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27012026_2

&

27012026_1

DONOR 1

Fullname

27012026_2

Country

United States

Address

Eye Color

Brown

Hair Color

Dark Brown

Height

6’3”

Ethnicity

White/Caucasian

Education

Graduate degree

Hobbies

Being a leader of a group, Belonging to a club, Fishing, Listening to music, Going to church/temple, Playing an instrument, Singing, Taking care of people, Visiting with friends, Working out/exercising

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

I'm a lymphoma survivor. Cured and in remission for the last 5 years

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

DONOR 2

Fullname

27012026_1

Country

USA

Address

Eye Color

Brown

Hair Color

Dark Brown

Height

5'3

Ethnicity

Asian

Education

High School

Hobbies

Cooking, Drawing/painting, Gardening, Hiking, Photography, Taking care of people, Visiting with friends, Working out/exercising

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 

Allergic to shellfish

BASIC INORMATION

Full name

27012026_2

27012026_1

Country

United States

USA

Address

Eye color

Brown

Brown

Hair color

Dark Brown

Dark Brown

Height

6’3”

5'3

Ethnicity

White/Caucasian

Asian

Education

Graduate degree

High School

Hobbies

Being a leader of a group, Belonging to a club, Fishing, Listening to music, Going to church/temple, Playing an instrument, Singing, Taking care of people, Visiting with friends, Working out/exercising

Cooking, Drawing/painting, Gardening, Hiking, Photography, Taking care of people, Visiting with friends, Working out/exercising

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

I'm a lymphoma survivor. Cured and in remission for the last 5 years

Allergic to shellfish

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

Have the embryos from this batch resulted in a life birth

Age of embryos when they were frozen

Yes

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

Donor

Alzheimer

Anxiety

Asthma

Autism

Bipolar disorder

Cancer

Donor, Donor's parent, Donor's grandparent

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

Alzheimer

Anxiety

Asthma

Autism

Bipolar disorder

Cancer

Donor, Donor's parent, Donor's grandparent

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

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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