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31012024_1

&

31012024_2

DONOR 1

Fullname

31012024_1

Country

USA

Address

Eye Color

Brown

Hair Color

Dark Brown

Height

5'7

Ethnicity

White/Caucasian

Education

Bachelor’s degree

Hobbies

Camping, Cooking, Drawing/painting, Eating, Reading, Hiking, Horseback riding, Listening to music, Sewing/knitting, Watching TV or movies

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

Chiari Malformation Type 1: donor child
Arthritis: donor, donor parent, donor grandparent

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

I crochet

DONOR 2

Fullname

31012024_2

Country

USA

Address

Eye Color

Brown

Hair Color

Dark Brown

Height

6'0

Ethnicity

White/Caucasian

Education

Some college

Hobbies

Camping, Cooking, Fishing, Hunting, Playing video games, Visiting with friends, Watching TV or movies

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

Working on vehicles
Yard work
Skilled driver- CDL

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

Donors past substance abuse was 20 years ago.
Psychogenic Nonepileptic spells or seizures (PNES)

BASIC INORMATION

Full name

31012024_1

31012024_2

Country

USA

USA

Address

Eye color

Brown

Brown

Hair color

Dark Brown

Dark Brown

Height

5'7

6'0

Ethnicity

White/Caucasian

White/Caucasian

Education

Bachelor’s degree

Some college

Hobbies

Camping, Cooking, Drawing/painting, Eating, Reading, Hiking, Horseback riding, Listening to music, Sewing/knitting, Watching TV or movies

Camping, Cooking, Fishing, Hunting, Playing video games, Visiting with friends, Watching TV or movies

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

I crochet

Working on vehicles
Yard work
Skilled driver- CDL

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

Chiari Malformation Type 1: donor child
Arthritis: donor, donor parent, donor grandparent

Donors past substance abuse was 20 years ago.
Psychogenic Nonepileptic spells or seizures (PNES)

Photos

PHOTOS

EMBRYO

How many embryos do you wish to donate

What are the grades of the embryos?

6

Unsure what this means

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

5-7 days

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

Donor's parent

Alzheimer

Anxiety

Donor, Donor child, Donor's parent

Donor, Donor's parent, Donor's grandparent

Asthma

Donor child

Autism

Bipolar disorder

Cancer

Donor's parent

Donor's grandparent

Celiac disease

Cystic fibrosis

Depression

Donor child, Donor's parent

Donor, Donor's parent

Diabetes

Epilepsy

Donor's parent

Fibromyalgia

Fragile X syndrome

Heart conditions

Donor's parent, Donor's grandparent

Donor's grandparent

Hemochromatosis

High blood pressure

Donor's parent, Donor's grandparent

Huntington’s disease

Lupus

Marfan syndrome

Multiple sclerosis

Obesity

Phenylketonuria

Polycystic kidney disease

Rheumatoid arthritis

Schizophrenia

Stroke

Substance abuse

Donor's parent

Donor, Donor's parent, Donor's grandparent

Tay-Sachs disease

Medical Histroy

DONOR 1

Allergy

Donor

Alzheimer

Anxiety

Donor, Donor child, Donor's parent

Asthma

Donor child

Autism

Bipolar disorder

Cancer

Donor's parent

Celiac disease

Cystic fibrosis

Depression

Donor child, Donor's parent

Diabetes

Epilepsy

Donor's parent

Fibromyalgia

Fragile X syndrome

Heart conditions

Donor's parent, Donor's grandparent

Hemochromatosis

High blood pressure

Donor's parent, Donor's grandparent

Huntington’s disease

Lupus

Marfan syndrome

Multiple sclerosis

Obesity

Phenylketonuria

Polycystic kidney disease

Rheumatoid arthritis

Schizophrenia

Stroke

Substance abuse

Donor's parent

DONOR 2

allergy

Donor's parent

alzheimer

anxiety

Donor, Donor's parent, Donor's grandparent

asthma 

autism

bipolar disoder

cancer

Donor's grandparent

celiac disease

cystic fibrosis

depression

Donor, Donor's parent

diabetes

epilepsy

fibromyalgia

fragile x syndrome

heart conditions

Donor's grandparent

hemochromatosis

high blood pressure

huntington's disease

lupus

marfan syndrome