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. This can be found here.

 

Under 10 year storage:

If you wish to continue the storage of your embryos, you must complete new WT (female) or MT (male) HFEA forms. These consent forms can be downloaded and printed here (WT) and here (MT).

 

WT form (female partner)

 

MT form (male partner)

Pg 3

Complete sign and date

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

Pg 4

4.1 Tick no to sperm storage.

 

4.2 Tick yes for embryos and indicate total number of years you would like to store.

 

Sign and date page 4

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

Pg 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).

Sign and date page 5

Pg 6 to pg 12

Please complete all sections. Sign and date each page.

Pg 6 to pg 12

Please complete all sections. Sign and date each page.

 

Please note we will require BOTH partners to compete a form each. We can only accept original ink signatures (not electronic).

Please print, complete and return:

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

 

There will continue to be an annual storage fee for embryo storage as indicated in our current price list. This can be found here.

 

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 Embryo Disposal Tick List Consent Form here.

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, you will need to read this information sheet which explains what the embryos are likely to be used for if they are donated to research.

If you wish to donate your embryos to research, please complete the Embryo Disposal Tick List Consent Form here.

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

Over 10-year 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:

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

 

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. This can be found here.

 

Under 10 year storage:

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

Pg

Section

Information

2

1

Complete Name, DOB

3

1 & 2

Complete Name, DOB

2

2.1

Tick yes to eggs, no to sperm

3

3.1

Tick yes if you wish to create embryos

2

 

Sign and date the page declaration

3

 

Sign and date the page declaration

3

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).

3

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

4.2

Complete as per your wishes, sign and date.

3

 

Sign and date the page declaration

5

4.3

Tick yes, specify the additional number of years you would like to store (should not exceed 10 years from date of freeze).

4

3 to 4

Complete as per your wishes

5

4.4

Leave blank

4

 

Sign and date the page declaration

5

 

Sign and date the page declaration

5

 

Sign and date the page declaration

6 to 12

Complete sections as per your wishes and sign and date the page declaration.

 

We can only accept original ink signatures (not electronic).

Please print, complete and return 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

 

There will continue to be an annual storage fee for embryo storage as indicated in our current price list. This can be found here.

 

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 eggs to research please read the information explaining the current research being undertaken at UHCW NHS Trust. The information can be found at the following link under the research option.

https://www.uhcw.nhs.uk/ivf/embryo-and-sperm-storage/

If you would like to donate the eggs to research, please complete and return Egg disposal tick list form.

The form can be found here.

 

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).

 

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

 

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

This section is for patients with frozen stored sperm. If you have any queries, please do not hesitate to contact the embryology team on StorageExpiry@uhcw.nhs.uk

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:

  1. CONTINUE IN STORAGE

Over 10-year storage:

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.

 

Please print, complete and return 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 

 

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. This can be found here.

 

Under 10 year storage:

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

 

MT form

Pg

Section

Information

Pg

Section

Information

2

1

Complete Name, DOB

3

1, 2 & 3

Complete details

2

2.1

Tick yes to sperm, no to eggs

4

4.1

Tick yes for sperm storage. Specify total number of years you wish to store from date of freeze.

2

 

Sign and date the page declaration

4

4.2

Complete as per your wishes

3

2.2

Leave blank

4

 

Sign and date the page declaration

3

2.3

Tick yes, specify the additional number of years you would like to store (should not exceed 10 years from date of freeze).

5

4.3

Tick yes, specify the additional number of years you would like to store (should not exceed 10 years from date of freeze).

3

 

Sign and date the page declaration

5

4.4

Complete as per your wishes

4

3 to 4

Complete as per your wishes

5

 

Sign and date the page declaration

4

 

Sign and date the page declaration

6 to 14

Complete sections as per your wishes and sign and date the page declaration.

5

 

Sign and date the page declaration

 

 

We can only accept original ink signatures (not electronic).

Please print, complete and return 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 

 

There will continue to be an annual storage fee for sperm storage as indicated in our current price list. This can be found here.

 

DISPOSE SPERM

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 sperm to be removed from storage please complete and return Sperm disposal tick list form

The form can be printed from here.

 

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).

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 SPERM TO RESEARCH

To help decide if you would like to donate your sperm to research please read the information explaining the current research being undertaken at UHCW NHS Trust. The information can be found at the following link under the research option.

https://www.uhcw.nhs.uk/ivf/embryo-and-sperm-storage/

 

If you would like to donate the sperm to research, please complete and return Sperm disposal tick list form.

The form can be found here.

 

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).

 

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

 

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