Embryo Donor Application - Identifying Information (1/13)

Thank you for considering donating your embryos to Embryo Donation International (EDI)! After the information is entered, the staff of EDI will review it and contact the facility that created your embryos. If we feel that we can find a wonderful home for your embryos, we will contact you and start the process to bring the embryos to our facility. We do our best to accomplish all of this within 10 days of your application!

Why "Embryo Donation" and NOT "Embryo Adoption"?

Adoption refers to the legal process where a new relationship is created between a parent and a live child. Adoptions can only be granted by the court after the birth of a child. Embryo donation, however, is regulated by the Federal Drug Administration (FDA) and not the courts. While we at EDI feel your embryos deserve a tremendous amount of respect, assigning personhood to an embryo has tremendous moral, ethical and legal ramifications. For a detailed discussion on this topic, please click here.

General Information

The information you provide on this form will be placed in our Embryo Search data base system. Your name will never be released without your expressed permission. Segments of the information will also be loaded onto our Website. Click here if you want to see an example of the embryo donation section of our Website. If you would like to see an example of the embryo donation sections of our Website.

Choose A Charity

By selecting a charity below, we will .

Choose A Charity

The Potential for Future Blood Testing

Additional laboratory testing may be requested by the Embryo Recipients including HIV, hepatitis and inheritable diseases. This blood testing is purely optional but often encouraged.

Source of Embryos

The information you provide here will remain confidential. These materials may only be released in their entirety with your written permission. Those items shaded will not be posted on the web site.

Much of the information requested below will only be seen by the medical staff of Embryo Donation International. Many of the questions are quite personal and the answers will not be posted on the Embryo Donation web site.

It is understood that some of the embryos were created using donor eggs and donor sperm. If so, please indicate the following (Check all that apply):

Options Applicant Initials

 

We appreciate your honesty in answering the questions listed in this application. Any missing information will require follow-up and significantly delay your posting in any of the databases. All of the embryos were created using donor sperm.

Donation Process

Please select one of the following donation processes you are interested in. Click here for more information on the different types of donation.

 

Preliminary Embryo Information

When were they created? *
Where were they created? *
Is there more than one storage facility that currently has your embryos? *
Where are they currently being stored? *
How many are currently stored? *
Are there any residual storage fees currently? *

In order for us to review the information about your embryos, please download, complete and fax/mail to the facility where the embryos were originally created so EDI can contact them. If the cryopreserved embryos have been moved to more than one facility, EDI will need releases for each facility that had contact with them.

Consent for Transfer to and Acceptance by SRMS-EDI of Cryopreserved Donated Embryos
Release of Records to SRMS-EDI

Limiting Stipulations

You are free to make specific stipulations regarding what type of patient(s) you feel comfortable assisting. Please select all that you AGREE to

Marital Status:

Race:

Religion:

If there are any other limiting stipulations, please list them below. The less selective you are, the more likely you are to be chosen.
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