Interesting. I wonder what causes the suppression effect in that protocol? My protocol is an agonist/antagonist estrogen priming protocol where the priming is done in the follicular phase of the IVF cycle. I have never heard of another cIinic besides SIRM doing EPP this way....and believe me I looked as I found it rather odd. I also use Lupron at the end of the cycle before IVF. My protocol I start the cetrotide and never stop until trigger. I don't really have a lead follie problem...mine grow mostly together for the most part...knock on wood. This protocol has done well by me and it will be the protocol I use for my final IVF.
Is the protocol you mentioned considered a flare protocol as you stop and start the ganerilix? SIRM seems dead set against flare protocols because of the rise in LH.