Share Your Success Story Your experience can be the hope others need. Tell us about your journey to fertility. Basic Information General information about you Name (optional for publication) Email address * Please enter a valid email address. Do you live in Panama? * Yes No Country you visited us from * Do you have a partner? Yes No Treatment Information Details about your medical journey Doctor who treated you * Dr. Mario Vega Crocker Dr. Mario Vega Rich Dr. Germán Arrocha Please select a doctor. Treatments received * Fertility consultation Ovulation induction Intrauterine insemination (IUI) In vitro fertilization (IVF) ICSI Embryo transfer Egg freezing Embryo freezing Egg donation Sperm donation Genetic testing (PGT) Fertility preservation Please select at least one treatment. Reason for treatment * Please tell us the reason for your treatment. Share Your Success Story We want to hear your experience in your own words Tell us your experience * Please share your experience with us. The Special Moment * Please describe that special moment. Message of Hope Media (optional) If you'd like, accompany your story with a video or photos Video Upload your video here MP4, MOV — max 100 MB Photos Upload your photos here JPG, PNG, WEBP Social Media Participation Tell us how you'd like to connect with our community Share your Instagram username @ Would you like us to tag you on social media? Yes No Would you like to participate in webinars, Facebook, Instagram, YouTube or podcasts sharing your story with Panama Fertility? Yes No Would you like to share your story as a success case in professional videos? Yes No Consent Authorizations required to use your testimonial I agree that my testimonial, images and/or video may be used by Panama Fertility on social media, website and promotional materials. I declare that I have read and accept that all information provided is truthful and that I am completing this form voluntarily. * You must accept the mandatory declaration to submit the form. Submit My Story
