Sample Ovum Donor Profile

Ovum Donor #: OV 7000

This profile is a compilation obtained from an 19-page application that has been completed by the fertility helper.

PERSONAL INFORMATION

Date of Birth: 7/13/1981

Race: caucasian                                       Ethnic History: Irish, German

Hair Color: blonde                                     Hair Type:  wavy

Eye Color: blue                                          Weight (lbs): 125 lbs

Blood Type: O+                                          Complexion:

Height: 5'5''                                                  Illegal Drug Use: never

Religion: Catholic                                      Criminal Record: no

Smoker: no                                                How Often: n/a                                   

Alcohol Consumption: yes                     How Often: 2-3 times per month

PREGNANCIES

Number of Pregnancies: 1                                Number of Abortions: 0        Year:

Number of Children: 1                                        Number of Micarriages: 0      Year:      

INFORMATION ABOUT PREGNANCIES

Present Method Of Birth Control: Birth Control Pill

EDUCATIONAL /VOCATIONAL HISTORY

Education: She has a Bachelor's Degree in Earth Science and Environmental Studies and a Master's Degree in Environmental Science.

Plans for Additional Education:  She is currently working on a PH.D. in Geophysics.

Special Achievements: Graduated high school with honors.

Best Subjects in School: Biology

Hobbies and Special Interests: She enjoys singing, cooking, sports, helping the community, reading, symphonies, and art showings.

Employment History: She is currently a Graduate Teaching Assistant.

Volunteer Work: Habitat for Humanity, church mission work, and helping in soup kitchens

MEDICAL HISTORY

Vision: good                                              Hearing: good

Sexually Transmitted Diseases: none

Previous Hospitalizations/Surgery:  1999 - tonsillectomy                                              

Previous Psychiatric History: none

Allergies: penicillin

Exercise Program: regular

Type of Exercise: She does Yoga 3-4 times a week, climbs at the gym 5 days a week for about a half hour. Lifts weights 1 or 2 days a week, and also tries to climb outdoors one day on the weekend. She runs with her dog for a half hour 3-5 times a week and rides her bike to work (3.5 miles one way).

FAMILIAL HEALTH HISTORY

Number of Blood-Related Siblings: 2                       

Twins in Family Tree: yes

Special Achievements of Family Members:  Paternal Grandfather had military honors.

LONGEVITY   Please remember that older grandparents may not have had the benefit of modern medicine.)

FAMILIAL MEDICAL HISTORY

Each Fertility Helper was provided with a list of 70 different medical conditions to review including: heart and circulatory conditions, blood disorders, respiratory conditions, illnesses affecting sight/sound/smell, neurological conditions, skin disorders, mental health problems, reproductive system disorders and disorders of the internal organ systems.

This Fertility Helper identified the following conditions in her family members:

This Fertility Helper has agreed to maintain contact for:  more than 10 years

In your own words, describe your personality and character:

I am a very ambitious and hard working person. I have certain goals in life and work hard each day towards accomplishing those goals, taking small steps along the way. I feel as though I am able to communicate and be friends with people of all backgrounds and am comfortable in most social situations.

If you could pass a message to the prospective parent(s), what would that message be?

There is no greater love than that of a parent and a child, and no greater gift than that of a child. It is my desire that you experience all the joy a child can bring to your life, and my wish to be able to help in your dreams of having a family.