This section is for patients with frozen stored embryos. If you have any queries, please do not hesitate to contact the embryology team on StorageExpiry@uhcw.nhs.uk
If you currently have embryos in storage that are expiring and you would like to extend storage or you no longer wish to continue with storage, you have the following three options:
CONTINUE STORAGE
Over 10-year storage:
If you wish to continue the storage of your embryos, you must complete Renewal Consent Form HFEA RE (TP). This consent form can be downloaded and printed here.
Please print, complete and return this form:
By post to:
Embryology Team (Expiry)
Centre for Reproductive Medicine
UHCW NHS Trust
Clifford Bridge Road
Coventry
CV2 2DX
Alternatively, by email to: StorageExpiry@uhcw.nhs.uk
Please note we will require BOTH partners to compete a form each. We can only accept original ink signatures (not electronic).
There will continue to be an annual storage fee for embryo storage as indicated in our current price list.
Under 10 year storage:
If you wish to continue the storage of your embryos, you must complete new WT (egg provider) or MT (sperm provider) HFEA forms. These consent forms can be downloaded and printed here (WT) and here (MT).
WT form (egg provider)
MT form (sperm provider)
Pg 3
Complete sign and date
Pg 4
4.1 Tick no to egg storage.
4.2 Tick yes for embryos and indicate total number of years you would like to store.
Sign and date page 4
4.1 Tick no to sperm storage.
Pg 5
4.3 Tick no for eggs.
4.4 Tick yes for embryos. Specify the additional number of years you would like to store (should not exceed 10 years from date of freeze).
Sign and date page 5
4.3 Tick no for sperm.
4.4 Tick yes for embryos and specify the additional number of years you would like to store (should not exceed 10 years from date of freeze).
Pg 6 to pg 12
Please complete all sections. Sign and date each page.
Please print, complete and return:
DISPOSE EMBRYOS
This can understandably be a very difficult decision to make. You can always discuss your feelings and thoughts with one of our supportive counsellors. An appointment can be made by emailing uhcwfcs@uhcw.nhs.uk
If you wish to dispose of the frozen embryos, please complete the
1) Embryo Disposal Tick List Consent Form.
2) HFEA WCS Form
Please note, for this option we will require BOTH partners’ signatures and a copy of a form of photo ID (driving licence, passport) for each. We can only accept original ink signatures (not electronic).
TO DONATE THE FROZEN EMBRYOS TO RESEARCH
Before deciding to donate your frozen embryos to research, please read this information sheet which explains what the embryos will be used for if they are donated to research. Then please complete the project consent form. Note, please put your initials in the boxes on the consent form, not ticks or crosses.
If you wish to donate your embryos to research, please complete and return:
1) Embryo Disposal Tick List Consent Form
2) Embryo Research Consent Form
3) HFEA WCS Form
Please note, to donate the embryos to research we will require BOTH partners’ signatures and a copy of a form of photo ID (driving licence, passport) for each. We can only accept original ink signatures (not electronic).
If you require further information or clarification or any form sent to you via email, please do not hesitate to contact the embryology team either by email to StorageExpiry@uhcw.nhs.uk or by telephone 02476 968876.
This section is for patients with frozen stored eggs. If you have any queries, please do not hesitate to contact the embryology team on StorageExpiry@uhcw.nhs.uk
If you currently have eggs in storage that are expiring and you would like to extend storage or you no longer wish to continue with storage, you have the following three options:
CONTINUE IN STORAGE
If you wish to continue the storage of your eggs, you must complete Renewal Consent Form HFEA RG (TP). This consent form can be downloaded and printed here.
Please print, complete and return form:
We can only accept original ink signatures (not electronic).
If you wish to continue the storage of your eggs, you must complete GS HFEA forms (if you have no partner) or WT HFEA forms (if you have a partner). These consent forms can be downloaded and printed here (GS) or here (WT).
HFEA GS Form
WT form
Pg
Section
Information
2
1
Complete Name, DOB
3
1 & 2
2.1
Tick yes to eggs, no to sperm
3.1
Tick yes if you wish to create embryos
Sign and date the page declaration
2.2
Leave blank
4
4.1
Tick yes to egg storage, specify the additional number of years you would like to store (should not exceed 10 years from date of freeze).
2.3
Tick yes, specify the additional number of years you would like to store (should not exceed 10 years from date of freeze).
4.2
Complete as per your wishes, sign and date.
5
4.3
3 to 4
Complete as per your wishes
4.4
6 to 12
Complete sections as per your wishes and sign and date the page declaration.
DISPOSE Eggs
This can understandably be a very difficult decision to make. You always have the opportunity to discuss your feelings and thoughts with one of our supportive counsellors. An appointment can be made directly with the counselling team by emailing uhcwfcs@uhcw.nhs.uk
If you would like the eggs to be removed from storage please complete and return Egg disposal tick list form
The form can be printed from here
Please note, to dispose the eggs we require an ink signature (not electronic) and a copy of a form of photo ID (driving licence, passport).
We can also send you the printed form in the post. If you would like us to do this, please email StorageExpiry@uhcw.nhs.uk
TO DONATE THE FROZEN eggs TO RESEARCH
To help decide if you would like to donate your frozen eggs to research please read this information sheet. If you decide to donate the eggs to research, please complete this consent form. Note, please put your initials in the boxes on the consent form, not ticks or crosses.
If you would like to donate the eggs to research, please complete and return:
Egg Disposal Tick List Form
Egg Research Consent Form
HFEA WCS Form
Please note, to donate the eggs to research we require an ink signature (not electronic) and a copy of a form of photo ID (driving licence, passport).
If you currently have sperm in storage that is expiring and you would like to extend storage or you no longer wish to continue with storage, you have the following three options:
If you wish to continue the storage of your sperm, you must complete Renewal Consent Form HFEA RG (TP). This consent form can be downloaded and printed here.
If you wish to continue the storage of your sperm, you must complete GS HFEA forms (if you have no partner) or MT HFEA forms (if you have a partner). These consent forms can be downloaded and printed here (GS) or here (MT).
MT form
1, 2 & 3
Complete details
Tick yes to sperm, no to eggs
Tick yes for sperm storage. Specify total number of years you wish to store from date of freeze.
6 to 14
There will continue to be an annual storage fee for sperm storage as indicated in our current price list.
DISPOSE SPERM
If you would like the sperm to be removed from storage, please complete and return
1) Sperm disposal tick list form
Please note, to dispose the sperm we require an ink signature (not electronic) and a copy of a form of photo ID (driving licence, passport).
TO DONATE THE FROZEN SPERM TO RESEARCH
To help decide if you would like to donate your frozen sperm to research, please read this information sheet. If you decide to donate the sperm to research, please complete this consent form.
If you would like to donate the sperm to research, please complete and return:
Sperm Disposal Tick List Form
Sperm Research Consent Form
Please note, to donate the sperm to research we require an ink signature (not electronic) and a copy of a form of photo ID (driving licence, passport).
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