 Women who demonstrate a suboptimal response to controlled ovarian hyperstimulation COH are a challenge to treat with assisted reproductive technologies such as in vitro fertilization IVF. Such patients are often referred to clinically and in the medical literature as poor responders. A variety of different protocols have been studied and used to treat these patients. One protocol used to treat poor responders is the microdose leuprolide flare protocol 1,2. This widely-used protocol was first described in 1997 by Schoolcraft et al. 1 The microdose leuprolide flare protocol is so named because the administration of a gonadotropin-releasing hormone agonist GnRH-a in the early follicular phase causes an initial rise in endogenous gonadotropins called a flare before it causes downregulation and suppression of gonadotropins. Use of oral contraceptive pills OCPs in the preceding cycle prevents corpus luteum formation which could be supported by exogenous GnRH-a in the subsequent cycle. The microdose leuprolide flare protocol has been shown to be a safe and effective protocol which may lead to decreased cycle cancellation rates and increased clinical and ongoing pregnancy rates in poor responders 2,3. 