A – SC 3187, Johannesburg
Generate PDFAvailability status: | Available in Pretoria |
Race: | Caucasian |
Age: | 22 |
Hair colour: | Straight, fine, blonde |
Eye colour: | Blue |
Has children: | No |
Proven donor | Yes |
Post matric studies: | Yes |
Other physical information: | 1.7m., 55kg., athletic build, bilateral dimples |
Face shape: | Inverted Triangle |
Other personal information: | South African nationality, O+ blood group, Christian. Candidate is studying a bachelors degree in emergency medical care. She enjoyed sports, outdoor activities, swimming and reading. She is an outgoing extrovert. Non-smoker. Reason for donating: I know how difficult it can be for some people to fall pregnant, people who would be really awesome parents and i don't think it's fair. If I can help someone through their journey, I will be very happy! |
Reproduction history: | No children and proven donor resulting in pregnancies. |
What are your views on religion and spirituality, and practiced religion? | Practicing Christian |
Category: Uncategorized
Additional donor information
Initial information
In which town and province do you live? | Johannesburg, Gauteng |
Nationality | South African |
Where were you born? | Johannesburg |
What language(s) do you speak? | Afrikaans, English |
Year of birth | 1999 |
Age | 22 |
Star sign | Leo |
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 know how difficult it can be for some people to fall pregnant, people who would be really awesome parents and i don't think it's fair. If I can help someone through their journey, I will be very happy! |
How do you best describe yourself? | Funny, outgoing, easy-go-lucky girl with an adventurous spirit. |
Relationship status | Serious relationship |
Physical profile
Race | White/ Caucasian |
Skin complexion | Fair |
Face shape | inverted triangle |
Nose shape defined by Wikipedia | Greek - perfect straight nose |
Eye shape | Round Almond |
Height in metres | 1.70m. |
Weight in kilograms | 55kg. |
What is your usual or ideal weight? | 55kg. |
Build and body shape | Slim, athletic |
Which body part is most sensitive to weight gain or loss? | Waist |
Eye colour | Blue |
Natural hair colour | Blonde |
Hair colour as a child | Blonde |
Hair type | Straight |
Hair texture | Fine |
Description of hands and fingers | Thin, delicate hands with long, slim fingers |
Any other defining traits such as breast cup, size shoe size, freckles, dimples, etc | A breast cup, size 5 shoe, some dimples. |
Are you left handed or right handed? | Right handed |
With celebrity do you most resemble - physically? | Charlize Theron |
Siblings physical traits - hair and eye colour, height, weight and build | Tall, strong build, blonde, blue/green eyes, 1.88m/1.90m, 73kg/82kg |
Reproductive information
Are you a virgin? | No |
Ever miscarried? | No |
No. and ages of children (if applicable) | None |
Fertility issues | None |
Health of egg donor
Are you a twin? | No |
Are you adopted? | No |
Current health status lifestyle and/ or current diseases | Healthy |
Smoker | never smoked |
Alcohol consumption per week. | None |
Do you wear glasses? | Since last year |
How would you rate your sight? | Very good, only reading glasses when studying |
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 | Hayfever |
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. | Contraception |
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? | Wisdom tooth removal |
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. | Mainly vegetarian |
How often do you excercise? | A few times a week |
In which exercises or sports do you partake now? | Running, swimming, netball |
Have you excelled in any sports? | Yes |
What sports did you play at school? | Netball, hockey, swimming, athletic |
Professional and academic information
Occupation | Student |
What is your ideal career/ occupation? | Emergency Care Practitioner |
What are you doing to get to your desired profession in life? | Currently studying |
Do you have a matric and university exemption? | Matric and Exemption |
Subjects and grades or marks at school | Afrikaans home language, English first addition language, Math, Science, Biology, Business studies, average of 70% for most subjects |
What is the name of any course / degree completed? | None yet |
Planned studies | Currently studying and want to do a second degree in education |
In what aspects do you have a keen interest? | Medicine, people, sports |
What type of books do you like to read? | |
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? | Happiness and family |
If you had unlimited resources and could save one thing on earth what would it be? | Water resources |
What are your views on religion and spirituality, and practiced religion? | Practicing Christian |
Childhood religion? | Christian |
Any specific achievements or aspects of recognition in your family | None |
Interests and hobbies | Sports, reading |
What is your preferred holiday? | |
If you were offered an all-inclusive holiday, what would it be? | |
Which interesting places have you visited? | Swaziland and most of South Africa |
What are your feelings on animal welfare? | I respect people who go out of their way to protect innocent animals |
Strength and weaknesses | Strength - any physical activities, self confidence, self love; weakness - claustrophobia |
What do others generally think of you? | I get along with others easily, so I tend to think people have a positive image of me |
Favourite flower | Orchids |
What is your favourite meal? | Pasta |
What is your favourite movie? | Shutter Island |
What is your favourite book? | Me before you |
Who is your favourite actor? | Matthew McConaughey |
Who is your favourite actress? | Mila Kunis |
What is your favourite colour? | Light pink |
What is your favourite colour lipstick? | I don't wear lipstick |
What is your favourite perfume? | Katy perry killer queen |
Who is your favourite person? | My mom |
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? | Yes, I'm musical |
Are you more cultural or more adventurous? | More Adventurous |
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 African |
Country of origin and ancestry for mother and father | Both South African |
Language spoken for mother and father | Both Afrikaans |
Professions for mother and father | Mom - nurse, dad - own construction company |
Achievements on an academic level for mother and father | Mom - Bachelors degree, dad - matric |
Race for mother and father | Both Caucasian |
Natural hair colour for mother and father | Both dark blonde |
Eye colour for mother and father | Mom - green, dad - blue |
Height for mother and father | Mom - 1.69m., dad - 1.95m. |
Mother and father build | Mom - slightly short, good build; dad - tall, skinny, strong |
Any specific defining traits for both parents | None |
Are your parents still alive? | Only my mother |
If deceased, cause of death | Dad - cancer |
Age (if living, or age deceased) | Mom - 54, dad - 50 at death |
Health status | Healthy |
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, father and MGM |
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? | 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? | None |
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 | None |
Any physical deformaties or handicaps? If yes, please state | None |
History of asthma | Not Selected |
Any skin disorders, albinism, ectodermal dyslasia or other in your family – please explain | None |
Any other comments regaring any health aspects in your family | None |
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 | 91 and 76 |
Grandfathers still alive? | No to Both |
If deceased, state cause of death | MGF - hospital acquired sepsis, PGF - cancer |
Current age or age at time of death | MGF - 70, - PGF - 40 |
Grandfathers' eye colour (maternal and paternal) | Both green |
Grandmothers' eye colour (maternal and paternal) | Both blue |
Grandfathers' hair colour (maternal and paternal) | Both dark blonde |
Grandmothers' hair colour (maternal and paternal) | MGM - blonde, PGM - brown |
Health of grandmothers (maternal and paternal) | Healthy |
Health of grandfathers (maternal and paternal) | Semi healthy |
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 | 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 | Pretoria |
Towns available in which to donate - travel costs will be covered |
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 |