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14032025_2

&

Egg donor

DONOR 1

Fullname

14032025_2

Country

USA

Address

Eye Color

Blue

Hair Color

Black

Height

5'5"

Ethnicity

White/Caucasian

Education

Graduate degree

Hobbies

Playing sports, Visiting with friends, Working out/exercising, Watching TV or movies, Listening to music, Taking care of people, Being a leader of a group, Bicycling, Keeping pets

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 

Graduate Degree in Social Work

DONOR 2

Fullname

Egg donor

Country

USA

Address

Eye Color

Blue

Hair Color

Light Brown

Height

5'9"

Ethnicity

White/Caucasian

Education

Hobbies

Beauty and hair care, Cooking, Reading, Listening to music, Playing sports, Taking care of people, Visiting with friends, Watching TV or movies, Working out/exercising

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

Donor Mother is an avid swimmer

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

BASIC INORMATION

Full name

14032025_2

Egg donor

Country

USA

USA

Address

Eye color

Blue

Blue

Hair color

Black

Light Brown

Height

5'5"

5'9"

Ethnicity

White/Caucasian

White/Caucasian

Education

Graduate degree

Hobbies

Playing sports, Visiting with friends, Working out/exercising, Watching TV or movies, Listening to music, Taking care of people, Being a leader of a group, Bicycling, Keeping pets

Beauty and hair care, Cooking, Reading, Listening to music, Playing sports, Taking care of people, Visiting with friends, Watching TV or movies, Working out/exercising

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

Graduate Degree in Social Work

Donor Mother is an avid swimmer

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

HHB GAA, HHB GAB, HHB GBB

Have the embryos been genetically tested

Do you know the gender of the embryos

Yes

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 25 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

Asthma

Donor, Donor child

Donor child

Autism

Bipolar disorder

Cancer

Donor's parent

Celiac disease

Cystic fibrosis

Depression

Donor's parent

Diabetes

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

Tay-Sachs disease

Medical Histroy

DONOR 1

Allergy

Alzheimer

Anxiety

Asthma

Donor, Donor child

Autism

Bipolar disorder

Cancer

Donor's parent

Celiac disease

Cystic fibrosis

Depression

Donor's parent

Diabetes

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

DONOR 2

allergy

alzheimer

anxiety

asthma 

Donor child

autism

bipolar disoder

cancer

celiac disease

cystic fibrosis

depression

diabetes

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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