Consent and Storage Agreement Sample Contracts

This agreement must be renewed on an annual basis. It can signed and completed at Women’s Specialty & Fertility Center with a staff member present, or it may be mailed in after signing with a notary.
Consent and Storage Agreement • April 20th, 2020

As part of the usual process of In Vitro Fertilization (IVF), multiple eggs may be stimulated to grow, be recovered from the ovary, and become fertilized. This may result in additional embryos in excess of the number that a couple or a patient would desire to have transferred back to the uterus at one time. If the additional embryos are of sufficiently good quality to undergo the process of cryopreservation (freezing), this can be performed in order to provide another opportunity for a future embryo transfer cycle. That is, if the IVF embryo transfer does not result in pregnancy, the frozen embryos can subsequently be thawed and transferred to the uterus in either a natural menstrual cycle or a hormonally controlled cycle. Alternatively, if the IVF cycle is successful, the embryos can be stored for several years, should the couple or patient decide to attempt to have more children.

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This agreement must be renewed on an annual basis. It can be signed and completed at Women’s Specialty & Fertility Center with a staff member present, or it may be mailed in after signing with a notary.
Consent and Storage Agreement • April 20th, 2020

As part of the process for in vitro fertilization (IVF) multiple eggs may be stimulated to grow, be recovered from the ovary, fertilized, embryos be formed and transferred back to the uterus and/or cryopreserved for future use. In some rare cases, oocytes can’t be inseminated and oocytes may need to be cryopreserved. This includes cases when sperm is not available for different reasons (no sperm sample available, lack of viable sperm for ICSI, etc.) Recently, fertility preservation for females has become available through the cryopreservation of oocytes. This includes patients suffering from cancer who wish to cryopreserve eggs before chemotherapy and/or radiotherapy starts. The process also includes the development of multiple eggs with ovarian stimulation then recovered from the ovary with the cryopreservation of mature oocytes. These oocytes may be thawed in the future for fertilization with the resulting embryos transferred back to the uterus. The oocytes can be stored for several

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