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Client Deposit Order and Forms

Client Deposit Order and Forms

Client Deposit Ordering and Forms


Open/Download Form: Client (AIH) Specimen Release Form

Open/Download Form: Client (AIH) Discard Specimen Form

Open/Download Form: Client (AIH) Will Letter


Procedures for ordering and shipping your specimens to a physician

1. We highly recommend that you seek a fertility specialist when you decide to utilize your frozen semen specimens. You will be working with a limited number of vials and it is very important to go to a physician that can accurately pinpoint ovulation, handle and thaw the specimens properly, decide the best method to utilize the specimens based on the quality of the specimens and the fertility status of the recipient.

2. We need a minimum of 10 days to 2 weeks notice prior to the first time your specimens are shipped. Subsequent orders if shipping to the same physician should be place a minimum of 3 to 4 business days in advance of the date they are to arrive at the doctor’s office. Orders that are placed that must be shipped with less than 24 hours notice will be accessed a late order-processing fee.

3.  The client that banked the specimens must sign a notarized release form authorizing us to ship the specimens to a physician of his choosing.

4.  Orders should be placed so that the specimens arrive in the physician’s office 1 to 2 days prior to the date you think they will be utilized. If the specimens are to be used over a weekend or on a Monday, they should arrive no later than Friday. The liquid nitrogen shipping canister will keep the specimens frozen for 7 days from the date of shipment. You don’t want to ship them too early or you run the risk of them thawing before the date you of the procedure. For example shipments within the Detroit surrounding metro area we ship via a local courier service. The shipment is prepared the day prior to the shipping date. The courier picks up the shipper in the morning and it is delivered the same day by 5;00 pm to the physicians office. (Example: If a specimen needs to arrive at the doctors office for use on a Wednesday, the order would need to be placed the Friday prior to the shipment or at the very latest early Monday morning. We would prepare the shipment on Monday and it would be picked up and delivered by 5:00 pm on Tuesday for use on Wednesday or the following few days.

5.  Shipments that are sent outside of the Detroit metro area are shipped via Federal Express 2 business day service. (Example: If specimens are to be used on a Thursday, orders should be placed no later than the previous Friday. They will be shipped out on Monday for arrival by Wednesday the 2nd business day by 5:00pm to be utilized on Thursday or the next few following days.) Remember when timing shipments FedEx does not count Saturday and Sunday as business days. If you send a 2 day shipment on a Friday its guaranteed to arrive at the physicians office Tuesday by 5:00 pm. We can always upgrade the shipment to overnight service for an additional charge.

6.  If the physician has a liquid nitrogen storage tank in their facility, they may recommend that you ship all of your specimens to their office and they will keep them in their storage tank while the recipient undergoes treatment. We recommend if you are shipping all of your specimens that you ship them in 2 different shipments on 2 different dates. This will insure that if something happens during the shipping process you won’t risk losing all of your specimens. If you plan to ship all of your specimens in 2 shipments we recommend that you send ½ and if she doesn’t get pregnant then send the other ½ . This way they are still being stored in 2 separate storage tanks which is how we store them here. If the physician’s storage tank fails they are not all stored in the same tank. We can provide you with shipping fees based on the destination zip code.

If you have any further questions about Client Deposit Banking, please call 248-397-8449.

Client Deposit Fee Schedule

SEMEN BANKING (each ejaculate)
Includes semen analysis, office call, freezing procedure, post-thaw semen analysis, plus first six months of storage,a $95.00 consultation fee is included in the banking fee and is non-refundable
$250.00
SEMEN BANKING WITH GRADIENT WASH $310.00
LABORATORY FEE required bloodwork and STD screening $235.00
YEARLY SEMEN STORAGE FEE (per ejaculate)
Billed in advance of the year starting 6 months after initial banking was completed
$105.00
* We recommend a minimum of five ejaculates to be banked *
DIRECTED DONOR BANKING (per ejaculate)
Includes semen analysis, office call, freezing procedure, post-thaw semen analysis, plus first six months of storage,a consultation fee of $100.00 is included in the banking fee and non-refundable
$325.00
DIRECTED DONOR BANKING WITH WASH $395.00
DIRECTED DONOR INITIAL LAB $365.00
DIRECTED DONOR REPEAT LAB POST 6 MONTHS IF ALL BANKING COMPLETED WITHIN 7 DAYS OF INITIAL LAB WORK-UP * $220.00
DIRECTED DONOR REPEAT LAB POST 6 MONTHS IF BANKING EXCEEDS 7 DAYS FROM INITIAL LAB WORK-UP * $365.00
DIRECTED DONOR STORAGE per 6 months (per ejaculate) $105.00
BANKING SURGICALLY RETRIEVED SPECIMENS (Epididymal Retrieval, Vasovasotomy, Testicular Biopsy)
Includes semen analysis, office call, transportation kit, freezing procedure, post-thaw analysis, plus first six months of storage,a $100.00 consultation fee is included in the banking fee and is non-refundable
$280.00
LABORATORY FEE required bloodwork and STD screening $235.00
YEARLY SEMEN STORAGE FEE (per ejaculate)
Billed in advance of the year starting 6 months after initial banking was completed
$105.00
WITHDRAWAL OF SPECIMENS 1st withdrawal
Plus shipping (Determined by destination)
$60.00
SUBSEQUENT WITHDRAWAL OF SPECIMENS
Plus shipping (Determined by destination)
$40.00

*Directed donors that plan to bank 1 or 2 times and can complete all banking within 7 days of their initial lab work up require fewer tests be repeated post 6 months and therefore the cost is less.  If the directed donor banks over a period of time that exceeds 7 days from their initial lab work-up the full panel of tests must be repeated per FDA requirements.

The fees listed above are subject to change based on cost increase of liquid nitrogen plus inflation. Sperm banking unfortunately is not usually covered by medical insurance. We ask for payment at the time of the visit; we then issue an itemized insurance form to the patient. This form can be submitted to his insurance company for reimbursement if covered under his insurance plan.

A written request with a notarized signature is required to discard specimens. Storage fees are not credited on specimens withdrawn or discarded that are stored for more than 3 months into your billing year. Past due accounts are subject to late fees.



For Donor (TDI) Ordering Information and Donor Account Setup - Click here


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