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11112025_1

&

11112025_2

DONOR 1

Fullname

11112025_1

Country

United States

Address

Eye Color

Brown

Hair Color

Dark Brown

Height

5'3

Ethnicity

White/Caucasian

Education

Some college

Hobbies

Eating, Fishing, Hiking, Photography, Listening to music, Singing, Watching TV or movies

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 

I love college football , I cheered in high school , I enjoy kayaking

DONOR 2

Fullname

11112025_2

Country

United States

Address

Eye Color

Blue

Hair Color

Dark Brown

Height

6'0

Ethnicity

White/Caucasian

Education

High school

Hobbies

Fishing, Hiking, Taking care of people, Playing sports, Listening to music

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

11112025_1

11112025_2

Country

United States

United States

Address

Eye color

Brown

Blue

Hair color

Dark Brown

Dark Brown

Height

5'3

6'0

Ethnicity

White/Caucasian

White/Caucasian

Education

Some college

High school

Hobbies

Eating, Fishing, Hiking, Photography, Listening to music, Singing, Watching TV or movies

Fishing, Hiking, Taking care of people, Playing sports, Listening to music

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

I love college football , I cheered in high school , I enjoy kayaking

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?

2

Have the embryos been genetically tested

Do you know the gender of the embryos

Yes

Boys

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 2 years ago

Less than 35 years old

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

No

Embryo

MEDICAL HISTORY

DONOR 1

DONOR 2

Allergy

Donor, Donor child

Donor

Alzheimer

Anxiety

Asthma

Autism

Bipolar disorder

Cancer

Celiac disease

Cystic fibrosis

Depression

Diabetes

Donor's grandparent

Donor's parent

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

Tay-Sachs disease

Medical Histroy

DONOR 1

Allergy

Donor, Donor child

Alzheimer

Anxiety

Asthma

Autism

Bipolar disorder

Cancer

Celiac disease

Cystic fibrosis

Depression

Diabetes

Donor's grandparent

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

DONOR 2

allergy

Donor

alzheimer

anxiety

asthma 

autism

bipolar disoder

cancer

celiac disease

cystic fibrosis

depression

diabetes

Donor's parent

epilepsy

fibromyalgia

fragile x syndrome

heart conditions

hemochromatosis

high blood pressure

huntington's disease

lupus

marfan syndrome

multiple sclerosis

obesity

phenylketonuria

polycystic kidney disease

rheumatoid arthritis

schizophrenia

stroke

substance abuse

Information on egg/sperm donor

Letter

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