Definitions:

• SxSB – Sussex Sperm Bank, the donor bank releasing the sperm for use.
• Primary clinic – licensed fertility unit that treats the patients using the donor sperm.
• Secondary clinic – clinic, centre or fertility unit that may take over the treatment of the patient and the storage of the donor sperm.
• Post thaw – the sample quality immediately after the thawing procedure.
• Post preparation – the sample quality after processes performed by the secondary clinic after the thaw step (e.g. washing, density gradient, swim up etc.)

1. Donor sperm will only be supplied for use in licensed treatment and samples will be sent directly to a treatment centre. The treatment centre will be responsible for all legal consents and treatment information.
2. These terms will still apply if patients pay for the samples directly with SxSB or if the treatment clinic purchases the samples on their behalf.
3. The implications and risks of the use of donated sperm have been explained to me/us and I/We have signed the disclaimer. (Form D)
4. There is no guarantee of a successful pregnancy and the pregnancy rates are influenced by the treatment cycle management.
5. I/We understand that this is a biological sample and sperm concentrations will fluctuate, however SxSB will endeavour to ensure the appropriate number of motile sperm can be achieved. Sperm counts may vary by up to 25% due to human or laboratory processing differences at the secondary clinic.
6. SxSB will replace any sample / straws with unreasonably low post thaw results – as long as the centre who thaws the sperm can demonstrate suitable thawing and processing procedures. Fertility centres have various protocols for preparation of sperm post thaw step and this can influence the final numbers of sperm available for treatment.
7. If I/We choose to move our treatment to another centre, the same conditions of use are applied.
8. It is the patient(s) responsibility to inform the treatment unit of the outcome of any treatment cycle(s).
9. If the purchaser chooses to buy individual samples for treatment, SxSB cannot guarantee that the chosen donor will be available for successive cycles.
10. I/We understand that children born from donation may apply to the HFEA for non-identifiable information about the donor at the age of 16 and identifiable information will be available to them when they become 18.
11. I/We understand that we have to register name and contact details with SxSB as part of their release procedures for the donor sperm. The details are used to register the use of the donor sperm only, but may also be used to contact me to follow up on any treatment outcomes. Any personal details given are not used for any other purposes or passed to any other organisations.
12. I/We have undertaken suitable implications counselling before consenting to treatment with the donor sperm.
13. I/We have discussed and understand the issues of parenthood and the term parental responsibility with our treatment centre.
14. I/We understand that the appropriate informed consent for having treatment using donor sperm my be signed at my / our treatment centre prior to treatment.
15. Important: I/We understand that we should not attempt to search via non-official routes for the sperm donor, his extended family, and / or other recipients of the same donor or any other children born as a result of donations by this donor. This includes any ancestry and genetic testing websites. This would be a breach of confidentiality and is likely to break privacy laws. Identifying information can only be released to donor children when they are 18 years old. Donor children can access information through the official HFEA donor sibling link.

Please Proceed to Form C.