S – RN 6037, Boksburg
Generate PDF| Availability status: | Available now in Johannesburg and Pretoria |
| Race: | White/ Caucasian |
| Age: | 33 |
| Hair colour: | Black |
| Eye colour: | Brown |
| Has children: | Yes |
| Proven donor | No |
| Post matric studies: | No |
| Other physical information: | 1.65m. 58kg. |
| Face shape: | Inverted Triangle |
| Other personal information: | South African nationality. Candidate is employed in admin. Light to non-smoker. Message to recipient: I believe everyone should have a chance to become pregnant. Never give up. |
| Reproduction history: | Two children and no donations as yet. |
| What are your views on religion and spirituality, and practiced religion? | I am a Christian |
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Category: Active Donor
Additional donor information
Initial information
| In which town do you live? | Boksburg |
| In which province do you live? | Gauteng |
| Nationality | South African |
| Where were you born? | Carletonville |
| What language(s) do you speak? | Afrikaans English |
| Year of birth | 1992 |
| Age | 33 |
| Star sign | Taurus |
| 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 believe everyone should have a chance to become pregnant. Never give up. |
| How do you best describe yourself? | Funny Loyal Soft Heart Loving Caring Independent |
| Relationship status | Single |
| Have you donated eggs before? | No |
Physical profile
| Race | White/ Caucasian |
| Skin complexion | Tanned |
| Face shape | Inverted Triangle |
| Nose shape defined by Wikipedia | Greek - perfect straight nose |
| Eye shape | Asian |
| Height in metres | 1.65 |
| Weight in kilograms | 58 |
| What is your usual or ideal weight? | 60 |
| Build and body shape | Slim |
| Which body part is most sensitive to weight gain or loss? | Stomach |
| Eye colour | Brown |
| Natural hair colour | Black |
| Hair colour as a child | Black |
| Hair type | Straight |
| Hair texture | Fine |
| Description of hands and fingers | Normal Fingers |
| Any other defining traits such as breast cup, size shoe size, freckles, dimples, etc | Freckles Dimpels Dark Spots Acne |
| Cup size | 32A |
| Shoe size | 6 & 7 |
| Are you left handed or right handed? | Right handed |
| With celebrity do you most resemble - physically? | None |
| How many siblings do you have? | 4 |
| Sibling 1 Hair Colour | Black |
| Sibling 1 Eye Colour | Brown |
| Sibling 1 Build | Slightly overweight |
| Sibling 2 Hair Colour | Brown |
| Sibling 2 Eye Colour | Green |
| Sibling 2 Build | Overweight |
| Sibling 3 Hair Colour | Black |
| Sibling 3 Eye Colour | Brown |
| Sibling 3 Build | Slim |
| Sibling 4 Hair Colour | Black |
| Sibling 4 Eye Colour | Brown |
| Sibling 4 Build | Slim |
Reproductive information
| Are you a virgin? | No |
| Ever miscarried? | No |
| No. of children | 2 |
| Child 1 Date of Birth | 23/06/2020 |
| Child 2 Date of Birth | 31/07/2023 |
| 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 |
| Please list | Dark Spots Acne |
| Smoker | 0 - 5 per day |
| Alcohol consumption per week. | 0_drinks |
| Do you wear glasses? | Never |
| How would you rate your sight? | 8 |
| 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? | 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? | Daily |
| In which exercises or sports do you partake now? | Walking |
| Have you excelled in any sports? | None |
| What sports did you play at school? | Netball |
Professional and academic information
| Occupation | Dispatcher |
| What is your ideal career/ occupation? | Admin |
| What are you doing to get to your desired profession in life? | Learner and growing |
| Do you have a matric and university exemption? | No matric |
| Subjects and grades or marks at school | English 65% Afrikaans 70% Maths 45% |
| What is the name of any course / degree completed? | Grade 10 |
| Planned studies | None |
| In what aspects do you have a keen interest? | None |
| What type of books do you like to read? | fiction |
| Would you prefer to read the book or watch the movie? | Watch the Movie |
| Do you know if your IQ was ever tested and the score please? | No |
Behavioural traits
| What is most important in life to you? | My children |
| If you had unlimited resources and could save one thing on earth what would it be? | Lifes |
| What are your views on religion and spirituality, and practiced religion? | I am a Christian |
| Childhood religion? | Christian |
| Any specific achievements or aspects of recognition in your family | None |
| Interests and hobbies | Singing Photography Reading |
| What is your preferred holiday? | Bush |
| If you were offered an all-inclusive holiday, what would it be? | Kruger National Park I love the outdoors and animals |
| Which interesting places have you visited? | Lesotho Durban |
| What are your feelings on animal welfare? | I Love Animals |
| Strength and weaknesses | Strengths - cooking, peoples person Weakness - trust Issues |
| What do others generally think of you? | I talk a lot and easy to mingle with |
| Favourite flower | Orange roses |
| What is your favourite meal? | Sushi |
| What is your favourite movie? | Vampire Diaries |
| What is your favourite book? | The Bible |
| Who is your favourite actor? | Channing Tatum |
| Who is your favourite actress? | Miley Cyrus |
| What is your favourite colour? | Black & Red |
| What is your favourite colour lipstick? | Purple |
| What is your favourite perfume? | White Diamond |
| Who is your favourite person? | My Parents |
| Are you more introverted or extroverted? | Introverted |
| Would you prefer to go out with friends or stay in with a loved one or book? | Depends on the situation |
| Are you more cultural or more adventurous? | More Adventurous |
| Do you prefer indoors or outdoors? | Outdoors |
| Which weather do you prefer? | rain |
| Are you more creative or analytical? | analytical |
Family information of genetic parents
| Nationality for mother and father | South Africans |
| Country of origin and ancestry for mother and father | South Africa |
| Language spoken for mother and father | Afrikaans English |
| Professions for mother and father | Mom - homemaker Dad - maintenance manager |
| Achievements on an academic level for mother and father | Unknown |
| Race for mother and father | White |
| Natural hair colour for mother and father | Black Blonde |
| Eye colour for mother and father | Brown Hazel |
| Height for mother and father | Unknown |
| Mother and father build | Slim Slightly Overweight |
| Are your parents still alive? | Yes to Both |
| Age (if living, or age deceased) | 56 66 |
| Health status | Normal |
| Please indicate if any twins in your family | Yes |
| Details of twins | Dad And Mom Side Cousins |
| Any family members who have had cancer including aunts or uncles? | Yes |
| Please provide details about cancer in your family | 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? | 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? | No to Both |
| If deceased, state cause of death | Sick |
| Current age or age of death | 70 |
| Grandfathers still alive? | No to Both |
| If deceased, state cause of death | Sick |
| Current age or age at time of death | 65 |
| Grandfathers' eye colour (maternal and paternal) | Brown Hazel |
| Grandmothers' eye colour (maternal and paternal) | Brown Hazel |
| Grandfathers' hair colour (maternal and paternal) | Brown |
| Grandmothers' hair colour (maternal and paternal) | Brown Blonde |
| 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 | 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 | No |
| Preferred town to donate | Johannesburg |
| Towns available in which to donate - travel costs will be covered | Johannesburg, Pretoria |
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 |
