I.C.E. Blastocyst Vitrification Kit

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I.C.E. Blastocyst Vitrification Kit Vitrification Media V1, V2, V3

ICE Blastocyst Vitrification Instructions For Use Testing and Cautions Innvative Cryo Enterprises LLC 317 Springfield Road Linden, New Jersey 07036 USA 973-632-8635 Intended Use: To be used for vitrification of human blastocysts (Day 5 or Day 6). It is preferable to use blastocysts that have a large cavity. Blastocysts can be hatching or completely hatched. Blastocoel collapse is not necessary. Not to be used with morulae, earlier stage embryos, or oocytes. Quality Control Testing: Sterility (SAL 10-3 ) ph Endotoxin Tested 0.5 EU/ml (USP) Mouse Embryo assay (MEA) Note: The results of each batch are listed on a Certificate of Analysis, which is available upon request. Storage instructions and stability: Store in original container at 2 C to 8 C protected from light. The product is packaged in tubes and can be used multiple times. Keep media at 2 C to 8 C when not in use, do not keep at room temperature for extended periods of time. Precautions and Warnings: Do not use product if: 1) Product packaging appears damaged or if the seal is broken. 2) Expiration date has been exceeded. 3) Any solution becomes discolored, cloudy, turbid, or shows any evidence of microbial contamination. To avoid contamination problems, handle using aseptic techniques. Keep away from sunlight. Consult operating instructions. ICE Blastocyst vitrification and thaw solutions contain the antibiotic gentamicin sulfate. Appropriate precautions should be taken to ensure the patient is not sensitized to this antibiotic. The long term safety of blastocyst vitrification on children born using this technique is unknown. This product contains albumin, a product of human blood.

*Human source materials used in the manufacture of this product have been tested with FDA licensed kits, and found to be non-reactive to the antibodies for Hepatitis B surface antigen (HsbAg), antibodies to Hepatitis C (HCV) and antibodies to Human Immuno-deficiency Virus (HIV). Donors of the source material have also been screened for CJD. However, no test method offers complete assurance that products derived from human sources are noninfectious. Handle all human source material as if it were capable of transmitting infection, using universal precautions. Caution: US federal law restricts this device to sale by or on the order of a physician (Rx only) or a practitioner trained in its use. Caution: The user should read and understand the Directions for Use, Warnings, and Precautions, and be trained in the correct procedure before using the ICE Blastocyst Vitrification kits for storage of human blastocysts. Quality Assurance All solutions are membrane filtered and aseptically processed according to manufacturing procedures which have been validated to meet a sterility assurance level (SAL) of 10-3. Each lot of ICE Blastocyst Vitrification & Thaw receives the following tests: ph Endotoxin by LAL methodology Biocompatibility and functionality by mouse embryo assay (MEA) Sterility by the current USP Sterility Test <71>

I.C.E. BLASTOCYST VITRIFICATION PROTOCOL (for use with 0.25cc or 0.5cc cryo-straws) PART 1 Materials Required: ICE Blastocyst Vitrification Media V1, V2, & V3 Materials required but not included: 0.25cc or 0.5cc sterile cryo-straw(s) or micro-volume device (cryo-top, cryo-tec, cryo-loc, etc.) Heat sealer Container for liquid nitrogen Storage tank Sterile petri dishes (60x9mm or 4-6 well dish or similar) 1ml sterile syringe Stopwatch or Timer Liquid nitrogen Micropipettes for moving cells (270-300um inner diameter) Storage cane and goblet Stereomicroscope (Heating plate off) CAUTION: Use for vitrification of blastocysts only. Do not freeze cleavage stage embryos or eggs. Blastocysts with a large cavity & thinning zona or that are hatching/hatched can be frozen.

I.C.E. BLASTOCYST VITRIFICATION PROTOCOL PART 2 Preparation for Vitrification: 1) Bring V1, V2, & V3 to room temperature (23-27 C). 2) Label Cryostraw (0.25cc) or storage device with necessary patient information. (1-2 blastocysts per storage device is recommended). 3) Fill container with liquid nitrogen. V1 V2 4) Turn on heat sealer and test. (If using straws). V3 5) Label one petri dish or 4-6 well plate: V1, V2, V3 for each straw or device to be stored. (See Figure 2.1). Figure 2.1

I.C.E. BLASTOCYST VITRIFICATION PROTOCOL Part 3. Blastocyst Vitrification Note: All steps are performed at 23-26 C. Use a timer for all steps. 1) Pipet 75-100ul of V1, V2, & V3 into the labeled dish and replace the cover. (Do not use oil!) V1 V2 2) Collect and transfer 1-2 blastocysts with minimal media to the V1 drop. The number of blastocysts will depend on how many you will vitrify per device. 5 min 5 min V3 3) Incubate in V1 for 5 min. Figure 3.1 1-2 min 4) Transfer the blastocyst with minimal media to V2 for 5 min. 5) Transfer the blastocyst with minimal media to V3 for 1-2 min. Move blastocyst to a clean area of the drop several times to ensure complete mixing. Figure 3.2. Be sure to soak the blastocyst at least 1 min in V3 prior to storing in LN2. V3 Figure 3.2

Instructions for loading and storing blastocyst(s) in 0.25cc or 0.5cc straws. 6) Load blastocyst(s) in a 0.25cc or 0.5cc straw between columns of V3. See Figure 3.3 & 3.4. Aspirate the first column of V3 to the cotton plug, as this will allow the columns to remain intact. Figure 3.3 Cotton Plug 1cc Syringe 200ul pipet tip Syringe V3 Air V3 with Blastocyst 7) Heat seal both ends of the straw. See Figure 3.4. You must heat-seal both ends of the straw! Periodically check seal under microscope to ensure a good seal. Column with cells should be 1/4 to 1/3 the length of the straw. V3 with Blastocyst Air 8) Plunge and store in LN 2. Cotton Plug V3 Heat seal Figure 3.4 Instructions for loading and storing blastocyst(s) on a micro-volume device. 6) Load blastocyst(s) onto micro-volume device (cryo-top, cryo-tec, rapid-i, cryo-loc, etc.). Be careful not to load too much media onto device. See Figure 3.5. Always refer to the manufacturers recommendations for loading and storing the device. Figure 3.5 7) Plunge and store in LN 2. For optimal performance: Push the cotton plug in 2cm to have room for heat-sealing. Label the straw directly or use a flattened 0.5cc straw as a label that can be heat-sealed onto the 0.25cc straw. Use a new dish with fresh drops of vitrification media for each set of cells to be frozen. Culture blastocysts until the blastocoel cavity is expanding and the zona is thinning before vitrification (late D5 or D6). Hatching or fully hatched blastocysts can be vitrified. There is no need to collapse the blastocoel prior to vitrification. Store media at 2-8 C.

I.C.E. Blastocyst Thaw Kit Thaw Media T1, T2, T3, T4, T5

ICE Blastocyst Thaw Instructions For Use Testing and Cautions Innvative Cryo Enterprises LLC 317 Springfield Road Linden, New Jersey 07036 USA 973-632-8635 Intended Use: To be used for thawing blastocysts frozen using ICE Blastocyst Vitrification. Not to be used with morulae, earlier stage embryos, or oocytes. Quality Control Testing: Sterility (SAL 10-3 ) ph Endotoxin Tested 0.5 EU/ml (USP) Mouse Embryo assay (MEA) Note: The results of each batch are listed on a Certificate of Analysis, which is available upon request. Storage instructions and stability: Store in original container at 2 C to 8 C protected from light. The product is packaged in tubes and can be used multiple times. Keep media at 2 C to 8 C when not in use, do not keep at room temperature for extended periods of time. Precautions and Warnings: Do not use product if: 1) Product packaging appears damaged or if the seal is broken. 2) Expiration date has been exceeded. 3) Any solution becomes discolored, cloudy, turbid, or shows any evidence of microbial contamination. To avoid contamination problems, handle using aseptic techniques. Keep away from sunlight. Consult operating instructions. ICE Blastocyst Thaw solutions contain the antibiotic gentamicin sulfate. Appropriate precautions should be taken to ensure the patient is not sensitized to this antibiotic. The long term safety of blastocyst vitrification on children born using this technique is unknown. This product contains albumin, a product of human blood. *Human source materials used in the manufacture of this product have been tested with FDA licensed kits, and found to be non-reactive to the antibodies for Hepatitis B surface antigen (HsbAg), antibodies to Hepatitis C (HCV) and antibodies to Human Immuno-deficiency Virus (HIV). Donors of the source material have also been screened for CJD. However, no test method offers complete assurance that

products derived from human sources are noninfectious. Handle all human source material as if it were capable of transmitting infection, using universal precautions. Caution: US federal law restricts this device to sale by or on the order of a physician (Rx only) or a practitioner trained in its use. Caution: The user should read and understand the Directions for Use, Warnings, and Precautions, and be trained in the correct procedure before using the ICE Blastocyst Thaw kits for recovery of vitrified human blastocysts. Quality Assurance All solutions are membrane filtered and aseptically processed according to manufacturing procedures which have been validated to meet a sterility assurance level (SAL) of 10-3. Each lot of ICE Blastocyst Vitrification & Thaw receives the following tests: ph Endotoxin by LAL methodology Biocompatibility and functionality by mouse embryo assay (MEA) Sterility by the current USP Sterility Test <71>

I.C.E. BLASTOCYST THAW PROTOCOL PART 1 Materials Required: ICE Blastocyst Thaw Media T1, T2, T3, T4, & T5 Materials required but not included: Container for liquid nitrogen Sterile petri dishes (60x9mm or 4-6 well dish or similar) 1ml sterile syringe Stopwatch or Timer Liquid nitrogen Micropipettes for moving cells (270-300um inner diameter) Stereomicroscope (Heating plate off) Disposable gloves Scissors (sterile) 30 C water bath Mineral oil Culture medium appropriate for blastocyst stage embryos

I.C.E. BLASTOCYST THAW PROTOCOL PART 2 Preparation for Thawing: 1) The day before thawing prepare dishes with culture medium for the thawed blastocyst(s) and allow to equilibrate in incubator overnight. It is recommended to culture thawed cells in media containing 20% HSA or a similar protein, after thawing and before embryo transfer. 2) Label one petri dish or 6 well plate: T1, T2, T3, T4, T5. Do this for each straw or device to be thawed. (See Figure 2.1). Figure 2.1 T1 T2 T3 T4 T5 3) Pipet 75-100ul of T1, T2, T3, T4, T5 into the labeled dish and cover the drops with mineral oil. (Return media to refrigerator at 2-8 C). 4) Fill container with liquid nitrogen. 5) Select straw(s) or devices to be thawed and place into container with liquid nitrogen. 6) Bring T1 to room temperature (23-27 C).

I.C.E. BLASTOCYST THAW PROTOCOL PART 3 Blastocyst Thawing Please Note: All steps are performed at 23-26 C unless otherwise indicated. Use a timer for all steps. Blastocysts are most often vitrified in a conventional 0.25cc straw or 0.5cc straw, but other microvolume devices can be used. The cells are located in the middle column of a straw or the tip of the micro-volume device. See Figure 3.1. or Figure 3.1 Blastocysts Micro-volume device T1 For thawing straws: 1) Label one petri dish T1 and pipet 250-300ul T1 into dish. Do not cover with oil. See Figure 3.2. Figure 3.2 2) Remove straw from liquid nitrogen and hold for 6 sec in room temperature air. Use a timer! See Figure 3.4. 3) Submerge straw completely in 30 C water for 10 sec. Figure 3.4. 4) Wipe excess water off straw and cut off heat-sealed end of the straw. Insert syringe and cut off the other heat-sealed end. See Figure 3.5. Cut end of straw Hold in air 6 sec Figure 3.4 Hold in 30 C water 10 sec Insert Syringe Figure 3.5 Cut other end off Agitate 30-45 sec 5) Empty contents of straw into 250-300ul T1. 6) Shake dish back and forth on workbench for 30-45 sec to mix contents. See Figure 3.6. This helps dilute out the cryoprotectants and allows the blastocysts to settle Figure 3.6

to the bottom of the drop. Be careful not to let the media touch the sides of the dish as this will make locating the blastocyst(s) more difficult. Go to Step #7. For thawing micro-volume devices (cryo-top, cryo-loc, cryo-tec, etc): 1) Label one small petri or organ culture dish T1 and pipet 500ul-1500ul T1 into dish. Do not cover with oil. Place lid on dish. Incubate dish at 37-38 C for 10-15 min to warm the media. Make sure T1 media is warm and at 37-38 C before using. Figure 3.7 2) Remove micro-volume device from liquid nitrogen and immediately T1 37-38 C submerge the end containing the blastocyst(s) completely into 37-38 C T1. Wait until the blastocyst(s) fall off the device. See Figure 3.7. Always refer to micro-volume device manufacturers recommendations for thawing. 3) Go to Step #7. All steps are performed at 23-26 C in microdrops under oil. 7) Transfer the blastocyst(s) to T1 for 3 min. See Figure 3.8. 8) Transfer the blastocyst(s) to T2 for 3 min. 9) Transfer the blastocyst(s) to T3 for 3 min. 10) Transfer the blastocyst(s) to T4 for 3 min. 11) Transfer the blastocyst(s) to T5 and place dish on a 37 C warmer for 3 min. 12) Transfer the blastocyst(s) to equilibrated and warmed culture medium in a 37 C incubator. Transfer to patient. Figure 3.8 3 min each step T1 T2 T3 T4 T5 For optimal performance: For best results use a new dish (with fresh medium) for each straw thawed. Store media at 2-8 C. Culture thawed cells in media containing 20% HSA or a similar protein, after thawing and before transfer.