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宏其國際生殖中心<凍卵需求諮詢單>
預約未來幸福， 凍齡卵子。為您留住生機 ! Make an appointment for future happiness
適合對象: 25~45歲女性
1.
專注於事業上的發展，目前並沒有計畫生育
2.
還沒有找到合適的伴侶
3.
對於未來組建家庭是有著明確的想法
4.
適婚年齡但還不想急著成家生子
5.
在考慮是否要進行卵子冷凍，因此想要多了解一些相關的資訊。
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姓名 name
*
Your answer
連絡電話 Tel
*
Your answer
e-mail
*
Your answer
想諮詢的問題可以先寫在下方喔~
Your answer
想凍卵的可能原因 (可複選) The reasons
*
目前尚未考慮生育 ( Fertility has not been considered yet)
年齡大於35歲，尚未生育者 (over 35 years old and have not yet given birth)
卵巢庫存量評估衰退者 (AMH low)
即將接受化療 , 放射線治療 或會影響生殖功能的治療 (About to undergo chemotherapy, radiation therapy or treatment that affects reproductive function)
卵巢早衰或相關癌症家族史 (Premature ovarian failure or family history of cancer)
自體免疫疾病 ( autoimmune disease)
先生無精或精蟲品質不佳，妻子等待期間 (The husband has no sperm or the quality of sperm is poor, while the wife is waiting)
生涯規劃，規劃生育 ( career planning, family planning)
等待代理孕母合法期間 ( Waiting for the legal period of the surrogate mother)
LBGQ家庭 ( LBGQ family)
代孕需求 ( Surrogacy needs)
捐卵
Other:
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出生年月日 Birthday
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MM
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DD
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YYYY
居住地 where you live
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如何得知此表單訊息？(複選題)
親友告知
FB
Google搜尋
宏其官網
Youtube
Other:
凍卵3步驟
了解桃園凍卵補助
https://www.hungchihospital.org.tw/reproduction13_198.htm
🥚
https://bit.ly/捐卵精子登記
🤝
https://bit.ly/卵精受贈登記
❄
https://bit.ly/凍精卵需求登記
☎️諮詢電話：03-4618888分機8885、8803，1131
聯絡我們
❤服務項目：
https://www.hungchihospital.org.tw/reproduction10_51.htm
❤追蹤IG：
https://www.instagram.com/hungchihospital/
❤追蹤FB 生殖中心粉絲團：
https://www.facebook.com/ivfhungchi/
🥚
https://bit.ly/捐卵精子登記
🤝
https://bit.ly/卵精受贈登記
❄
https://bit.ly/凍精卵需求登記
☎️諮詢電話：03-4618888分機8885、8803，1131
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