Form 4. Ovarian Tissue Preparation for NPC-2015-__ Date: __/__/15

1.  Ovary should be placed in COLD holding media and transported to the laboratory. Please record the time the ovary was removed:______

2.  Perform tissue dissection using sterile technique, in the COLD (on ice packs or frozen tissue culture flask). Please note step #5, and save all media from dissection.

  1. Please record the time the dissection starts: ______
  2. IF pathology needs a portion of one or both of the ovaries, remove that portion now.
  3. Halve the ovary with scissors or a scalpel.
  4. Trim the medulla from the cortex, and discard the medulla (don’t save in media).
  5. Cut the 20% research tissue from whole tissue (if dissecting a whole ovary, less than ½ of an ovary half).
  6. Where possible, please DO NOT SCRAPE THE RESEARCH TISSUE. Leave it the full thickness.
  7. Dissect research tissue into 0.5 x 2cm strips.
  8. Cut one of the research tissue strips into half (~0.5cm x 1cm), and place it into a container of buffered formalin (after this step, set your forceps aside and use a fresh pair – formalin is toxic to tissue).
  9. Scrape the patient tissue with a scalpel (per NPC protocol), and section into 0.5cm x 2cm strips.
  10. Please record the time the dissection is complete: ______

3.  Freeze the patient portion of the tissue following the protocol on the NPC website.

4.  Set up a container (specimen cup or 50 mL conical) that is mostly filled with cold holding media. Place remaining strips of RESEARCH tissue into the container.

5.  Please place all wash media used during dissection in a specimen cup or conical tube.

6.  Close all of the containers (fresh research tissue, fixed research tissue, media) tightly, and label with the NPC research number and date (no patient information, please).

7.  Seal the tops of the containers with parafilm or saran wrap.

8.  Place individual containers into Ziploc-type baggies and seal.

9.  Place the containers of 1) fresh research tissue, 2) fixed research tissue, and 3) wash media in the shipping container. Place cold packs around the tubes. Tape the box closed and prepare for FedEx First Overnight.

10.  Package will be sent to Sarah Kiesewetter, FedEx First Overnight delivery. FedEx account number: 1190-7323-5.

Shipping Address: Megan Romero

Oncofertility Consortium

Northwestern University

303 E. Superior, Lurie 10-121

Chicago IL 60611-3015

Phone: 312-503-3378

Fax: 312-472-5270

NOTE: PLEASE fax a copy of the FedEx air bill and a copy of this form with the times inserted to Kristin Smith at the fax number listed above [312-472-5270]. Please feel free to call with any questions. THANK YOU!