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I see being an egg donor as helping those who want to become parents but are having trouble doing it alone. So many people would make fantastic parents but need that extra help to be the great parents they were meant to be.
DONOR EGG AVAILABILITY: Available
- Age: 26
- Eye Color: Brown
- Hair Color: Brown
- Height: 5'6''
- Weight: 185 lb
- Location: Texas
- Ethnic Background:
- Prior Cycle History: 0X Donor
- Cycle Outcome Details:
- 1/2011: Description, e.g.: 30 eggs retrieved, 24 mature, 23 fertilized, 17 embryos cryopreserved. FET update: twin birth.
- Blood Type: O-
- Weight: 185 lb
- Height: 5'6''
- Eye Color: Brown
- Hair Color: Brown
- Hair Type: Wavy / Medium
- Skin Tone: Fair
- Do you have freckles? Few
- Body Frame: Medium
- Dominant Hand: Ambidextrous
- Do you use corrective lenses? yes
- Ethnic Background:
- What was your age at first menstruation?
- How many days between menstrual cycles?
- How many days does your menstrual cycle last?
- Has your menstrual cycle ever been irregular?
- Are you currently sexually active?
- Has anyone in your family had problems becoming pregnant?
- How many sexual partners have you had in your lifetime?
- How many sexual partners have you had in the past year?
- Are you currently in a monogamous relationship?
- Have you ever been diagnosed for a sexually transmitted disease?
- Have you had any reproductive problems?
- Have you ever been pregnant?
- Do you smoke, or have you smoked in the past (cigarettes, e-cigarettes, etc)?
- Do you drink alcohol?
- Do you use recreational and/or illegal drugs?
- Do you have any allergies, or have you in the past?
- Describe your diet:
- Do you exercise?
- Are you currently under a physician's care for any reason?
- Are you currently or have you ever suffered from depression?
- Do you have a history of depression in your family?
- Have you ever undergone surgery?
- Have you ever been hospitalized for reasons other than those listed above?
- Have you had any piercings or tattoos in the past year?
- Have you ever traveled outside the United States?
- Heart defect:
- Hardening of the arteries:
- High cholesterol:
- Heart disease:
- Heart murmur:
- High blood pressure:
- Stroke:
- Thalassemia:
- Anemia:
- Sickle-cell anemia:
- Hemophilia:
- Leukemia:
- Lymphoma:
- Immune disorder:
- Autoimmune disorders:
- Lupus:
- Pneumonia:
- Allergies:
- Hay fever:
- Asthma:
- Emphysema:
- Cystic fibrosis:
- Chronic obstructive pulmonary disorder (COPD):
- Lung cancer:
- Tuberculosis:
- Cirrhosis of the liver:
- Colon cancer:
- Crohn's disease:
- Prostate cancer:
- Testicular cancer:
- Appendicitis:
- Gallstones:
- Ulcers of the stomach or duodenum:
- Diabetes - type I:
- Diabetes - type II:
- Hypoglycemia:
- Hypothyroid:
- Hyperthyroid:
- Thyroid cancer:
- Kidney disorder:
- Kidney stones:
- Down syndrome (trisomy 21):
- Klinefelter syndrome (XXY):
- Turner syndrome (X):
- Fragile X:
- Miscarriage:
- Endometriosis:
- Ovarian cysts:
- Polycystic ovaries:
- Ovarian cancer:
- Cervical cancer:
- Breast cancer:
- Premature menopause:
- Uterine fibroids:
- Uterine cancer:
- Gaucher disease:
- Wilson's disease:
- Tay-Sachs disease:
- Canavan disease:
- Hydrocephalus:
- Cerebral palsy:
- Neurofibromatosis:
- Epilepsy:
- Spinal cord disorders:
- Spina bifida:
- Migraines:
- Multiple sclerosis:
- Parkinson's disease:
- Huntington's disease:
- Alzheimer's disease:
- Unexplained senility or mental decline before age 50:
- Autism spectrum:
- Asperger's syndrome:
- Anxiety disorder:
- Depression:
- Manic depression:
- Bipolar disorder:
- Schizophrenia:
- Drug abuse:
- Alcoholism:
- Suicide:
- Deviated septum:
- Cleft palate/cleft lip:
- Marfan syndrome:
- Spinal muscular atrophy (SMA):
- Muscular dystrophy:
- Dwarfism:
- Congenital hip disorder:
- Gout:
- Osteoarthritis:
- Rheumatoid arthritis:
- Osteoporosis:
- Color blindness:
- Cataracts before age 50:
- Blindness:
- Glaucoma:
- Deafness before age 50:
- Acne:
- Eczema:
- Pigmentation disorder:
- Skin cancer:
- Club feet:
- Any other medical conditions not reported above?
- HIGH SCHOOL EDUCATION
- Year of Graduation:
- GPA:
- List applicable high school awards, honors, clubs, sports, other extracurricular activities:
- GPA:
- What were your favorite classes or subjects?
- What were your least favorite classes or subjects?
- Why do you want to become an egg donor?
- Describe your personality as a child:
- Describe your personality now:
- Describe your relationship with your parents as a child:
- Describe your relationship with your parents as a teen:
- Describe your relationship with your parents as an adult:
- What are your personal goals?
- What are your professional goals?
- What are you doing at this point in your life?
- What do you like most about yourself?
- Describe your likes and dislikes in life:
- What is your favorite color?
- What is your favorite food?
- What is your favorite music genre or music group?
- What is your favorite author or book?
- What is your favorite movie?
- What is your favorite season?
- Why?
- What is your favorite holiday?
- Why?
- What are your hobbies?
- Describe your dream vacation:
- What was the most memorable moment you remember from childhood?
- What is the most memorable and/or monumental moment in your life to date?
- As a child, what did you want to be when you grew up?
- What characteristics do you hold that you feel would be important for potential parents to know about you?
Donor Egg Availability:
AVAILABLE
