We will be closed November 24th and 25th in observance of Thanksgiving. Please be advised our shipping will be closed on Wednesday November 23rd.

Please be advised, masks are required when visiting our facility. Thank you!

Report a Pregnancy Loss

We maintain records of all outcomes that include not only births, but also miscarriages, stillbirths, and therapeutic abortions. This helps us maintain a donor's family limit, track health and medical information for donors, recipients, and children, and provide ongoing services to families after children are born, including alerts when medical issues arise. 

This report concerns a pregnancy loss with TSBC samples. If you are unsure about a question, leave it blank. We guarantee complete confidentiality. No identifying information is released.

If you prefer to mail or fax the form, click here for a pdf version or simply fill out the form below, print it, and fax or mail it in. Thank you for your time.

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Pregnancy Outcome:
Pregnancy loss
Additional Questions
If you did not complete an intial Pregnancy Report, please complete the following:

Planning to donate embryos? Please contact us to check donor family limit and add receiving family to follow-up when medical issues arise.