin, curvy |
Which body part is most sensitive to weight gain or loss? | Buttocks and thighs |
Eye colour | Blue |
Natural hair colour | Brown |
Hair colour as a child | -1 |
Hair type | Straight |
Hair texture | medium |
Description of hands and fingers | Feminine, soft hands with thin fingers, round natural shaped nails |
Any other defining traits such as breast cup, size shoe size, freckles, dimples, etc | Breast cup size 32DD, size 6 shoe, freckles on the nose and cheekbones, one dimple on the left cheek |
Are you left handed or right handed? | Right handed |
With celebrity do you most resemble - physically? | |
How many siblings do you have? | -1 |
Reproductive information
Are you a virgin? | No |
Ever miscarried? | No |
No. of children | -1 |
Fertility issues | No |
Health of egg donor
Are you a twin? | No |
Are you adopted? | No |
Current health status lifestyle and/ or current diseases | Going to the gym regularly, eating according to diet, no current diseases, healthy. |
Smoker | Ex-smoker |
Alcohol consumption per week. | -1 |
Do you wear glasses? | Since childhood |
How would you rate your sight? | -1 |
Any skin disorders, albinism, ectodermal dysplasia, eczema, acne, etc | -1 |
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? | -1 |
Have you had any cancer? | No |
Have you had any heart problems? | No |
Please indicate if you have any allergies | -1 |
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. | -1 |
Any physical handicaps or deformaties? If yes, please state. | -1 |
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? | -1 |
History of asthma | No |
Indicate any medication you are taking and reason for it. | Contraceptive pill, for hormone balance |
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. | -1 |
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. | -1 |
Any specific diet such as vegan, vegetarian, health conscious, low fat, etc. | -1 |
How often do you excercise? | A few times a week |
In which exercises or sports do you partake now? | Gym: weight lifting and cardio |
Have you excelled in any sports? | Track and field items at school |
What sports did you play at school? | Hockey |
Professional and academic information
Occupation | Waitress and retail worker |
What is your ideal career/ occupation? | Interior Designer |
What are you doing to get to your desired profession in life? | I am currently studying to become an Interior Designer |
Do you have a matric and university exemption? | Only Matric |
Subjects and grades or marks at school | 70's and 80's in school. I had EGD, Consumers's Studies, Music, Maths and excelled in English and Afrikaans |
What is the name of any course / degree completed? | |
Planned studies | |
In what aspects do you have a keen interest? | Music, art, design |
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? | -1 |
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? | Water |
What are your views on religion and spirituality, and practiced religion? | I am very religious and believe in Christianity, but respect other religions. |
Childhood religion? | Christianity |
Any specific achievements or aspects of recognition in your family | No. |
Interests and hobbies | Playing piano, singing, reading, drawing, painting, decorating |
What is your preferred holiday? | -1 |
If you were offered an all-inclusive holiday, what would it be? | |
Which interesting places have you visited? | Abu Dhabi |
What are your feelings on animal welfare? | The welfare of animals is of utmost importance as they are beings on this earth just as we are. |
Strength and weaknesses | My strength and my weakness falls into the same category and is divided by a very thin line. I am very hardworking, and this is my strength because I will always push myseld to be the best verion of myself that I possibly could. But this is also my weakness as I don't know where to stop or draw the line. I feel lazy when I allow myself to rest and I hate asking for help because I feel like I am useless if I can't do something myself. |
What do others generally think of you? | That I am friendly, outgoing, energetic and reliable |
Favourite flower | Tulip |
What is your favourite meal? | Anything with potato |
What is your favourite movie? | Baby Driver |
What is your favourite book? | Harry Potter |
Who is your favourite actor? | Matthew Perry |
Who is your favourite actress? | Megan Fox |
What is your favourite colour? | Sage green |
What is your favourite colour lipstick? | Nude Pink |
What is your favourite perfume? | Black Opium by YSL |
Who is your favourite person? | My little 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? | Go out with friends |
Are you musical or played any musical instruments? | Yes, piano |
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? | -1 |
Are you more creative or analytical? | -1 |
Family information of genetic parents
Nationality for mother and father | Both South African |
Country of origin and ancestry for mother and father | Mom - French, dad - Netherlands |
Language spoken for mother and father | Both Afrikaans |
Professions for mother and father | Mom - teacher, dad - Programmer |
Achievements on an academic level for mother and father | Mom - Bcomm Degree in Tourism and teaching, dad - none |
Race for mother and father | Both white |
Natural hair colour for mother and father | Mom - light brown, dad - dark brown |
Eye colour for mother and father | Both blue |
Height for mother and father | Mom - 1.72m., dad - 1.80m |
Mother and father build | Mom - tall, skinny, curvy, dad - tall, athletic, muscular |
Any specific defining traits for both parents | Tall |
Are your parents still alive? | Yes to Both |
If deceased, cause of death | Not applicable |
Age (if living, or age deceased) | Mom - 43, dad - 45 |
Health status | Healthy. |
Please indicate if any twins in your family and the relationship to you | No twins |
Please list any family members who have had cancer including aunts or uncles and on which family side | MGF |
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 | Only my father |
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? | Yes to Both |
If deceased, state cause of death | Not applicable |
Current age or age of death | MGM - 86, PGM - 70 |
Grandfathers still alive? | Only PGF |
If deceased, state cause of death | MGF - prostate cancer (diagnosed at age 80) |
Current age or age at time of death | MGF - 84, PGF - 70 |
Grandfathers' eye colour (maternal and paternal) | Both blue |
Grandmothers' eye colour (maternal and paternal) | MGM - blue, PGM - green |
Grandfathers' hair colour (maternal and paternal) | MGF - light brown, PGF - dark brown |
Grandmothers' hair colour (maternal and paternal) | MGM - blonde, PGM - dark brown |
Health of grandmothers (maternal and paternal) | MGM - bladder disfunction , PGM - In good health |
Health of grandfathers (maternal and paternal) | PGF - In good health |
Please specify if the race of your grandparents is different to yours. If mixed race, please specify race for maternal and patermal grandparents | All white |
Any genetic health or psychological concerns worth noting regarding your grandparents | No. |
Any notes/ comments re family of family health aspects - genetic ito psychological, physical, deformaties, diseases, concerns | No. |
Egg donation stipulations
Please indicate if you have any donation conditions or criteria such as persons to whom you prefer not to donate | People with serious criminal records. |
Preferred town to donate | Johannesburg |
Towns available in which to donate - travel costs will be covered | Johannesburg |
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 indicated |
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 |