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DONOR 1
Fullname
M_09052023_1
Country
United States
Address
Eye Color
Brown
Hair Color
Black
Height
5’4”
Ethnicity
Asian
Education
Bachelor’s degree
Hobbies
Eating, Going to church/temple, Listening to music, Playing an instrument, Playing video games, Using a computer
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
Country
Address
Eye Color
Hair Color
Height
Ethnicity
Education
Hobbies
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
M_09052023_1
Country
United States
Address
Eye color
Brown
Hair color
Black
Height
5’4”
Ethnicity
Asian
Education
Bachelor’s degree
Hobbies
Eating, Going to church/temple, Listening to music, Playing an instrument, Playing video games, Using a computer
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
Have the embryos been genetically tested
Yes
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
3 days
How long ago the embryos were created
Genetic mother’s age at the egg retrieval
Less than 5 years ago
Less than 30 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
Celiac disease
Cystic fibrosis
Depression
Diabetes
Donor
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
Celiac disease
Cystic fibrosis
Depression
Diabetes
Donor
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
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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