BECOMING AN EGG DONOR
Participating in the process of helping a young family fulfill its dream is a beautiful endeavor. In return, young parents have the joy of helping you achieve your dreams.
To begin, please click the arrow button in the bottom right corner of this page.
NOTICE: Please DO NOT close any windows during your application. If you do, you will have to RESTART it completely! Now, to become an egg donor, we need to learn some information about your personal and medical history.
Your responses to these questions will help us to make sure that your health and medical history are compatible with the donation process and in particular for egg donors that it will not involve any increased risks for you. This effort will also help us to match you to an appropriate recipient.
Please provide complete and accurate information to these questions. If you do not know the answer, ask a parent or family member. Any information you provide during the donation process will remain completely confidential. Some of the information from this questionnaire will be given to the recipient(s) as noted but all identifying information is removed.
Please read the following NON-ELIGIBLE CRITERIA in their entirety. These are FDA Requirements. If any of these apply to you, you are not eligible to become an egg donor with Nation Wide Egg Donation.
The following 2 pages include additional criteria required to confirm your eligibility as an egg donor. Please read each page, in their entirety.
• Must be between the ages of 21-30
• Fall within normal BMI Index
• Not taking the Depo shot
• Have regular menstrual cycles every month
• Have a great family health history including self.
• Have no genetic/hereditary diseases that run in family
• Not have traveled anywhere where the Zika Virus is present
• No mental illnesses self or family
• Not suffering from ADHD, ADD or depression
• College Education Preferred
• Non-smoker (including marijuana)
• Have lived outside of the United States for more than 3 years
• Able to work in the United States
• Responsible, committed and reliable
• No tattoos or piercing within the past year
• Be able to administer daily medications for approx. 2 weeks
• Must have a flexible schedule for appointments
Personal Health History
Additional Personal Health History
About your Brother(s)
About your Sister(s)
About your Mother
About your Father
Next section is about your maternal and paternal grandparents
Please carefully review the following list of medical problems and identify which ones you or one of your genetic relatives have or had.
Family Health History. Please specify who suffered or experienced certain medical problems stated in the next pages (ie: Self, Mother, Father, Sibling, Maternal or Paternal Grandparent)
CONGENITAL ABNORMALITIES/BIRTH DEFECTS
If your family member have any from list below, please specify who and % if know)
PERSONAL AND MOTIVATIONAL