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This protocol differs to the Antagonist regime and is used in patients who require full suppression of their menstruation. This is commonly used in patients with endometriosis. The protocol begins before your scheduled period by temporarily switching off your pituitary gland (‘down regulation’). The most common medication used for this is Synarel which is a nasal spray used twice daily. If the nasal spray is not tolerated then injectable medications, Lucrin or Decapeptyl, can be used.

Long down-regulation cycle suppression: Synarel and Lucrin ADD (L-R)

Your nurse will demonstrate your particular medication to you.

In the first cycle, your period should still arrive as scheduled even though you are taking this medication and you must contact Eve Health on day 1. Your cycle will then continue like the Antagonist cycle except that you will not need the antagonist injection – instead you continue the Synarel or Lucrin to ensure you do not ovulate during the treatment. It is very important that you do not stop the Synarel or Lucrin until advised to do so. The Long Down-Regulation cycle often takes longer to achieve a response and so we do not usually see you for your first scan until approximately 7 days after starting your FSH.

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