Fertility Consent Forms

Clomid & Injectable Follicle Stimulating Hormone (FSH)

• Authorization for clomiphene therapy (PDF)
• Authorization for gonadotrophin therapy (PDF)

In-vitro Fertilization (IVF)

• In-vitro fertilization (IVF) treatment (PDF)
• Embryo freezing and frozen embryo disposition (PDF)
• Intracytoplasmic sperm injection (ICSI) (PDF)
• Assisted hatching (PDF)

Sperm

• Insemination with anonymous donor sperm (PDF)
• Insemination with known (intimate) donor sperm (PDF)
• Insemination with known (non-intimate) donor sperm (PDF)
• Freezing sperm (PDF)

Preimplantation Genetic Diagnosis (PGD)

• Embryo biopsy (PDF)

Egg Donor & Gestational Carrier

• Receipt of human eggs for in-vitro fertilization (IVF) anonymous donor (PDF)
• Transfer of human embryos for in-vitro fertilization (IVF) gestational carrier (PDF)
• Donation of human eggs for in-vitro fertilization (IVF) anonymous donor (PDF)
• Donation of human eggs for in-vitro fertilization (IVF) known donor (PDF)

Frozen Embryo Transfer (FET)

• Directive to transfer cryopreserved embryos (PDF)

Final Disposition of Gametes

• Disposition cryopreserved embryos (PDF)
• Disposition cryopreserved sperm (PDF)
• Disposition cryopreserved oocytes (PDF)

Thawing

• Consent to thaw sperm (PDF)
• Embryo thaw and biopsy (PDF)
• Consent to thaw oocytes (PDF)