Estrogen Priming Protocol - sample calendar

Different REs will have varying EPP plans for their patients, but all include estrogen priming in the prior cycle, sometimes all month, sometimes just a few days. Most will stim with FSH or a combination of FSH + LH. Most will include an antagonist (e.g. Ganirelix) to try to keep you lead follicles in check and allow as many as possible of the smaller ones to catch up in size before retrieval.

Here is the breakdown of my own protocol:

No BCPs	Suppression as a way to take control of my cycle would be detrimental as I'm already too suppressed naturally.
CD MINUS-5	After b/w to confirm I am mid-LP, will start on estrogen patches to build up the egg quality. Will change them every 3 days.
CD MINUS-4 thru CD MINUS-2	Add daily ganirelix shots for 3 days. This quiets the ovaries and gets the receptors ready for the FSH to come in the stimming portion. Also to keep my body from getting confused by the excess estrogen and accidentally increasing LH.
CD1/AF	Call RE to schedule CD2 u/s.
CD2	Baseline u/s to confirm no cysts, resting follicle count. Stop ganirelix shots. Keep final estrogen patch on through trigger shot or until it falls off on its own.
CD3	Start stimming with Gonal-F and Menopur injections. Recombinant Gonal-f and purified "natural" Menopur have been shown to work well in combination. The FSH in both Gonal-f and Menopur should produce more follicles while the LH in the Menopur should help mature the eggs.
Stimming	Will continue with u/s and b/w as the follicles develop. Probably somewhere from 6-12 days. Will add ganirelix back in when the lead follicle reaches 14mm to prevent premature ovulation.
Triggering	Will trigger with Ovidrel (HCG) once I have more than 3 good follicles, hoping for more than 5.
Egg retrieval	The usual.
Fertilization	The usual.
Egg transfer	Transfer at Day 3.