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30072024_1

&

30072024_2

DONOR 1

Fullname

30072024_1

Country

United States

Address

Eye Color

Blue

Hair Color

Red/Auburn

Height

5ft 5in

Ethnicity

White/Caucasian

Education

Bachelor’s degree

Hobbies

Gardening, Taking care of people, Visiting with friends, Cooking, Hiking

Anything else would you like to mention about your family medical history to the
Adoptive parent

Anything else would you like to mention about your talents,skills,interests 

DONOR 2

Fullname

30072024_2

Country

United States

Address

Eye Color

Blue

Hair Color

Light Brown

Height

6ft 5in

Ethnicity

White/Caucasian

Education

Bachelor’s degree

Hobbies

Anything else would you like to mention about your family medical history to the
Adoptive parent

Anything else would you like to mention about your talents,skills,interests 

BASIC INORMATION

Full name

30072024_1

30072024_2

Country

United States

United States

Address

Eye color

Blue

Blue

Hair color

Red/Auburn

Light Brown

Height

5ft 5in

6ft 5in

Ethnicity

White/Caucasian

White/Caucasian

Education

Bachelor’s degree

Bachelor’s degree

Hobbies

Gardening, Taking care of people, Visiting with friends, Cooking, Hiking

Anything else would you like to mention about your talents, skills, interests

Anything else would you like to mention about your family medical history to the
adoptive parent

Photos

PHOTOS

EMBRYO

How many embryos do you wish to donate

What are the grades of the embryos?

3

2- Grade 1; 1- Grade 2

Have the embryos been genetically tested

No

Do you know the gender of the embryos

No

Have the embryos from this batch resulted in a life birth

Age of embryos when they were frozen

Yes

5-7 days

How long ago the embryos were created

Genetic mother’s age at the egg retrieval

Less than 5 years ago

Less than 40 years old

Have the embryos from this batch been already donated to another adoptive parent

No

Embryo

MEDICAL HISTORY

DONOR 1

DONOR 2

Allergy

Alzheimer

Anxiety

Donor, Donor's parent

Asthma

Autism

Bipolar disorder

Cancer

Donor's grandparent

Donor's grandparent

Celiac disease

Cystic fibrosis

Depression

Donor, Donor's parent

Diabetes

Donor's grandparent

Epilepsy

Fibromyalgia

Fragile X syndrome

Heart conditions

Hemochromatosis

High blood pressure

Donor's parent

Huntington’s disease

Lupus

Marfan syndrome

Multiple sclerosis

Obesity

Donor

Phenylketonuria

Polycystic kidney disease

Rheumatoid arthritis

Schizophrenia

Stroke

Substance abuse

Tay-Sachs disease

Medical Histroy

DONOR 1

Allergy

Alzheimer

Anxiety

Asthma

Autism

Bipolar disorder

Cancer

Donor's grandparent

Celiac disease

Cystic fibrosis

Depression

Diabetes

Donor's grandparent

Epilepsy

Fibromyalgia

Fragile X syndrome

Heart conditions

Hemochromatosis

High blood pressure

Donor's parent

Huntington’s disease

Lupus

Marfan syndrome

Multiple sclerosis

Obesity

Phenylketonuria

Polycystic kidney disease

Rheumatoid arthritis

Schizophrenia

Stroke

Substance abuse

DONOR 2

allergy

alzheimer

anxiety

Donor, Donor's parent

asthma 

autism

bipolar disoder

cancer

Donor's grandparent

celiac disease

cystic fibrosis

depression

Donor, Donor's parent

diabetes

epilepsy

fibromyalgia

fragile x syndrome

heart conditions

hemochromatosis

high blood pressure

huntington's disease

lupus

marfan syndrome

multiple sclerosis

obesity

Donor

phenylketonuria

polycystic kidney disease

rheumatoid arthritis

schizophrenia

stroke

substance abuse

Information on egg/sperm donor

Letter
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