Pregnancy Report Form

Congratulations on your pregnancy! Thank you for taking the time to complete this form to report your pregnancy using a Fairfax Cryobank donor.  

If you used an ID Option donor, you will also need to complete the ID Option Birth Registration form to allow your child to have the option to obtain donor information on or after their 18th birthday. For a pregnancy by an ID Option donor, we encourage you to fill out the form below but it will not be a substitute for completing the registration paperwork after birth. You can always call Client Services at 800-338-8407 to assist you.

If you are reporting a pregnancy for a Cryogenic Laboratories, Inc (CLI) donor, please contact us by phone or email at 800-338-8407 or info@fairfaxcryobank.com

See our Policy on Limiting Donor Births to see when donors are stopped.

* Indicates required field

* Order No.
(Obtained at time order placed. Call us or click to chat if you need this information.)
* Donor No.
Preparation Type
* Pregnancy
Pregnancy Ongoing?
Due Date (MM/DD/YYYY)

Please report the birth of this pregnancy to us using this same online form. We carefully track births and limit the number of offspring for each donor.

Pregnancy Ongoing?
Due Date (MM/DD/YYYY)

Please report the birth of this pregnancy to us using this same online form. We carefully track births and limit the number of offspring for each donor.

Birth Date (MM/DD/YYYY)
No. of Babies Born
* Location where insemination took place
Select State:    Zip:
* Have you filled out a pregnancy report form on this pregnancy already?
Person filling out this form?

Please enter your email address. We will contact you only if we have questions about the data you have submitted.

* Email: