Oregon Health & Science University                                         PROFILE FOR SPERM DONOR  #9890

Andrology/Embryology Lab

3303 S.W. Bond Ave., 10th floor

Portland, OR 97239

Phone:  (503) 418-3700

 

PHYSICAL CHARACTERISTICS

 

Height:             6’ 1”

 

Weight:      165

 

Hair Color:     Light Brown

 

Eye Color:       Brown

 

Hair Type:  Straight, Slightly Wavy

 

Complexion:  Fair

 

Race:               Caucasian

 

Mother’s Ethnic Background: English, Irish, German

Father’s Ethnic Background: Scottish, Irish,
native North American (Osage tribe)

 

Blood Type:    B +

 

FAMILY AND MEDICAL HISTORY

For each item below, if there is a history of the condition, the condition poses a risk of one percent or less to offspring.

The family relationship is indicated.

 

Alcoholism:

 

Edema:

 

Mental disorders:

 

Allergy:

 

Emphysema:  Mother (mild)

 

Mental retardation:

 

Anemia:

 

Epilepsy:

 

Miscarriages:

 

Asthma:

 

Glaucoma:

 

Stillbirths:

 

Blindness:

 

Goiter:

 

Migraine:

 

Cancer:  Mother (kidney, benign)

 

Gout:

 

Muscular dystrophy:

 

Cataracts:

 

Heart attack:

 

Myasthenia gravis:

 

Cirrhosis:

 

Heart disease:

 

Paraplegia:

 

Cleft palate or lip:

 

Hemophilia:

 

Parkinson’s:

 

Club foot:

 

Hermaphrodotism:

 

Psoriasis:

 

Color blindness:

 

Hernia, inguinal:

 

Sickle cell anemia:

 

Cystic fibrosis:

 

Huntington=s chorea:

 

Tay Sachs disease:

 

Deafness:

 

Hypertension:

 

Thalassemia:

 

Diabetes:

 

Jaundice:

 

Undescended testicles:

 

Dislocated hip:

 

Juvenile arthritis:

 

 

 

Eczema:

 

Lymphedema:

 

 

 

ABBREVIATIONS:                                      M=Mother, or Maternal      S=Sibling                       F,P=Father, or Paternal

N=Nephew or Niece                                              GF, GM=Grandfather, Grandmother

A=Aunt                             U=Uncle                        C=Cousin

 

MEDICAL HISTORY COMMENTS:  The donor’s mother (67), father (63), brother (34), sister (38), three P uncles (67-73), two P aunts (76, 82), 1 M uncle (59), 3 M aunts (57-63) are all living and in good health.  The two P aunts had minor strokes at age 70-71.  The MGF died at age 82 (heart attack), the MGM at 75 (unknown cause), the PGF at 86 (unknown cause), the PGM at 82 (lung cancer), one P aunt in her 70s (died in her sleep).

Donor’s vision:  20/30.

Donor’s hearing:  good.

Donor’s dental history:  wisdom teeth removed, just cavities.

 

 

 

EDUCATION:

 

Subject of study

 

Type of University

 

> 1 year college

 

 

 

 

 

Baccalaureate Degree

 

B.S. (Biology)

 

large university

 

Master's Degree

 

 

 

 

 

Professional Degree

 

 

 

 

 

OCCUPATION:  Post baccalaureate student, science-related

 

RELIGION:  None, agnostic


Social History: 

                                                                                         

1. Do you have any special talents?

Low body fat.

Athletic.

Strong visuospacial thinking.

 

2. Are there any special talents that seem to run in your family? (athletics, music, artistic, etc.)

Low body fat (Mother, Father, brother, sister)

Athletic (Father, brother, sister)

Music: Father: piano & organ

                Brother: guitar

Artistic drawing (brother)

 

3. What are your interests and hobbies?

Science (biology, psychology, anthropology)

Strategy board games

Reading

Exercise

Health & Nutrition

 

4. What did you enjoy studying in high school and college?

Theater

Biology (micro & macro)

Nutrition

Psychology

Anthropology

Biochemistry

Organic Chemistry

Anatomy & physiology

 

5. High School GPA  3.3             College GPA  3.3                 I.Q.

 

6. How would you describe your personality characteristics?

Likeable

Thoughtful

Funny

Self-reliant

Helpful

Caring

 

7. Why do you want to be a sperm donor?

 

Additional Descriptive Characteristics:

 

Handedness:  Right                                                                      Foot/Shoe Size:  10.5 - 11

 

Hairy Chest:  Moderate amount on chest

 

Hairy:  Moderate amount on chest and forearms                                      

 

Beard Color:  Individual hairs range form: blond to red-blond, red-brown and dark brown.  As a composite, my beard appears mostly dark red-brown, burgundy brown.          

 

Any Distinguishing Features (Dimples, Cleft Chin, Roman Nose, Freckles, etc.):

Dimples, attached ear lobes, potters thumb, slim waist and hips

 

Acne problems:

None

 

Reactivity/Sensitivity to sun exposure:

Average Caucasian sensitivity

 

Do you smoke?

No

 

Family Social History:                                                                                                    

 

       

Education

Occupation

Interests

Eye color

Hair color

Height

Body Type 

PGF

 

 

 

 

Brown

Brown

6’

slim

PGM

 

 

 

 

Brown

Auburn

5’ 6”

slim

MGF

 

 

 

 

 

 

 

 

MGM

 

 

 

 

 

 

 

 

Father

 

 

 

 

Brown

Brown

5’ 10”

Med.

Mother

 

 

 

 

Grey

Light Brown

5’ 6”

Slim

Brother

 

 

 

 

Brown

Brown

5’ 9”

Slim

Sister

 

 

 

 

Grey

Light Red

5’ 7”

Med.

 

 


Comments Following an Interview with the OHSU Fertility Consultants Clinic Counselor:

 

Referral Information:  Donor is a thirty one year old single Caucasian male that is a full time student in the medical field.  He was referred for a psychological evaluation and interview by OHSU Fertility Consultants. He has completed his medical evaluation and has been donating to OHSU for one year but has not been matched with recipients yet.  This was a one hour in depth evaluation following the Guidelines of The American Society of Reproductive Medicine Mental Health Professional Group psychological assessments for anonymous donors.

 

Motivation for Donation: Donor states his motivation is primarily financial in being a sperm donor.  He was not sure why there was such a large need for donors.  In this interview I explained to him the reasons why people elect to build a family using an anonymous donor, including infertile male partners, single woman and lesbian couples.  He was very open minded about having his donation used by any of these groups and stated to have no ethical conflict with any aspect of being a donor.  He further stated that he feels his genes are already in the population as he himself is a genetic combination of so many other people. He has a B.S. in Biology and thoroughly understands how genes are combined over and over in each generation. 

 

Informal Mental Status and Behavioral Observations: Donor was on time to this evaluation and appropriately dressed.  His mannerisms and language skills were in the normal range.  He was oriented to person, place and time.  He did not display any cognitive abnormalities and answered all questions in a thoughtful, intelligent, and insightful way.  He presented as an emotional mature adult with well developed coping skills.  He appeared to be very comfortable with being an anonymous donor and was very warm and engaging in this interview.

 

Brief Psychosocial History:  Donor grew up in Oregon.  His parents are both retired.  His father (67) was a carpenter and his mother (69) was a third grade teacher. She had benign kidney cancer many years ago but is healthy now. He has a thirty nine year old sister that is married and has two daughters ages five and four years old. She works as a CNA for an assisted living facility. He also has a thirty five year old brother that is single with no children and works doing manual labor. Donor states all of his family of origin members are healthy including his two nieces.  Donor is a full time student and also works on campus part time at his college.  He has one year of school left before he graduates.

 

Psychiatric History and Personal History:  Donor states there is no history of mental illness in his family of origin.  He has recently sought professional psychological support that is offered to student at his school.  He has been interested in getting help for balancing work, personal relationship, and financial stress and worry.  He states to have a very mild depression that he doesn’t believe would benefit from antidepressants as it is situational in nature.  He has no thoughts of self harm or suicidal ideation.  He sleeps fine and is improving now that he is on winter break.  He is a non-smoker.  There is a positive family history of alcoholism with his father, paternal uncle, and his maternal uncle.  Donor is a social drinker averaging one to two drinks per week, with no alcohol problems to report.  He has no history of physical or sexual abuse, but states his father did psychologically abuse the children in the family. He is not close to his parents but very close to both of his siblings. He does not use recreational drugs. He has no legal or financial issues other than the financial strain of going to school full time. He states to have no unresolved loss or grief.  He has never had a girlfriend become pregnant but would like to marry in the future and have his own children. He describes his personality as very outgoing and extroverted and enjoys being with his friends.

 

Hobbies and Interests:   Donor enjoys reading technical books about evolutionary theory.  He loves strategy board games and role playing computer games.  He goes to the gym and enjoys working out, and likes swimming, biking, and frisbee.   He would like to have the time to do martial arts again.  He also enjoys cooking and reports to like a wide variety of foods and ethnic flavors. 

 

Impressions:  Donor is a very likeable man with an easy going manner and very friendly.  He is tall and slender and very nice looking and has a kind personality.  He appears to be very caring and sensitive.  Donor is obviously very intelligent and will likely be very successful in his professional life.  He states to feel very good about helping others achieve a family and is open to being an information release donor.  He understands that in the far future there might be a medical need to have contact with him and he had no hesitation in being able to help someone in the future.  He has not as yet filled out the paperwork to be an information release donor but plans on doing so he reported.  He has a nice smile and is someone that would draw others as friends very easily. 

 

 

Paula Acker LCSW

Licensed Clinical Social Worker

 

Summary of the Taylor-Johnson Temperament Analysis:

 

Donor #9890 took the Taylor Johnson Temperament Analysis which is an evaluation of several personality characteristics.  He scored in the “excellent” range in five of the nine measurements.  He scored in the “acceptable range” in two of the measurements and in the “improvement desirable” range in the last two measurements.


The first “excellent” range score was in the measurement of “composed” verses “nervous.”  This is an indicator the donor is a man who does not suffer from excessive worry or anxiety.  It is also a measurement of one’s ability to recover from extreme stress quickly.  It likely means he does not have nervous mannerisms such as nail biting, excessive eating, smoking, alcohol abuse, or restlessness.  A composed individual is one that moves through life with a balance perspective and is not overwhelmed easily by life’s trails.  He has the ability to relax and work through trying events.


The second “excellent” score was in the measurement of “expressive responsive” verses “inhibited.”  This is a person who is able to be demonstrative with family and close friends.  He is likely spontaneous, and shows warmth and friendliness to others.  He may be talkative, outgoing, and able to express tenderness and share his joys and sorrows with others without being inhibited.  He is not likely to be restrained, unfeeling, reserved or self-conscious.  This is also a measurement of one’s ability to be responsive to others emotions and often indicates one who is satisfied with interpersonal relationships and desires to have close personal friends.


The third “excellent” score was in the measurement of “objective” verses “subjective.”  This indicates a man that is fair minded, logical and reasonable. He is able to sort through complex life problems and find answers that are truly fair minded to those concerned.  This category is a measurement of one’s ability to be impartial, without being excessively sensitive.  It is the ability to interpret conflict accurately, to be analytical and impartial.  This shows a level of adult maturity and wisdom without being preoccupied and self centered.


The fourth “excellent” score was in the measurement of “hostile” verses “tolerant.”  A tolerant individual shows respect for others, and is patient and accepting.  They are people we call “humane” because they are free from personal, racial, or class prejudice. They are not inclined to be critical of others and don’t verbalize hostility to those they don’t agree with or have a different lifestyle from.  This indicates an individual who is likely logical and thoughtful in their approach to life and is open minded and considerate of others. 


The fifth “excellent’ score was in the measurement of “light-hearted” verses “depressive.”  This is an indication of someone that everyone wants to be friends with as they are joyful about life and fun to be with.  They are likely to be objective, happy, upbeat, and optimistic.  They have as sense of well being and that life is working well for them.  They may be very hard workers and not resentful of others doing less because they accepting of the path they have chosen in life.  They are not likely to suffer from depression other than situational distress which we are all affected by at times.  They have an ingrained sense that life is worthwhile.


The first “acceptable” score was in the measurement of “quiet” verse “active-social.”  This indicates a person that is socially involved and enjoys the companionship of others but also enjoys time to himself.  He likely finds a balance in both participation in activities and time alone for solo pursuits. He is not withdrawn or unfriendly but like many people can appreciate time to themselves to get caught up on work and quiet for rejuvenation.


The second “acceptable” score was in the measurement of “indifferent” verses “sympathetic.”  A sympathetic person is a kind hearted individual that considers the needs of others including those that are less fortunate.  They are aware of others needs for support, caring and concern.  They are likely to have special concern for the elderly, children or animals.  They have a great amount of empathy and compassion. In contrast, an indifferent individual would be slow to recognize the needs of others.


The first score in “improvement desirable” range was in the measurement of “submissive” verses “dominant.”  This shows a tendency to be reliant on others and to possible seek peace at any cost. It may indicate a person who is not able to be sufficiently assertive, is somewhat submissive and relies on others to help them make important decisions in their life. 


The second and last score in “improvement desirable” was in the measurement of “self disciplined” verses “impulsive.”  This indicates a person that is likely to postpone getting things done and is more impulsive with life’s activities.  They may make decisions hastily or not at all, and often struggle with the ability to plan ahead.  They could struggle with the difficulty of postponing choices for immediate gratification.  An impulsive individual may struggle with the tendency to be easily tempted by others to go along with their plans even if it isn’t in their best interest.

 

Paula Acker LCSW

01/11/08


extra item from DONOR  #9890: "I would like to add this poem by Khilil Gibran to my donor profile:"

And a woman who held a babe against her bosom said, "Speak to us of Children."
And he said:
Your children are not your children.
They are the sons and daughters of Life's longing for itself.
They come through you but not from you,
And though they are with you, yet they belong not to you.
You may give them your love but not your thoughts.
For they have their own thoughts.
You may house their bodies but not their souls,
For their souls dwell in the house of tomorrow, which you cannot visit, not even in your dreams.
 
You may strive to be like them, but seek not to make them like you.
For life goes not backward nor tarries with yesterday.
You are the bows from which your children as living arrows are sent forth.
The archer sees the mark upon the path of the infinite, and He bends you with His might that
His arrows may go swift and far.
Let your bending in the archer's hand be for gladness;
For even as he loves the arrow that flies, so He loves also the bow that is stable.

 

KID PAGE
1. In general, please describe your childhood.

Got along with siblings well.

Shared room with older brother until I was 14 years old. Wasn’t allowed to watch too much TV

 

2. Were there any family members other than your parents and siblings with whom you regularly had contact?

Whenever I’d visit my paternal grandmother she would give my brother, sister and I a crushingly strong hug. Her strong hug always made us feel loved.

 

3. As a child, what was/were your favorite:       (Please include a reason, or why, if you can.)

Food(s)?

Green beans (canned or cooked with butter and salt, just loved them), whole grain toasted bread with butter,

 fruit (especially apples, oranges, peaches, cherries, blueberries (used to pick these and fill up our bellies,

 mmm, mmm, fun), raspberries (with ½ & ½, paternal grandmother made this), pears, apricots, plumbs,

 strawberries, papaya, coconut, pineapple, nuts (especially walnuts and pecans) milk, cheese, pizza, candy

(serious candy junkie, because parents wouldn’t allow it very often).

Color(s)?         

Aqua green, aqua blue

Toy(s)?

Lego’s (infinite possibilities, use your imagination)

Indoor game(s)?          

Outdoor game(s)?       

Soccer (loved to run and chase the ball)

Book(s)?         

White Fang (lonely rugged individual attempting to take on life alone meets outcast canine companion. Loneliness and hardship transformed by loving, caring, friendship. It should be the story of everyone’s lives.) 

Sport(s)?         

Dodge ball       

Other activity(s)?         

 

4. What is your earliest memory?

I was 4 years old. I awoke late at night and went into the living room to find my father watching TV. He picked me up to take me back to bed and the flickering light from the TV fell across his 5 o’clock shadow.

 

5. What did you do during the summers?

I visited relatives in Idaho, ran around the neighborhood exploring (foraging for fruit & nuts, tunneling into blackberry bushes, catching snakes & grasshoppers), played with kids in the neighborhood and went to the State fair for my birthday, among other things.

 

6. Are there any new technologies you remember becoming available during your childhood which now are commonplace in our society, or which have now been replaced by a newer technology?

I remember my parents getting a phone answering machine. Another highlight was playing the Oregon Trail game on a new Apple computer at school and getting a commodore 64 as a family computer.

 

7. Did you enjoy school as a child?  Do you have any memories of teachers that influenced you, or that you especially liked (or disliked)?

I enjoyed school as a child. My 4th grade teacher was especially memorable. She was very in touch with the social, emotional and educational aspects of each child and tended to all of those critical developmental aspects.  She also worked hard to make everyone feel important and encouraged everyone to be inclusive of one another.

 

8. Did you have chores or tasks that you were regularly expected to do?

I had regular chores and they helped me develop a strong work ethic. I regularly did the dishes, folded laundry, cleaned my room, washed the dog, helped with yard work and picked up messes I made around the house.

 

9. Any other recollections of importance that come to mind?