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16082023_1

&

16082023_2

DONOR 1

Fullname

16082023_1

Country

USA

Address

Eye Color

Blue

Hair Color

Dark Brown

Height

5'5

Ethnicity

White/Caucasian

Education

Graduate degree

Hobbies

Being a leader of a group, Bicycling, Reading, Horseback riding, Photography, Sewing/knitting, Taking care of people, Visiting with friends, Cooking

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

16082023_2

Country

United States of America

Address

Eye Color

Green

Hair Color

Light Brown

Height

6'3

Ethnicity

Education

Associates degree

Hobbies

Cooking, Bicycling, Camping, Hunting, Listening to music, Working out/exercising, Using a computer, Visiting with friends, Playing sports, Woodworking, Going to church/temple

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

16082023_1

16082023_2

Country

USA

United States of America

Address

Eye color

Blue

Green

Hair color

Dark Brown

Light Brown

Height

5'5

6'3

Ethnicity

White/Caucasian

Education

Graduate degree

Associates degree

Hobbies

Being a leader of a group, Bicycling, Reading, Horseback riding, Photography, Sewing/knitting, Taking care of people, Visiting with friends, Cooking

Cooking, Bicycling, Camping, Hunting, Listening to music, Working out/exercising, Using a computer, Visiting with friends, Playing sports, Woodworking, Going to church/temple

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?

1

One Day 6 Blastocyst 2/2 (Fair/Fair)

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

Not sure

How long ago the embryos were created

Genetic mother’s age at the egg retrieval

Less than 2 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

Donor child

Donor child

Alzheimer

Anxiety

Asthma

Autism

Bipolar disorder

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

Tay-Sachs disease

Medical Histroy

DONOR 1

Allergy

Donor child

Alzheimer

Anxiety

Asthma

Autism

Bipolar disorder

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

DONOR 2

allergy

Donor child

alzheimer

anxiety

asthma 

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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