S – SD 6280, Bloemfontein
Generate PDF| Availability status: | Available now in Bloemfontein |
| Race: | White/ Caucasian |
| Age: | 20 |
| Hair colour: | Brown |
| Eye colour: | Brown |
| Has children: | No |
| Smoker: | never smoked |
| Proven donor | No |
| Post matric studies: | Yes |
| Other physical information: | Height: 1.69 meters Weight: 60 kg. Fair skin complexion. |
| Face shape: | Round |
| Other personal information: | Christian South African nationality, of Belgic ancestry. Candidate aspires to study business. She is presently employed as a waitress. She is a friendly and kind person to everyone even if she does not know them. She is shy but opens up when people get to know her. She loves flowers and cars and spending time with people she loves. Non-smoker. Reason for Donating: I want to be a donor because I know there is women out there that wants to be a mom but can do it self so I want to help because I know I can. |
| Reproduction history: | Has Children: No Number of Children: 0 Have you donated eggs before: No |
| What are your views on religion and spirituality, and practiced religion? | My faith is a central part of my life. I actively practice Christianity, attend services regularly, and find that my religious community provides me with a strong moral framework and sense of purpose |
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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? | Bloemfontein |
| What language(s) do you speak? | Afrikaans and English |
| Year of birth | 2006 |
| Age | 20 |
| Star sign | Libra |
| 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 want to be a donor because I know there is women out there that wants to be a mom but can do it self so I want to help because I know I can. |
| How do you best describe yourself? | I am friendly and kind to everyone even if I don't know you, I am shy but when i get to know you I can talk a lot and open up to you, I love flowers and cars and spending time with people I love. |
| Relationship status | New relationship |
| Have you donated eggs before? | No |
Physical profile
| Race | White/ Caucasian |
| Skin complexion | Fair |
| Face shape | Round |
| Nose shape defined by Wikipedia | Snub |
| Eye shape | Round Almond |
| Height in metres | 1.69 |
| Weight in kilograms | 60 |
| What is your usual or ideal weight? | 60 |
| Build and body shape | Slim figure, smaller breast, bigger bum, small waist |
| Which body part is most sensitive to weight gain or loss? | My breast and tummy |
| Eye colour | Brown |
| Natural hair colour | Brown |
| Hair colour as a child | Blonde |
| Hair type | Straight |
| Hair texture | medium |
| Description of hands and fingers | Slim hands, medium length fingers |
| Any other defining traits such as breast cup, size shoe size, freckles, dimples, etc | Dimples |
| Cup size | 34B |
| Shoe size | 6/7 |
| Are you left handed or right handed? | Right handed |
| With celebrity do you most resemble - physically? | Britney Spears and Devon Aoki |
| How many siblings do you have? | 1 |
| Sibling 1 Hair Colour | Blonde |
| Sibling 1 Eye Colour | Black |
| Sibling 1 Build | Slim, small waist, small bum and breast |
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 |
| Smoker | never smoked |
| Alcohol consumption per week. | 1_drink |
| Do you wear glasses? | Never |
| How would you rate your sight? | 7 |
| 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? | Yes |
| Please list | Mild asthma |
| 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. | Yes |
| Please list | Mild dyslexia |
| 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 | Yes - Mild |
| Indicate any medication you are taking and reason for it. | Asthma pump for my Asthma The pill for my acne |
| 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? | When I Get A Chance |
| In which exercises or sports do you partake now? | Some core and dardio exercises and sometime playing a little field hockey |
| Have you excelled in any sports? | Ffield hockey Dance in primary school |
| What sports did you play at school? | Field hockey |
Professional and academic information
| Occupation | Currently Waiter but waiting for hear back ons my interview for front desk position |
| What is your ideal career/ occupation? | Flight attendant or bakery owner |
| What are you doing to get to your desired profession in life? | Baking more often to get more knowledge on baking and learning about business owning |
| Do you have a matric and university exemption? | Only Matric |
| Subjects and grades or marks at school | Afrikaans: 62% English: 63% Math lit: 82% CAT: 59% Tourism: 65% Consumer Studies: 54% |
| What is the name of any course / degree completed? | Business Management Essentials |
| Planned studies | Want to study Bcom Business management |
| In what aspects do you have a keen interest? | Entrepreneurship and Innovation I want to focus on the process of starting and scaling a business. |
| 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? | My family and friends |
| If you had unlimited resources and could save one thing on earth what would it be? | Equality For the ability for every person to access clean water, food, and education. |
| What are your views on religion and spirituality, and practiced religion? | My faith is a central part of my life. I actively practice Christianity, attend services regularly, and find that my religious community provides me with a strong moral framework and sense of purpose |
| Childhood religion? | I was raised in the Christianity religion |
| Any specific achievements or aspects of recognition in your family | My sister got the chance to go play in the Netherlands |
| Interests and hobbies | I love playing hockey and reading books |
| What is your preferred holiday? | Beach |
| If you were offered an all-inclusive holiday, what would it be? | Going to Greece and enjoying the buildings and views |
| Which interesting places have you visited? | Knysna |
| What are your feelings on animal welfare? | I feel that animals should be able to feel safe anywhere they go, and that they should not be put in situations where there welfare is put in danger |
| Strength and weaknesses | Strengths - cooking, Baking and Weakness - public speaking |
| What do others generally think of you? | That I'm shy and kind but when they get to know me they say I'm out going, funny, energetic and Kind |
| Favourite flower | Daisy and roses |
| What is your favourite meal? | Sushi and salads |
| What is your favourite movie? | Gran turismo |
| What is your favourite book? | All the bright places |
| Who is your favourite actor? | Dylan Obrein |
| Who is your favourite actress? | Christina Aguilera |
| What is your favourite colour? | Blue |
| What is your favourite colour lipstick? | A nice light brown or light red |
| What is your favourite perfume? | Christina |
| Who is your favourite person? | My mom |
| 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? | Bit of Both - depending on Situation |
| Do you prefer indoors or outdoors? | Depending on the Situation |
| Which weather do you prefer? | rain |
| Are you more creative or analytical? | creative |
Family information of genetic parents
| Nationality for mother and father | Mom - South African Dad - South African |
| Country of origin and ancestry for mother and father | Mom - Belgium Dad - Not indicated |
| Language spoken for mother and father | Mom - English and Afrikaans Dad - Afrikaans and English |
| Professions for mother and father | Not indicated |
| Achievements on an academic level for mother and father | Not indicated |
| Race for mother and father | Both white |
| Natural hair colour for mother | Brown |
| Natural hair colour for father | Brown |
| Eye colour for mother | Blue |
| Eye colour for father | Brown |
| Height for mother and father | Not indicated |
| Mother and father build | Mom - hourglass Dad - rectangle |
| Are your parents still alive? | Yes to Both |
| Age (if living, or age deceased) | Mom - 41 Dad - not indicated |
| Health status | Both healthy |
| Please indicate if any twins in your family | No |
| Any family members who have had cancer including aunts or uncles? | Yes |
| Please provide details about cancer in your family | My aunt had breast cancer and my grandmother and skin 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? | Yes |
| Please provide details of health concerns in your family | Some of my family have blood pressure problems |
| 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 | Yes |
| Please provide details of mental diseases in your family | My mom has depression |
| 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? | Yes to Both |
| Current age or age of death | MGM - 75 PGM - not indicated |
| Grandfathers still alive? | Only MGF |
| If deceased, state cause of death | PGF - unknown |
| Current age or age at time of death | MGF - 78 PGF - not indicated |
| Grandfathers' eye colour (maternal) | Blue |
| Grandmothers' eye colour (maternal) | Blue |
| Grandfathers' hair colour (maternal) | Brown |
| Grandmothers' hair colour (maternal) | Brown |
| Health of grandmothers (maternal and paternal) | MGM - unknown PGM - skin cancer |
| Health of grandfathers (maternal and paternal) | MGF - diabetic PGF - dead |
| 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 | 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 |
