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22012026

&

Sperm donor

DONOR 1

Fullname

22012026

Country

USA

Address

Eye Color

Brown

Hair Color

Black

Height

5'2

Ethnicity

White/Caucasian

Education

Graduate degree

Hobbies

Gardening, Playing sports, Taking care of people, Working out/exercising, Playing video games, 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

Sperm donor

Country

USA

Address

Eye Color

Hazel

Hair Color

Light Brown

Height

6'3

Ethnicity

White/Caucasian

Education

Graduate degree

Hobbies

Playing sports, Reading, Playing video games

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

22012026

Sperm donor

Country

USA

USA

Address

Eye color

Brown

Hazel

Hair color

Black

Light Brown

Height

5'2

6'3

Ethnicity

White/Caucasian

White/Caucasian

Education

Graduate degree

Graduate degree

Hobbies

Gardening, Playing sports, Taking care of people, Working out/exercising, Playing video games, Hiking

Playing sports, Reading, Playing video games

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?

5

3AB, 3BA, 4AA, 4AA, 4AA

Have the embryos been genetically tested

Do you know the gender of the embryos

No

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 15 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

Alzheimer

Anxiety

Donor, Donor child

Asthma

Autism

Bipolar disorder

Cancer

Celiac disease

Cystic fibrosis

Depression

Donor, Donor child

Diabetes

Epilepsy

Fibromyalgia

Fragile X syndrome

Heart conditions

Donor's grandparent

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, Donor child

Alzheimer

Anxiety

Donor, Donor child

Asthma

Autism

Bipolar disorder

Cancer

Celiac disease

Cystic fibrosis

Depression

Donor, Donor child

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 

autism

bipolar disoder

cancer

celiac disease

cystic fibrosis

depression

diabetes

epilepsy

fibromyalgia

fragile x syndrome

heart conditions

Donor's grandparent

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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