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To Donate Eggs Pre-Qualification Form - Ages 18, 19, 30, 31 and 32.

General Information

As you know, "age" is a significant factor in fertility.  Few agencies work with donors over 32, and some restrict their donors from 18 to 21.  Fortunately we work with several agencies around the country and will submit your pre-screen application to those who can support you.  It will be up to them to follow-up with your pre-screen applications.

You may provide us with your information, and we will attempt to forward it to an egg donation clinic on your behalf.

To donate eggs is a very involved process.  It involves psychological, medical and physical evaluations.  Each donor egg clinic is slightly different in the way they process the therapy.  Please direct all follow-up questions directly with the donor egg clinic.  Also, remember this is just the pre-qualification stage.  If a clinic follows up with you, they will have much more information to gather.

YOU MUST MEET THE FOLLOWING REQUIREMENTS TO BE AN EGG DONOR:

  • between the age of 18 and 32
  • non-smoker
  • healthy height to weight proportion
  • no significant history of depression or mental disorder
  • cannot be adopted (must know genetic history)
  • minimum education requirement: high school diploma or GED
  • must be able to travel

Other Areas of The Fertility Network:

Pre-Qualification Form to Donate Eggs

(this form is specifically for potential donors ages 18, 19, 30, 31 and 32)

Last Name:
First Name
Home Phone:
Cell Phone:
Address:
City:
State:
Zip Code:
Email:
Age:
Height    
Weight
Skin Complexion
Hair Color
Hair Type
Eye Color
Ancestor's Countries of Origin
(ex. Korea, Norway)::
Current Occupation
Completed Education
High School GPA
College GPA
College Degree and/or Major
Marital Status
How many children do you have?
Do you smoke?
Do you drink alcoholic beverages?
Why do you want to become a donor?

Any follow-up or questions you may have,
need to be directed to the fertility center and/or egg donation agency.



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