Donor 5100: Basic Donor Profile

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Pricing & Ordering Information

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Unit Type Available for Donor #CHL5100 Price Per Unit
Washed ID Disclosure $835
ICSI ID Disclosure Units $450

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General Information
Donor ID:
5100
Year of Birth:
1971
Marital Status:
Married
Number of Children:
0
Religion:
Lutheran
Occupation:
Attorney
Blood Type:
B +
Ethnicity:
English, Irish, Polish
Race:
Caucasian
CMV Status:
NEG
Last Medical History Update:
Dec 14, 2011
Reported Pregnancy:
Yes
Canadian Compliance:
No
UK Compliance:
No
Identity Disclosure:
Yes
5 photos available.

Purchase this enhanced profile to view the photos.
Child Photo
Adult Photo
Audio File:
Not Available

Genetic Testing Performed:

Genetic Testing Performed-Please review the list of genetic tests performed before choosing a donor because donors have different levels of testing. Genetics is very complicated and testing can only reduce but not eliminate the risk of a donor being a carrier of a particular condition.

Physical Attributes
Height:
5'09" (175.26 cm)
Weight:
165 lbs (74 kg)
Eye Color:
Blue
Hair Color:
Blonde, Dark
Hair Texture:
Thick
Hair Loss:
None
Hair Type:
Average
Body Build:
Medium
Freckles:
 
Skin Tone:
Fair

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Genetic Testing

Over the years, Xytex has expanded genetic testing of donors as genetic knowledge and technology have advanced. As a result, not all donors have been tested for the same conditions or with the same methods. "xyGene" donors have undergone the most extensive testing. For more information about genetic testing view our "Genetics Video and FAQs."

This donor has been evaluated for carrier status of the listed conditions. A negative result reduces, but does not eliminate, the likelihood of the donor being a carrier. If you are a known carrier of a genetic condition please contact us, and we will provide a copy of the donor's test reports to your physician and/or genetic counselor.

 

Normal complete blood count and hemoglobin analysis; does not exclude silent carrier status or alpha thalassemia minor
Normal complete blood count and hemoglobin analysis
Normal male karyotype
No disease-causing mutations detected
Normal complete blood count and hemoglobin analysis
No disease-causing mutations detected (2 copies)
Normal enzyme analysis
Donor Health Information
Medication Allergy:
No
Food Allergy:
No
Pet Allergy:
No
Hay Fever Allergy:
No
Insect Allergy:
No
Vaccine Allergy:
No
Healthy Teeth:
Yes
Braces:
Yes
Back Problems:
No
Bronchitis:
No
Chicken Pox:
Yes
Chicken Pox Age:
5
Vertigo:
No
Eyesight Correction:
No
Near or Far Sighted:
Nearsighted
Skin Infection:
No
Gallstones:
No
Removed Gall Bladder:
No
Hernia:
No
Mumps:
No
Measles:
No
Measles Age:
 
German Measles:
No
German Measles Age:
 
Sinus Infection:
No
Stomach Ulcers:
No

*The medical and social history was provided by the donor and cannot be verified for accuracy.

Personality and Interests Attributes
Skills Hobbies and Interest:
Billiards, Golf
Education Information

In School: No
In School Major: Econmics
Post Graduate: This donor holds a post graduate degree.

Training Type:
Army National Guard

College Degrees:
Bachelor of Science, Law Degree

Immediate Family Medical History
Family Member:
Father
Hair Color:
Black
Eyesight:
Excellent
 
 
Freckles:
 
Hair Texture:
 
 
 
Health Status:
Good
Skin Tone:
Medium
Dominant Hand:
Right
Year of Birth:
1941
Cause of Death:
 
Hair Loss
 
Height:
5' 08'' (172.72 cm)
Age at Death:
 
Body Hair:
Wavy
Weight:
180 lbs. (81 kg)
Occupation:
Retired- Management
Eye Color:
Brown
Half Siblings:
No
Education:
High School
Body Build:
Large
Half Siblings
Parent:
 
Eyesight
Correction:
 
Near or
Far Sighted:
 
Comments:
Has a dimple in his chin. Excellent golfer and billiards player. Looks a lot like James Garner.
Family Member:
Mother
Hair Color:
Brown, Light
Eyesight:
Good
 
 
Freckles:
 
Hair Texture:
 
 
 
Health Status:
Good
Skin Tone:
Fair
Dominant Hand:
Right
Year of Birth:
1946
Cause of Death:
 
Hair Loss
 
Height:
5' 08'' (172.72 cm)
Age at Death:
 
Body Hair:
Wavy
Weight:
145 lbs. (65 kg)
Occupation:
Retired customer service rep.
Eye Color:
Blue
Half Siblings:
No
Education:
College (Some)
Body Build:
Medium
Half Siblings
Parent:
 
Eyesight
Correction:
 
Near or
Far Sighted:
Nearsighted
Comments:
Very good typist.
Family Member:
Sister
Hair Color:
Brown, Lightest
Eyesight:
Excellent
 
 
Freckles:
 
Hair Texture:
 
 
 
Health Status:
Good
Skin Tone:
Medium
Dominant Hand:
Right
Year of Birth:
1970
Cause of Death:
 
Hair Loss
 
Height:
5' 04'' (162.56 cm)
Age at Death:
 
Body Hair:
Straight
Weight:
150 lbs. (68 kg)
Occupation:
Hospital staff scheduling
Eye Color:
Green
Half Siblings:
No
Education:
College
Body Build:
Medium
Half Siblings
Parent:
 
Eyesight
Correction:
 
Near or
Far Sighted:
 
Comments:
 
Paternal Family Medical History
Family Member:
Aunt
Hair Color:
 
Eyesight:
 
 
 
Freckles:
 
Hair Texture:
 
 
 
Health Status:
Good
Skin Tone:
 
Dominant Hand:
 
Year of Birth:
1934
Cause of Death:
 
Hair Loss
 
Height:
Age at Death:
 
Body Hair:
 
Weight:
Occupation:
 
Eye Color:
 
Half Siblings:
No
Education:
 
Body Build:
 
Half Siblings
Parent:
 
Eyesight
Correction:
 
Near or
Far Sighted:
 
Comments:
 
Family Member:
Aunt
Hair Color:
 
Eyesight:
 
 
 
Freckles:
 
Hair Texture:
 
 
 
Health Status:
Good
Skin Tone:
 
Dominant Hand:
 
Year of Birth:
1936
Cause of Death:
 
Hair Loss
 
Height:
Age at Death:
 
Body Hair:
 
Weight:
Occupation:
 
Eye Color:
 
Half Siblings:
No
Education:
 
Body Build:
 
Half Siblings
Parent:
 
Eyesight
Correction:
 
Near or
Far Sighted:
 
Comments:
 
Family Member:
Aunt
Hair Color:
 
Eyesight:
 
 
 
Freckles:
 
Hair Texture:
 
 
 
Health Status:
Good
Skin Tone:
 
Dominant Hand:
 
Year of Birth:
1948
Cause of Death:
 
Hair Loss
 
Height:
Age at Death:
 
Body Hair:
 
Weight:
Occupation:
 
Eye Color:
 
Half Siblings:
No
Education:
 
Body Build:
 
Half Siblings
Parent:
 
Eyesight
Correction:
 
Near or
Far Sighted:
 
Comments:
 
Family Member:
Grandfather
Hair Color:
Black
Eyesight:
Excellent
 
 
Freckles:
 
Hair Texture:
 
 
 
Health Status:
Deceased
Skin Tone:
Medium
Dominant Hand:
Right
Year of Birth:
1907
Cause of Death:
Lung Cancer
Hair Loss
 
Height:
5' 09'' (175.26 cm)
Age at Death:
57
Body Hair:
Straight
Weight:
180 lbs. (81 kg)
Occupation:
Salesman
Eye Color:
Brown
Half Siblings:
No
Education:
High School
Body Build:
Large
Half Siblings
Parent:
 
Eyesight
Correction:
 
Near or
Far Sighted:
 
Comments:
Smoked heavily.
Health Condition:
Cancer (Lung) at age 56
Family Member:
Grandmother
Hair Color:
Brown, Dark
Eyesight:
Good
 
 
Freckles:
 
Hair Texture:
 
 
 
Health Status:
Deceased
Skin Tone:
Fair
Dominant Hand:
Right
Year of Birth:
1907
Cause of Death:
Heart Attack
Hair Loss
 
Height:
5' 04'' (162.56 cm)
Age at Death:
76
Body Hair:
Wavy
Weight:
170 lbs. (77 kg)
Occupation:
Homemaker
Eye Color:
Green
Half Siblings:
No
Education:
High School
Body Build:
Small
Half Siblings
Parent:
 
Eyesight
Correction:
Glasses
Near or
Far Sighted:
Farsighted
Comments:
Loved to knit.
Health Condition:
Heart Attack at age 76
Maternal Family Medical History
Family Member:
Aunt
Hair Color:
 
Eyesight:
 
 
 
Freckles:
 
Hair Texture:
 
 
 
Health Status:
Good
Skin Tone:
 
Dominant Hand:
 
Year of Birth:
1941
Cause of Death:
 
Hair Loss
 
Height:
Age at Death:
 
Body Hair:
 
Weight:
Occupation:
 
Eye Color:
 
Half Siblings:
No
Education:
 
Body Build:
 
Half Siblings
Parent:
 
Eyesight
Correction:
 
Near or
Far Sighted:
 
Comments:
 
Family Member:
Grandfather
Hair Color:
Brown, Dark
Eyesight:
Good
 
 
Freckles:
 
Hair Texture:
 
 
 
Health Status:
Deceased
Skin Tone:
Medium
Dominant Hand:
Right
Year of Birth:
1907
Cause of Death:
Heart Attack
Hair Loss
 
Height:
6' 01'' (185.42 cm)
Age at Death:
82
Body Hair:
Straight
Weight:
180 lbs. (81 kg)
Occupation:
Mechanic
Eye Color:
Green
Half Siblings:
No
Education:
High School
Body Build:
Large
Half Siblings
Parent:
 
Eyesight
Correction:
Glasses
Near or
Far Sighted:
Farsighted
Comments:
Loved driving fast cars.
Health Condition:
Heart Attack at age 82
Family Member:
Grandmother
Hair Color:
Brown, Medium
Eyesight:
Excellent
 
 
Freckles:
 
Hair Texture:
 
 
 
Health Status:
Deceased
Skin Tone:
Fair
Dominant Hand:
Right
Year of Birth:
1914
Cause of Death:
Natural Causes
Hair Loss
 
Height:
5' 05'' (165.10 cm)
Age at Death:
94
Body Hair:
Wavy
Weight:
150 lbs. (68 kg)
Occupation:
Homemaker
Eye Color:
Blue
Half Siblings:
No
Education:
High School
Body Build:
Small
Half Siblings
Parent:
 
Eyesight
Correction:
 
Near or
Far Sighted:
 
Comments:
Excellent at knitting
Family Member:
Uncle
Hair Color:
 
Eyesight:
 
 
 
Freckles:
 
Hair Texture:
 
 
 
Health Status:
Good
Skin Tone:
 
Dominant Hand:
 
Year of Birth:
1939
Cause of Death:
 
Hair Loss
 
Height:
Age at Death:
 
Body Hair:
 
Weight:
Occupation:
 
Eye Color:
 
Half Siblings:
No
Education:
 
Body Build:
 
Half Siblings
Parent:
 
Eyesight
Correction:
 
Near or
Far Sighted:
 
Comments:
 
The following medical conditions apply to the donor and his BLOOD RELATIVES ONLY
(grandparents, parents, aunts, uncles, cousins, brothers, sisters, nieces, nephews, and children of the donor). Please click on the Medical History Questionnaire to see all the questions that the donor must answer. If the donor answers "yes" to any high risk question, the donor is ineligible.
Medical History Questionnaire
Autoimmune Diseases   Yes No Which
Relative
Father's
Side
Mother's
Side
Age of
Onset
CREST Syndrome     X        
Lupus     X        
Scleroderma     X        
Sjorgen's Syndrome     X        
Blood Diseases   Yes No Which
Relative
Father's
Side
Mother's
Side
Age of
Onset
Anemia     X        
Fanconi Anemia     X        
Hemophilia     X        
Immunodeficiency     X        
Leukemia     X        
Sickle Cell     X        
Thalassemia     X        
VonWillebrand's disease     X        
Cancer   Yes No Which
Relative
Father's
Side
Mother's
Side
Age of
Onset
Cancer (Breast)     X        
Cancer (Lung)   X   Grandfather X   56
Cancer (Other)     X        
Cancer (Skin)     X        
Lymphoma     X        
Melanoma     X        
Tumor     X        
Cardio Vascular Diseases   Yes No Which
Relative
Father's
Side
Mother's
Side
Age of
Onset
Congenital Heart Disease     X        
Heart Attack   X   Grandmother X   76
Heart Disease     X        
High Blood Pressure     X        
High Cholesterol / Triglycerides     X        
Stroke     X        
Congenital Malformations   Yes No Which
Relative
Father's
Side
Mother's
Side
Age of
Onset
Deviated Septum     X        
Malformations (Cleft Lip)     X        
Malformations (Cleft Palate)     X        
Malformations (Club Foot)     X        
Malformations (Hypospadias)     X        
Malformations (Other)     X        
Malformations (Polydactyly)     X        
Undescended Testicles     X        
Gastro-Intestinal Diseases   Yes No Which
Relative
Father's
Side
Mother's
Side
Age of
Onset
Gallstones     X        
GI (Crohns)     X        
GI (Diverticulitis)     X        
GI (Other)     X        
GI (Pyloric Stenosis)     X        
GI (Ulcerative Colitis)     X        
GI (Ulcers)     X        
Hemochromatosis     X        
Hepatitis     X        
Kidney Disease   Yes No Which
Relative
Father's
Side
Mother's
Side
Age of
Onset
Adrenal Hyperplasia     X        
Born with 1 kidney     X        
Kidney (Other)     X        
Kidney disease of urinary tract disorder     X        
Kidney Disorder     X        
Polycystic Kidney Disease     X        
Progressive Kidney Disease     X        
Mental Health   Yes No Which
Relative
Father's
Side
Mother's
Side
Age of
Onset
Mental (Depression)     X        
Mental (Manic Depressive)     X        
Mental (Schizophrenia)     X        
Mental Retardation     X        
Obsessive-compulsive disorder     X        
Metabolic / Endrocrine Dis.   Yes No Which
Relative
Father's
Side
Mother's
Side
Age of
Onset
Diabetes (Insulin Dependent)     X        
Diabetes (Non-Insulin Dependent)     X        
Galactosemia     X        
Gaucher's disease     X        
Goiter     X        
Hypoglycemia     X        
Maple Syrup disease     X        
PKU or Inherited Metabolic Disorder     X        
Tay Sachs     X        
Thyroid Disorder     X        
Muscular / Bones / Joint Disease   Yes No Which
Relative
Father's
Side
Mother's
Side
Age of
Onset
Acondroplasia (Dwarfism)     X        
Arthritis (Other)     X        
Congenital Hip Disease     X        
Gout     X        
Loss of Muscle Coordination     X        
Marfan's Disease     X        
Muscular Dystrophy     X        
Osteoarthritis     X        
Osteoporosis     X        
Rheumatoid Arthritis     X        
Scoliosis     X        
Spinal Muscular Atrophy     X        
Neurological Diseases   Yes No Which
Relative
Father's
Side
Mother's
Side
Age of
Onset
ADD or ADHD     X        
Autism / Aspergers     X        
Canavan's disease     X        
Cerebral Palsy     X        
Disorders of the spinal cord     X        
Dyslexia     X        
Familial dysautonomia     X        
Lesch-Nyhan Syndrome     X        
Migraines     X        
Mucolipidosis type IV     X        
Neurologic (Alzheimer's)     X        
Neurologic (Creutzfeld-Jacob Disease)     X        
Neurologic (Epilepsy)     X        
Neurologic (Guillain Barre)     X        
Neurologic (Huntington's)     X        
Neurologic (JC Virus)     X        
Neurologic (Lou Gehrig's Disease)     X        
Neurologic (Multiple Sclerosis)     X        
Neurologic (Neural Tube Defect)     X        
Neurologic (Neurofibrimatosis)     X        
Neurologic (Parkinson's Disease)     X        
Neurologic (Subacute Sclerosing Panencephalitis)     X        
Nieman-Pick     X        
Spongioform encephalopathy / prion disease     X        
Tourette Syndrome     X        
Respiratory Disease   Yes No Which
Relative
Father's
Side
Mother's
Side
Age of
Onset
Allergies (Drug)     X        
Allergies (Food)     X        
Allergies (Hay Fever)     X        
Allergies (Insect)     X        
Allergies (Other)     X        
Allergies (Pet)     X        
Asthma     X        
Emphysema     X        
SARS     X        
Tuberculosis     X        
Sight / Sound / Smell   Yes No Which
Relative
Father's
Side
Mother's
Side
Age of
Onset
Cataracts     X        
Deafness     X        
Deafness (before age 50)     X        
Ear deformity     X        
Eyesight (Blindness)     X        
Eyesight (Color Blindness)     X        
Eyesight (Glaucoma)     X        
Eyesight (Other)     X        
Eyesight (Retinoblastoma)     X        
Macular degeneration     X        
Skin   Yes No Which
Relative
Father's
Side
Mother's
Side
Age of
Onset
Albinism     X        
Eczema     X        
Pigmentation disorders (including Vitiligo)     X        
Psoriasis     X        
Skin Disease     X        
Additional Information