Register As An Egg Donor & Donate Your Eggs

By Donating Your Eggs You Will Be Able To Change Lives Forever By Helping To Create A Family

Register As An Egg Donor

Register As An Egg Donor
We welcome all new applications for premier donor eggs. People choose to be a fertility clinic donor for many different reasons. Whether to help people who are desperate to become parents or just for the financial rewards.
Whatever your reason for wanting to donate eggs you do need to make sure you comply with the following criteria:

  • Have a BMI of 30 or below
  • Be between 18-35 years of age
  • Of generally good health
  • No family history of recurrent bad health

If you have any questions when answering the questions, simply Contact Us and we will help you as much as we can.  If you are unable to answer a question, leave it blank and we can discuss this with you at a later date.

We will not share any of your personal data such as name and address with an intended parent.
By submitting this form you are providing us with authorisation to use your pictures solely for the purposes of promoting you to potential recipients of your eggs. Your images will never be used for any other purpose.

 This form is for women who would like to donate their eggs. If you are looking for an Egg Donor you can use our Egg Donor Search. Or Contact Us

 


Egg Donor Application Form

This form will take you 30-60 minutes to complete. So make a coffee, relax and make sure you will have enough time to complete it before you start


Personal Description

Your Name (required)

Your Email (required)

Address

Town

Zip/Post Code

Country

State (only applicable to US Residents)

Home Telephone No.

Mobile No.

Date of Birth (required)

Your Age (required)

Your Height (required)

Body Type (required)

Your Weight (required)

Describe Your Body (required)

Current Hair Color (required)

Natural Hair Color required)

Hair Type (required)

Eye Color (required)

How Is Your Vision, Do You Need Glasses / Contact Lenses? (required)
YesNo

Your Religion (required)

Your Race (required)

Your Natural Skin Tone (required)

What Is Your Occupation (required)

Marital Status (required)

Are You Willing Drive and Also Fly On An Airplane? (required)
YesNo

Did You Ever Have Braces For Your Teeth? (required)
YesNo

Have You Ever Had Plastic Surgery? (required)
YesNo

If Yes, Please Tell Us About It

Do You Smoke Cigarettes? (required)

Do You Drink Alcohol? (required)

Would You Prefer An Open Or Anonymous Donation? (required)
OpenAnonymous

What Is Your Blood Type (If Known)

Upload Some Pictures of Yourself and Your Family





Your Ethnic Makeup

Your Ethnic Makeup (Irish, German, Dutch etc)

Your Mothers Ethnic Makeup (Irish, German, Dutch etc)

Your Fathers Ethnic Makeup (Irish, German, Dutch etc)

Are You Of Jewish Descent?
YesNo

Family Information

Your Mother

Your Mothers Age

Your Mothers Eye Color

Your Mothers race

Your Mothers Height

Your Mothers Weight (in lbs)

Your Mothers Natural Hair Color

Your Mothers Build

Your Mothers Occupation

Your Mothers Highest Level of Education

Your Mothers Skin Tone

Your Father

Your Fathers Age

Your Fathers Eye Color

Your Fathers race

Your Fathers Height

Your Fathers Weight (in lbs)

Your Fathers Natural Hair Color

Your Fathers Build

Your Fathers Occupation

Your Fathers Highest Level of Education

Your Fathers Skin Tone

Personal Description

Have You Or Any Of Your Family Had Any Of The Following (Check All That Apply)
AIDS / HIVAllergiesAnemiaBack / Neck PainBirth DeformitiesBleeding / BruisingBlood ClotsBlood In StoolBreast Lumps / PainCancerChronic BronchitisConstipation or DiarrheaConvulsions / SeizuresCoughDiabetesDizziness / FaintingEar InfectionsEpilepsyExtreme NervousnessEye ProblemsGallbladder ProblemsGastric UlcerGenital Sores / DischargeGoiter ProblemsGonorrheaHearing Loss/RingingHeart DiseaseHeart MurmurHeartbeat IrregularityHemorrhoidsHepatitis (A, B or C)HerniaHigh Blood PressureHypo or Hyper ThyroidIncontinenceIndigestionJaundiceJoint Pain / ArthritisLiver DiseaseManic Depressive DisorderMigrainesNausea / VomitingNervousness . TensionNervous BreakdownsNight SweatsNosebleedsNumbness / TinglingPsychological DisorderPneumoniaRecent Weight Gain or LossShortness of BreathSkin ProblemsSpine Bifida / HydrocephalusSubstance AbuseSwollen Feet / AnklesTeeth/Gum DiseaseTuberculosisMiscarriages / StillbornUlcersWeakness/ParalysisNone Of These

Please Provide Full Details of Conditions, Dates and Treatments For All Conditions You Checked Above

Are You Allergic To Any Medications
YesNo

If Yes, Please Provide Details of These Allergies

Are You Allergic To Any Foods?
YesNo

If Yes, Please Provide Details of These Allergies


Additional Medical Information

Is Your Maternal Grandmother Still Alive?
YesNo

If not, what did she pass away from and at what age?

Is Your Maternal Grandfather Still Alive?
YesNo

If not, what did he pass away from and at what age?

Is Your Paternal Grandmother Still Alive?
YesNo

If not, what did she pass away from and at what age?

Is Your Paternal Grandfather Still Alive?
YesNo

If not, what did he pass away from and at what age?

Are You Currently Under A Physicians Care?
YesNo

If Yes, Please Provide Details

Please List All Prescription Medications That You Are Currently Taking

Have You Ever Been Exposed To Radiation or Toxic Chemicals?
YesNo

If Yes, Please Provide Details

Have You Ever Had Surgery?
YesNo

If Yes, Please Provide Details Of The Procedures, Dates And Locations

When Was The Last Time You Were Seen By Your General Practitioner Or Family Doctor?


Fertility Information

How Often Is Your Period and For How Long Do You Bleed?

Have You Ever Been Pregnant?
YesNo

Please List The Ages and Sex of Your Children (If Applicable)

Have You Ever Had An Abortion?
YesNo

If Yes, What Date Was This?

Has Anyone In Your Family Ever Struggled To Get Pregnant?
YesNo

If Yes, Please Tell Us Some Details

Have You Ever Been Told That You Have Problems With Infertility?
YesNo

If Yes, Please Tell Us Some Details


Previous Egg Donations

Have You Been An Egg Donor Before
YesNo

If Yes, Please Tell Us Some Details (dates of your previous donations,
the clinic you went to, the # of eggs retrieved,
the # of embryos if known, and if there was a successful pregnancy or not)


About Your Education

Where Did You Attend High School?

What Year Did You Graduate and What Was Your GPA?

What Were Your Favorite Subject At School?

Did You Attend College or University?
YesNo

If Yes, Where Did You Attend and What Courses Did You Study?

Diploma Or Certificates Earned?

Do You Have Any Plans or Goals For Further Education? Tell Us All About Them.


About Your Personality

Why Have You Decided To Be An Egg Donor

Please Describe Your Personality Now, As An Adolescent and As A Child

What Characteristics Do You Hope The Couple You Donate To Will Possess?

What Are Your Personal Goals

What Brings You The Most Joy In Life?

Would You Describe Yourself As A Girly-Girl, A Tomboy or Combination, Now and As A Child

How Do You Act When You Are Angry? Do You Have a Temper?

What Do You think Your Best Characteristic Is?

If You Could Change One Thing About Yourself, What Would It Be And Why?

Is There Anything Else You Would Like To Tell Intended Parents?