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30012025_1

&

Sperm Donor

DONOR 1

Fullname

30012025_1

Country

USA

Address

Eye Color

Hazel

Hair Color

Blond

Height

5'7

Ethnicity

White/Caucasian

Education

Some college

Hobbies

Gardening, Reading, Taking care of animals, Taking care of people, 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 

DONOR 2

Fullname

Sperm Donor

Country

USA

Address

Eye Color

Hazel

Hair Color

Brown

Height

6'2

Ethnicity

White/Caucasian

Scottish/German

Education

Bachelor of Art

Hobbies

Drawing/painting, Farming, Horseback riding, Playing sports, Singing, Visiting with friends

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

He loves running, surfing, snow skiing; He is an artist

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

BASIC INORMATION

Full name

30012025_1

Sperm Donor

Country

USA

USA

Address

Eye color

Hazel

Hazel

Hair color

Blond

Brown

Height

5'7

6'2

Ethnicity

White/Caucasian

White/Caucasian

Scottish/German

Education

Some college

Bachelor of Art

Hobbies

Gardening, Reading, Taking care of animals, Taking care of people, Watching TV or movies

Drawing/painting, Farming, Horseback riding, Playing sports, Singing, Visiting with friends

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

He loves running, surfing, snow skiing; He is an artist

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?

7

Cannot recall, you will see in records from the fertility clinic

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 10 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, Donor's parent, Donor's grandparent

Alzheimer

Anxiety

Asthma

Donor

Autism

Bipolar disorder

Cancer

Donor's parent, Donor's grandparent

Celiac disease

Cystic fibrosis

Depression

Diabetes

Epilepsy

Fibromyalgia

Fragile X syndrome

Heart conditions

Hemochromatosis

High blood pressure

Donor's parent

Huntington’s disease

Lupus

Marfan syndrome

Multiple sclerosis

Obesity

Phenylketonuria

Polycystic kidney disease

Rheumatoid arthritis

Schizophrenia

Stroke

Substance abuse

Donor's grandparent

Tay-Sachs disease

Medical Histroy

DONOR 1

Allergy

Donor

Alzheimer

Anxiety

Asthma

Donor

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, Donor's parent, Donor's grandparent

alzheimer

anxiety

asthma 

autism

bipolar disoder

cancer

Donor's parent, Donor's grandparent

celiac disease

cystic fibrosis

depression

diabetes

epilepsy

fibromyalgia

fragile x syndrome

heart conditions

hemochromatosis

high blood pressure

Donor's parent

huntington's disease

lupus

marfan syndrome

multiple sclerosis

obesity

phenylketonuria

polycystic kidney disease

rheumatoid arthritis

schizophrenia

stroke

substance abuse

Donor's grandparent

Information on egg/sperm donor

Letter

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