Personal Information
  • Body Type
    Hourglass
  • Height
    5 ft 1 in
  • Weight
    125
  • Any recent change in weight?
    No
  • Bone structure
    Medium
  • Body and facial features
    Medium
  • Dexterity
    Right handed
Skin & Teeth
  • Tan ability
    Slight
  • Skin condition
    Oily
  • Dimples
    No
  • Teeth condition
    Good
  • Orthodontic work?
    No
Eyes, Vision and Hearing
  • Eye color
    Brown
  • Eye shape
    Almond
  • Eye size
    Small
  • Eye set
    Average
  • How is your vision?
    Excellent
  • Do you need glasses or contact or have had corrective laser surgery?
    No
  • Do you have astigmatism?
    No
  • How is your hearing?
    Excellent
Hair
  • Hair color
    Dark brown
  • Hair texture
    Medium
  • Hair fullness
    Thick
  • Baldness
    No
  • Premature graying?
    No
Sexual History
  • Marital status
    Single
  • Living arrangement
    Living with parents / family
  • Sexual orientation
    Heterosexual
  • Total number of sexual partners in the last month
    0
  • Total number of sexual partners in the last 6 months
    0
  • Total number of sexual partners in the last 5 years
    1
  • Current sexual practice
    Oral given
  • Past sexual practice
    Oral given
  • Have you had sexual contact with a person who has injected drugs for a non-medical reason? (includes intravenous, intramuscular or subcutaneous injections)
    No
  • Have you had sexual contact with a person who has hemophilia or another blood clotting disorder who may have received human derived blood clotting factors?
    No
Sexual History
  • Have you engaged in sexual contact in exchange for money or drugs?
    No
  • Have you engaged in sexual contact with a person who has had sex in exchange for money or drugs?
    No
  • Have you had sexual contact with any person known or suspected to have infection with HIV (AIDS), a positive HIV test, Hepatitis B infection, Hepatitis C infection, Zika Virus, or any other sexually transmitted infection?
    No
  • In the last year, have you had vaginal intercourse without the use of a condom?
    No
  • Have you had sexual contact with a man who is homosexual or bisexual?
    No
  • Have you had sexual contact with an individual who was born in or lived in any of the following countries since 1977: Cameroon, Central African Republic, Chad, Congo, Equatorial Guinea, Gabon, Niger or Nigeria?
    No
Race and Ethnicity
  • Race
    Hispanic
  • Are you adopted?
    No
  • Mother
    Mexican
  • Maternal grandmother
    Mexican
Race and Ethnicity
  • Maternal grandfather
    Mexican
  • Paternal grandmother
    Mexican
  • Paternal grandfather
    Mexican
  • Religion
    Catholic
Menstrual
  • Age at which you had your first period
    13
  • I sometimes have bleeding after intercourse
    No
  • I sometimes have bleeding in between my normal periods
    No
  • Longest number of days of bleeding
    5
  • Shortest number of days of bleeding
    3
  • Longest time from the start of one period to the start of the next
    40
  • Shortest time from the start of one period to the start of the next
    26
Gynecologist visits
  • Have you ever been told you might have trouble having children?
    No
  • Have you ever had a pelvic exam?
    No
  • Have you ever had an abnormal PAP smear?
    No
Use of birth control
  • Oral Contraceptives (birth control pills)
    Never
  • Birth Control Patches (Xulane)
    Never
  • Progesterone Injections (Depo-Provera)
    Never
  • Progesterone Implants (Implanon, Nexplanon)
    Never
  • Intrauterine Device (IUD) Paragard, Mirena, Kyleena, Liletta, Skyla
    Never
  • Barrier contraceptives (Condoms, Diaphragms, Cervical caps)
    Never
  • Sterilization (tubal ligation, Essure tubal plugs)
    Never
Pregnancy History
  • Tell us about your pregnancy history
    I have never been pregnant and have never tried to become pregnant
Lifestyle
  • Athletic talents
    Running, Dancing
  • Interests or Hobbies
    Art/Crafts, Yoga, Reading, Working out
  • Amount of exercise
    Regular
  • Type of exercise
    Running, Dance, Yoga, Aerobics
  • Type of diet
    Vegetarian
  • Quality of diet
    Good
Drugs and Alcohol
  • Alcohol use
    Never
  • Tobacco use
    Never
  • Heroin or opiates
    Never
  • Cocaine, crack
    Never
  • Crystal meth
    Never
  • LSD / Acid
    Never
  • PCP / Angel Dust
    Never
  • Other illegal drugs not listed above
    Never
Legal history
  • I have been in trouble with the law
    No
  • I have been arrested before, but not convicted.
    No
  • I have been convicted of a crime.
    No
  • I have spent at least one hour in jail or prison.
    No
  • I have spent more than 72 consecutive hours in prison in the last year.
    No
Medical History
  • Have you injected drugs for a non-medical reason in the last 5 years?
    No
  • Do you have hemophilia and/or received human-derived clotting factor concentrates in the last 5 years?
    No
  • Have you in the last 12 months lived in the same dwelling with another person with hepatitis B infection or hepatitis C infection?
    No
  • Have you been exposed in the preceding 12 months to known or suspected HIV (AIDS), Hepatitis B, and/or Hepatitis C infected blood through a needle stick or through contact with an open wound, non-intact skin, or mucous membrane?
    No
  • Have you ever been diagnosed with any form of hepatitis?
    No
  • Have you been in juvenile detention, lock up, jail or prison in the last 12 months?
    No
  • In the last 12 months, have you gotten a new tattoo, ear piercing or body piercing, or had acupuncture treatment in which NON STERILE instruments may have been used?
    No
  • In the last 8 weeks, did you receive a smallpox vaccination (vaccinia virus)?
    No
  • In the last 12 months, have you had any contact with someone who received a smallpox vaccination or who was diagnosed with smallpox?
    No
  • Have you ever been diagnosed with smallpox?
    No
Defects
  • Birth defects / Congenital abnormalities
    Other
  • Chromosome abnormalities
    None
  • Specific genetic mutations and variants
    None
  • Cancer
    None
CJD - Creutzfeldt–Jakob disease
  • Has one or more blood relatives been diagnosed with CJD?
    No
  • Have you ever received injections of human pituitary-derived growth hormone?
    No
  • Have you ever received a dura mater transplant?
    No
  • Have you ever been diagnosed with dementia or any degenerative or demyelinating disease of the central nervous system (CNS) or other neurological disease of unknown etiology?
    No
Medical History
  • In the last 12 months, were you diagnosed with or treated for West Nile Virus?
    No
  • In the last 12 months, were you diagnosed with or treated for Syphilis?
    No
  • In the last 12 months, were you diagnosed with or treated for Chlamydia or gonorrhea infection?
    No
  • Have you ever received a blood transfusion?
    No
  • Have you ever been turned down to be a blood donor?
    No
  • Have you ever received a transplant of any tissue, cells or fluids from a non-human, animal source?
    No
  • Have you ever had intimate contact with a recipient of a transplant of any tissue, cells or fluids from a non-human, animal source?
    No
  • Were you born in or did you live in any of the following countries since 1977?
    No
  • Did you have a blood transfusion or have any medical treatment involving blood in any of the following countries since 1977?
    No
  • Have you been vaccinated in the last 6 months?
    No
Other Risk Factors
  • Neurologic problems
    Other
  • Diseases with genetic risk factors
    None
  • Problems that affect fertility
    None
CJD - Creutzfeldt–Jakob disease
  • Have you ever been diagnosed with vCJD or any other form of CJD?
    No
  • Have you received any transfusion of blood or blood components in the U.K. or France between 1980 to the present?
    No
  • Have you lived cumulatively for 5 years or more in Europe from 1980 until the Present?
    No
  • Are you a current or former U.S. military member, civilian military employee, or dependent of a military member or civilian employee who resided at U.S. military bases in
    No
  • Have you spent three months or more cumulatively in the U.K. from the beginning of 1980 through the end of 1996?
    No
Family Medical
  • Family Birth defects / Congenital abnormalities
    Babies that died at birth
  • Family birth defect comments
    Almost all babies born in my family ( both, my mother's and father's side) are born healthy. Twins run in my family, especially in my father's side. My Father's mother has a cousin that is a twin but her twin sister died at birth.
  • Family Chromosome abnormalities
    None
  • Family - Specific genetic mutations and variants
    None
Education
  • High school
    Graduated high school
  • College
    Planning to attend
  • Trade school
    I did not attend a trade school
Education
  • How many languages do you speak
    2
  • Which languages do you speak?
    Spanish and English
  • Musical training or talents
    Singing
  • Artistic training or talents
    Drawing, Painting
  • Current employment
    I work part-time outside the home
Donor Info
  • Egg donation experience
    No previous egg donations
  • If you have donated before, how many times?
    0
  • Personal statement

    I am a very cheerful and happy person. I was raised in Mexico and my family members were all kind and warm to me.  As far as I know, no member of my family has ever suffered from depression or such.  I am an artistic and athletic teenager. I am talented in the art of drawing and painting. My mother used to be an artist too.  I currently exercise at least 3 times a week. I am currently in my senior year of high school and I have a GPA of 3.7 approximately. I do well in school. I am very fond of running. In fact, I was in the track and field girl team in my high school during my freshman and junior years. I won first place at the district junior varsity level in both of the races I participated at: the 800 meters and the mile. I inherited my running and endurance from my dad. two of my father's brothers have talent at track and field too. My uncle runs marathons.  I won second place at a local bike race

    I have a twin sister, and we're very close.

    I was born here in the United States, but I was raised in Mexico. I didn't come back to this country until shortly before high school. I did not know any English, but I learned it fast during my freshman year. During the first semester of my sophomore year, I was in the Language Center program of the school. which basically was mostly students whose first language was not English.  After I took the specialized TELPAS practice test for English learners students, I got the highest score out of all the language center students.

    I am a hard-working student. I dream of finishing college with a bachelor's degree in Art teaching. I would also like to make my own graphic novel someday. I practice drawing regularly.

    I hope this information about me lets me be considered as a good candidate for being an egg donor. That would be an honor to me.

Donor Info
  • I am interested in becoming a donor because:
    I know someone with infertility and always wanted to help, I think it would be a rewarding experience for me, I think the process is fascinating and wanted to be involved
  • Access to the office
    Far away
  • Donor Type
    Egg Donor