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DONOR 1
Fullname
M_08042023
Country
United States
Address
Eye Color
Brown
Hair Color
Dark Brown
Height
5'6"
Ethnicity
Other
White, Black, Native American
Education
Graduate degree
Hobbies
Bicycling, Camping, Hiking, Visiting with friends, Listening to music, Playing an instrument, Reading, Gardening, Being a leader of a group, Drawing/painting
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
Mountain climbing, being on the water (boating, rowing, kayaking)
DONOR 2
Fullname
Sperm Donor
Country
Unknown
Address
Unknown
Eye Color
Brown
Hair Color
Dark Brown
Height
6'1"
Ethnicity
Latino/Hispanic
Education
Bachelor’s degree
Hobbies
Anything else would you like to mention about your family medical history to the
Adoptive parent
Tennis
Anything else would you like to mention about your talents,skills,interests
Pancreatitis - maternal grandmother
Diagnosed at age 58; treated with
surgery; treatment was successful; no
recurrences; poor diet was a contributing
factor.
Prostate Cancer - maternal grandfather
Diagnosed at age 63; treated with
surgery; treatment was successful; no
recurrences; contributing factors are
unknown.
Diabetes - Paternal grandfather
Diagnosed with type II in adulthood;
treats with prescription medication;
contributing factors are unknown.
BASIC INORMATION
Full name
M_08042023
Sperm Donor
Country
United States
Unknown
Address
Unknown
Eye color
Brown
Brown
Hair color
Dark Brown
Dark Brown
Height
5'6"
6'1"
Ethnicity
Other
White, Black, Native American
Latino/Hispanic
Education
Graduate degree
Bachelor’s degree
Hobbies
Bicycling, Camping, Hiking, Visiting with friends, Listening to music, Playing an instrument, Reading, Gardening, Being a leader of a group, Drawing/painting
Anything else would you like to mention about your talents, skills, interests
Mountain climbing, being on the water (boating, rowing, kayaking)
Tennis
Anything else would you like to mention about your family medical history to the
adoptive parent
Pancreatitis - maternal grandmother
Diagnosed at age 58; treated with
surgery; treatment was successful; no
recurrences; poor diet was a contributing
factor.
Prostate Cancer - maternal grandfather
Diagnosed at age 63; treated with
surgery; treatment was successful; no
recurrences; contributing factors are
unknown.
Diabetes - Paternal grandfather
Diagnosed with type II in adulthood;
treats with prescription medication;
contributing factors are unknown.
Photos
PHOTOS
EMBRYO
How many embryos do you wish to donate
What are the grades of the embryos?
4
unsure
Have the embryos been genetically tested
Yes
Do you know the gender of the embryos
I believe 2 male, 2 female
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 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
Alzheimer
Anxiety
Asthma
Autism
Bipolar disorder
Cancer
Donor's grandparent
Celiac disease
Cystic fibrosis
Depression
Diabetes
Donor's grandparent
Epilepsy
Fibromyalgia
Fragile X syndrome
Heart conditions
Donor's parent
Hemochromatosis
High blood pressure
Donor's parent
Donor's grandparent
Huntington’s disease
Lupus
Marfan syndrome
Multiple sclerosis
Obesity
Donor, Donor's parent, Donor's grandparent
Phenylketonuria
Polycystic kidney disease
Rheumatoid arthritis
Donor
Schizophrenia
Stroke
Substance abuse
Donor's grandparent
Tay-Sachs disease
Medical Histroy
DONOR 1
Allergy
Alzheimer
Anxiety
Asthma
Autism
Bipolar disorder
Cancer
Celiac disease
Cystic fibrosis
Depression
Diabetes
Epilepsy
Fibromyalgia
Fragile X syndrome
Heart conditions
Donor's parent
Hemochromatosis
High blood pressure
Donor's parent
Huntington’s disease
Lupus
Marfan syndrome
Multiple sclerosis
Obesity
Donor, Donor's parent, Donor's grandparent
Phenylketonuria
Polycystic kidney disease
Rheumatoid arthritis
Donor
Schizophrenia
Stroke
Substance abuse
Donor's grandparent
DONOR 2
allergy
alzheimer
anxiety
asthma
autism
bipolar disoder
cancer
Donor's grandparent
celiac disease
cystic fibrosis
depression
diabetes
Donor's grandparent
epilepsy
fibromyalgia
fragile x syndrome
heart conditions
hemochromatosis
high blood pressure
Donor's grandparent
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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