A little more info...

OK, for anyone following this for details on the Estrogen Priming Protocol, I found out a little bit more.

1) The reason for ganirelix in this priming part of the cycle is because the increased estrogen (from the patch) can sometimes cause your body to start increasing LH, so they want to nip that in the bud. Also, it lulls the FSH receptors in the ovaries and gets them ready for stimming in the early part of next cycle -- like lupron for better responders. More a gentle, swaying suppression over a rock concert suppression. All makes sense and is what I thought, but I started getting concerned that I was filling in the blanks with my own - not necessarily factual - explanations. Good thing it's now backed up by some degrees ;).

2) My concern about starting the priming on CD14 is legit, according to the nurse. But she explained that my hormones are actually a better indictator of where I am in my cycle than a bleed (i.e. period). I may be the kind of woman whose progesterone drops slowly rather than plummets, which is what triggers a period. And this actually jives with my weird hormones in the past few cycles, where hormonally I never seemed to be where I should be in the cycle according to what I thought was CD1. So, while I think I'm CD14, I may actually be hormonally in mid-luteal phase. Sooo, the solution is that if I don't get my period by next Monday, June 1st, I'll call the nurse and they'll bring me in for bloodwork. They're suspecting that my hormones will show that I am baseline even if I haven't had a bleed yet. If the hormones jive, I'll get started on the stimming, and the nurse assures me that a bleed a few days later won't affect anything - that the ovaries percolating is an independent process to the uterus clearing its lining.

I trust the RE and nurse and 100% believe that listening to my hormones over my period is the right thing to do. I just wish my body behaved predictably sometimes. Oh well, at least I work from home and can nag my nurse with all sorts of personal questions all day long without fear of my co-workers overhearing. I am always, always friendly and polite with the staff and try to crack jokes on the phone with the nurse, so I'm hoping that I'm not one of those dreaded patients despite my love of calling multiple times a day when I have questions. I read a blog by an RE a few weeks ago where he wrote about how the nurses in his office fight over getting to be the one letting their "favorite" patients know when they've gotten a positive pregnancy tests. I wonder which bucket I fall in to - are my questions endearing and make them feel closer to me? Am I a favorite? Or am I the pain in the butt they all punt around to each other? I hope the former, but either way, I can't stop the calling when I have questions, so I guess the answer doesn't really matter. Except to my need to be liked, which I'm trying to make take a backseat in this process.