Oncofertility Programs and Testicular Tissue Cryopreservation Study

Welcome to all institutions who have implemented Ovarian Tissue and/or Testicular Tissue Cryopreservation Protocols. ReproTech requires your institution to complete and sign the following agreement to establish a relationship for shipping cryopreserved reproductive tissue for long-term storage to one of our four cryostorage centers (Florida, Minnesota, Nevada or Texas). Please contact Lea Willcox, Fertility Preservation Network Manager, to prepare a template agreement for your center; byemailing or calling 651-478-5611. You may view the agerement template language by clicking the link below. Oncofertility Program and/or TTC Study Program Template Agreement with ReproTech Below are the forms required by patients to set up a long-term storage account with ReproTech. Please have your patients/families complete the applicable forms before tissue retrieval and return to Jeanne Blank, jeblank@reprotech.com or via FAX to 651-489-0442. Please call Jeanne with questions about account set-up or forms at 651-489-0827. Specimen Shipping Insurance is available exclusively to ReproTech clients through Falvey Cargo Insurance Group, a premier insurance broker in the U.S. ReproTech offers its Verna’s Purse Financial Assistance Program for qualified patients.The eligibility criteria and application are included in the list of forms below. Please note that approval is not guaranteed, an application must be completed and submitted by each qualifying patient to ReproTech, who will advise if approved. We look forward to serving you and your patients. Please note: a separate Addendum to Cryostorage Agreement for potentially infectious clients is no longer required for new accounts. We have incorporated this language into our new storage agreements as of 12/31/20.

Oocyte/Ovarian Tissue

Testicular Tissue