S – TR 6907, Germiston
Generate PDFReserve this donor| Availability status: | Available now in Johannesburg and Pretoria |
| Race: | Black/African |
| Age: | 31 |
| Hair colour: | Black |
| Eye colour: | Black |
| Has children: | Yes |
| Smoker: | never smoked |
| Proven donor | No |
| Post matric studies: | Yes |
| Other physical information: | Height: 1.67 meters Weight: 62 kg |
| Face shape: | Round |
| Other personal information: | Religion: Very much spirited, Christian Nationality: South Africa Blood Group: O+ Ever smiling, don't get offended, easily fast learner Smoker: never smoked Reason for Donating: I want to help. |
| Reproduction history: | Has Children: Yes Number of Children: 1 Have you donated eggs before: No |
| What are your views on religion and spirituality, and practiced religion? | Very much spirited, Christian |
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Category: Active Donor
Additional donor information
Initial information
| In which town do you live? | Germiston |
| In which province do you live? | Gauteng |
| Where were you born? | Pretoria |
| What language(s) do you speak? | Sepedi English |
| Year of birth | 1995 |
| Age | 31 |
| Star sign | Pisces |
| Relationship status | Engaged |
| Have you donated eggs before? | No |
Other personal info
| Religion | Very much spirited, Christian |
| Nationality | South Africa |
| Blood group (if known) | O+ |
| Ever smiling, don't get offended, easily fast learner | |
| Smoker | never smoked |
| Reason for donating | I want to help. |
Physical profile
| Race | Black/African |
| Skin complexion | Brown |
| Face shape | Round |
| Nose shape defined by Wikipedia | Jewish/ Hawk - Thin and sharp |
| Eye shape | Thin Almond |
| Height in metres | 1.67 |
| Weight in kilograms | 62 |
| What is your usual or ideal weight? | 62 |
| Build and body shape | Fit |
| Which body part is most sensitive to weight gain or loss? | Stomach |
| Eye colour | Black |
| Natural hair colour | Black |
| Hair colour as a child | Black |
| Hair type | Afro |
| Hair texture | Thick |
| Description of hands and fingers | Long slender fingers |
| Cup size | 34 |
| Shoe size | 4 |
| Are you left handed or right handed? | Right handed |
| With celebrity do you most resemble - physically? | Zahara |
| How many siblings do you have? | 4 |
| Sibling 1 Hair Colour | Black |
| Sibling 1 Eye Colour | Black |
| Sibling 1 Build | Fit |
| Sibling 2 Hair Colour | Black |
| Sibling 2 Eye Colour | Black |
| Sibling 2 Build | Fit |
| Sibling 3 Hair Colour | Black |
| Sibling 3 Eye Colour | Black |
| Sibling 3 Build | Fit |
| Sibling 4 Hair Colour | Black |
| Sibling 4 Eye Colour | Black |
| Sibling 4 Build | Fit |
Reproductive information
| Are you a virgin? | No |
| Ever miscarried? | No |
| No. of children | 1 |
| Child 1 Date of Birth | 28/06/2014 |
| Fertility issues | No |
Health of egg donor
| Are you a twin? | No |
| Are you adopted? | No |
| Would you consider your lifestyle | Moderate |
| Any current diseases? | No |
| 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. | No |
| 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? | Child birth |
| 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? | Home workouts |
| Have you excelled in any sports? | Yes |
| What sports did you play at school? | Running |
Professional and academic information
| Occupation | Unemployed |
| What is your ideal career/ occupation? | Office admistration finance |
| What are you doing to get to your desired profession in life? | Studying |
| Do you have a matric and university exemption? | Only Matric |
| Subjects and grades or marks at school | English - 51% Maths - 52% |
| What is the name of any course / degree completed? | Still studying |
| Planned studies | None |
| In what aspects do you have a keen interest? | Life explore |
| What type of books do you like to read? | i_do_not_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? | Taking care of my loved one |
| If you had unlimited resources and could save one thing on earth what would it be? | My son |
| Childhood religion? | Christian |
| Any specific achievements or aspects of recognition in your family | Best achievers |
| Interests and hobbies | Protecting my country |
| What is your preferred holiday? | Stay at home |
| If you were offered an all-inclusive holiday, what would it be? | Home getaway with all expenses paid |
| Which interesting places have you visited? | None |
| What are your feelings on animal welfare? | I love animals so much |
| Strength and weaknesses | Cooking |
| What do others generally think of you? | Kind hearted person and ever smilling |
| Favourite flower | Fiona |
| What is your favourite meal? | Burger and chips |
| What is your favourite movie? | Horror and fantasy |
| What is your favourite book? | None |
| Who is your favourite actor? | Tyler Perry |
| Who is your favourite actress? | Queen lathifa |
| What is your favourite colour? | Purple |
| What is your favourite colour lipstick? | Red |
| What is your favourite perfume? | Floral |
| 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? | Stay in with a loved one or book |
| Are you more cultural or more adventurous? | More Adventurous |
| Do you prefer indoors or outdoors? | Indoors |
| Which weather do you prefer? | rain |
| Are you more creative or analytical? | creative |
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 |
| Race for mother and father | Both black |
| Natural hair colour for mother | Black |
| Natural hair colour for father | Black |
| Eye colour for mother | Black |
| Eye colour for father | Black |
| Are your parents still alive? | Yes to Both |
| Age (if living, or age deceased) | Mom - 62 Dad - 73 |
| Health status | Still healthy just old age |
| Please indicate if any twins in your family | Yes |
| Details of twins | My brother has a boy and girl twins |
| Any family members who have had cancer including aunts or uncles? | Yes |
| Please provide details about cancer in your family | Uncle |
| 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 | Non |
| Alcoholism / substance abuse | No To Both |
| Grandmothers still alive? | No to Both |
| If deceased, state cause of death | Natural |
| Current age or age of death | 60+ |
| Grandfathers still alive? | No to Both |
| If deceased, state cause of death | Natural cause |
| Current age or age at time of death | 60+ |
| Grandfathers' eye colour (maternal) | Black |
| Grandfathers' eye colour (paternal) | Black |
| Grandmothers' eye colour (maternal) | Black |
| Grandmothers' eye colour (paternal) | Black |
| Grandfathers' hair colour (maternal) | Black |
| Grandfathers' hair colour (paternal) | Black |
| Grandmothers' hair colour (maternal) | Black |
| Grandmothers' hair colour (paternal) | Black |
| Health of grandmothers (maternal and paternal) | Deceased |
| Health of grandfathers (maternal and paternal) | Deceased |
| 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 | 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 |
