S – PM 5841, Bloemfontein
Generate PDF| Availability status: | Available now in Bloemfontein |
| Race: | Black/African |
| Age: | 20 |
| Hair colour: | Black |
| Eye colour: | Brown |
| Has children: | No |
| Proven donor | No |
| Post matric studies: | Yes |
| Other physical information: | 1.65m. 80kg. |
| Face shape: | Round |
| Other personal information: | South African nationality. Candidate is employed as an ophthalmic junior assistant. She aspires to work in healthy and safety. Non-smoker Reason for donating: I am fully aware that other people cannot conceive. I can help. Message to recipient: Children are a blessing from God and we are here to help you receive that wonderful gift. |
| Reproduction history: | No children and no donations as yet. |
| What are your views on religion and spirituality, and practiced religion? | No opinion as I grew up in a household of different beliefs. |
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Category: Active Donor
Additional donor information
Initial information
| In which town do you live? | Bloemfontein |
| In which province do you live? | Free State |
| Nationality | South African |
| Where were you born? | Botshabelo Hospital |
| What language(s) do you speak? | Sesotho English |
| Year of birth | 2005 |
| Age | 20 |
| Star sign | Cancer |
| 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 fully aware that other people cannot conceive. I can help. Message to recipient: Children are a blessing from God and we are here to help you receive that wonderful gift. |
| How do you best describe yourself? | I am a very humble and sometimes quiet person. I am loving, friendly and soft hearted. |
| Relationship status | New relationship |
| Have you donated eggs before? | No |
Physical profile
| Race | Black/African |
| Skin complexion | Medium |
| Face shape | Round |
| Nose shape defined by Wikipedia | African - wide nostrilled nose |
| Eye shape | Almond |
| Height in metres | 1.65 |
| Weight in kilograms | 80 |
| What is your usual or ideal weight? | 88 |
| Build and body shape | Curvy |
| Which body part is most sensitive to weight gain or loss? | Upper body |
| Eye colour | Brown |
| Natural hair colour | Black |
| Hair colour as a child | Black |
| Hair type | Straight |
| Hair texture | medium |
| Description of hands and fingers | Fingers are slender and well proportioned. index finder slightly longer than others. Short and well trimmed nails. |
| Cup size | D |
| Shoe size | 5 |
| Are you left handed or right handed? | Right handed |
| With celebrity do you most resemble - physically? | Unsure |
| How many siblings do you have? | 2 |
| Sibling 1 Hair Colour | Black |
| Sibling 1 Eye Colour | Brown |
| Sibling 1 Build | Medium |
| Sibling 2 Hair Colour | Black |
| Sibling 2 Eye Colour | Brown |
| Sibling 2 Build | Medium |
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 | Moderate |
| Any current diseases? | No |
| Current health status lifestyle and/ or current diseases | Healthy |
| Smoker | Ex-smoker |
| Alcohol consumption per week. | 0_drinks |
| Do you wear glasses? | Never |
| How would you rate your sight? | 10 |
| Any skin disorders, albinism, ectodermal dysplasia, eczema, acne, etc | No |
| 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 | No |
| 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? | A few times a week |
| In which exercises or sports do you partake now? | Gym every Saturday |
| Have you excelled in any sports? | Yes |
| What sports did you play at school? | Basketball |
Professional and academic information
| Occupation | Opthalmnic junior assistant |
| What is your ideal career/ occupation? | Occupational health and safety officer |
| What are you doing to get to your desired profession in life? | Partaking in three month courses |
| Do you have a matric and university exemption? | Only Matric |
| Subjects and grades or marks at school | English 61% Sesoth 67% Life Orientation 74% Life Sciences 52% Physical Sciences 34% Mathematics 32% Geography 54% |
| What is the name of any course / degree completed? | Matric |
| Planned studies | Occupational health and safety management |
| In what aspects do you have a keen interest? | Learning and education Language and communication Problem solving and critical thinking |
| 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? | 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? | My grandmother |
| What are your views on religion and spirituality, and practiced religion? | No opinion as I grew up in a household of different beliefs. |
| Childhood religion? | Christian |
| Any specific achievements or aspects of recognition in your family | None |
| Interests and hobbies | Cooking Listening to music Reading books and novels Basketball Sleeping |
| What is your preferred holiday? | Stay at home |
| If you were offered an all-inclusive holiday, what would it be? | Island getaway |
| Which interesting places have you visited? | Big hole in Kimberley |
| What are your feelings on animal welfare? | I love dogs and I have lived with dogs my entire life. I also had pigs and piglets for a few years. |
| Strength and weaknesses | Strengths - adaptability, teamwork, leadership, communication skills Weaknesses - public speaking, anxiety, time management |
| What do others generally think of you? | I am strong, loving and friendly |
| Favourite flower | Rose |
| What is your favourite meal? | Spaghetti and mice |
| What is your favourite movie? | Little man |
| What is your favourite book? | Pride and Prejudice by Jane Austin |
| Who is your favourite actor? | Leon Schuster |
| Who is your favourite actress? | Nomzamo Mbatha |
| What is your favourite colour? | Red |
| What is your favourite colour lipstick? | Red |
| What is your favourite perfume? | Oops Daisy from Signature Stardom from Signature |
| Who is your favourite person? | My grandmother |
| 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 more cultural or more adventurous? | Bit of Both - depending on Situation |
| Do you prefer indoors or outdoors? | Indoors |
| Which weather do you prefer? | rain |
| 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 | Both South Africa |
| Language spoken for mother and father | Both Sesotho |
| Professions for mother and father | Mom - domestic worker Dad - mechanic |
| Achievements on an academic level for mother and father | Mom - grade 10 Dad - grade 11 |
| Race for mother and father | Both black |
| Natural hair colour for mother and father | Both black |
| Eye colour for mother and father | Both brown |
| Height for mother and father | Mom - short Dad - tall |
| Mother and father build | Mom - lady figure Dad - masculine |
| Are your parents still alive? | Yes to Both |
| Age (if living, or age deceased) | Mom - 28 Dad - 40 |
| Health status | Both good |
| Please indicate if any twins in your family | Yes |
| Details of twins | Maternal aunt had twins and another set of twins on the maternal side |
| Any family members who have had cancer including aunts or uncles? | No |
| 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 | No To Both |
| Any skin disorders, albinism, ectodermal dyslasia or other in your family – please explain | No |
| 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 - natural death |
| Current age or age of death | MGM - 73 PGM - 66 |
| Grandfathers still alive? | No to Both |
| If deceased, state cause of death | Unknown |
| Current age or age at time of death | Unknown |
| Grandfathers' eye colour (maternal and paternal) | Unknown |
| Grandmothers' eye colour (maternal and paternal) | Both brown |
| Grandfathers' hair colour (maternal and paternal) | Unknown |
| Grandmothers' hair colour (maternal and paternal) | Both black |
| Health of grandmothers (maternal and paternal) | Unknown |
| Health of grandfathers (maternal and paternal) | Unknown |
| Please specify if the race of your grandparents is different to yours. If mixed race, please specify race for maternal and patermal grandparents | All black |
| 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 | bloemfontein |
| Towns available in which to donate - travel costs will be covered | Bloemfontein |
Confirmation
| I have only made myself available as an egg donor with baby2mom. | Yes |
| 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 |
